Dark Circles Under Eyes: 5 deep tear trough treatments

We’ve talked before about dark circles under eyes. One of the most common causes is a deep tear trough.  The tear trough is that depression extending from the inner corner of your eye diagonally toward your cheek.  This depression occurs where the facial fat has thinned out and dropped down into the cheeks. The bone of the eye socket is now right below the skin and the two are fairly well attached to each other.  As the skin above and below age and change, this area becomes even more apparent. It can become dark and develop a noticeable shadow, which makes one appear tired and more aged.  There are many options to treat this, and the methods are changing as we better understand facial aging.

dark circles under eyes - Facial filler Juverderm

Juvederm treatment under eyes and around mouth.

1. Make-up:

Many women (and even some men) utilize concealer in this area to lighten the skin and diminish the shadow.  When the problem is subtle, make-up is a great, non-invasive and inexpensive treatment.  As the problem worsens, however, make-up cannot fully hide the changes and may begin to accentuate it.

2. Skin lightening creams:

In certain people and ethnic groups, the skin in this area darkens. This can be due to actual pigment changes in the skin or from very shallow blood vessels just below the thin skin. When it is pigment related, skin lightening creams, such as hydroquinone, can be effective.  When starting this type of treatment, it is helpful to consult a skin specialist or aesthetician highly experienced in its use. Start with a weaker concentration (no higher than 4%) and use it for a short time until you are sure you aren’t especially sensitive.  Slowly increase the use and concentration until the desired effect is achieved. Rarely will these types of creams completely fix the problem, but they can make a noticeable improvement.

dark circles under eyes - Hydroquinone skin cream

Hydroquinone skin cream

3. Phototherapy:

Intense pulsed light, and even some laser treatments, are used to lighten skin pigmentation and tighten skin in the under eye area. Often this is proceeded by use of a topical lightening cream and possibly a short course of Retin-A to maximize effect.  Again, this should be done by someone with a lot of experience in administering the whole treatment.  Different skin types react differently, so be sure your practitioner explains how they are tailoring your treatment to you personally.

4. Facial Filler:

Hyaluronic acid fillers such as Juvederm, Belotero, and Restylane are well suited to treating the tear trough area when the problem is loss of facial fat volume.  Filling this area back up with a substance that is similar to the building blocks of normal collagen can give a new youthful appearance to the mid-face. It is relatively inexpensive, costing around $500 for a treatment. In many cases it lasts 12-18 months.  Filler is injected with a small needle into the space directly above the bone and then massage around until it appears smooth.  In a few weeks, it softens up be hardly be felt.  It is a safe procedure with some occasional bruising taking place. When injected deep, the chances of it getting into a blood vessel and causing problems in uncommon, although this is the greatest risk. See Dr. Harris explain more about facial filler in a short video here.

dark circles under eyes - Belotero facial filler

Belotero facial filler

5. Lower eyelid fat repositioning and blepharoplasty:

When fat in the lower eye socket begins to come forward, it creates a bag in the lower eyelid. A crease forms at the bottom of the bag over the bone of the eye socket. Lower eyelid surgery (blepharoplasty) is performed to move fat from this bag into the upper cheek and tear trough, which fills in the depression and returns the fat to a normal location, where it was before it descended into the cheek.  In some people, a portion of the fat is also removed. In others we also remove a small amount of skin below the eyelashes. All of these techniques serve to smooth out the transition from the eyelid to the cheek, which is a hallmark of a youthful, rested appearance. See our gallery for eyelid before and after photos.

If under eye shadow or bags are a problem for you, give us a call for a free consultation at (801)264-4420, or email Dr. Harris directly at [email protected].

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