Can Anything Be Done To Help My Dark Circles Look Better?

Q: Dr. Eppley, I have a very severe case of dark circles under my eyes. I am 30 years old and am of Indian ethnicity. I know this is a common problem in people of my heritage. I have tried numerous topical crèmes for dark circles but none of them have done anything. I am sending you some pictures for your assessment. Do you think there is anything you can do to help me?

 A: Thank you for sending all of your pictures. There is no question that you have is a fairly severe case of dark circles. Much of it is actual skin hyperpigmentation rather than a hollowing effect.  And the zone of skin hyperpigmentation extends fairly far outward from the eyelid area. I don’t think on seeing this extensive collection of photos that you have a really significant tear trough or hollowing problem. There is some mild hollowing but that is not the true cause of the problem, the hyperpigmentation of the skin is.

I don’t know how much improvement can actually be obtain in such a severe case  of dark circles but some effort is certainly justified given the magnitude of the problem. I would approach your dark circles with a combination procedure of fat injections to fill out some mild hollowing, a pinch lower blepharoplasty to remove some excess skin (you do have some despite your young age) and a 25% TCA peel to try and remove some of the superficial hyperpigmentation. 

How effective this combined approach would be is undetermined and I would never assume it to be a complete cure or solution…as there is no such thing with such severe dark circles. The goal is to see what degree of improvement can be obtained.

Dr. Barry Eppley

Indianapolis, Indiana