Dark Circles

Dark circle pigmentation is different for different people. Based on the pigmentation and vasculature involved, dark circles can be of four types:

• Pigmented: The skin under the eye appears brown coloured.
• Vascular: The skin under the eye appears blue or dark pink or purple coloured without any puffiness around the eyes.
• Structural: Though the pigmentation is skin-coloured, the undereyes appear dark due to shadows formed by anatomic surface contours of the face. Dark circles of this kind may accompany other conditions like presence of eye bags under the eye (infraorbital palpebral bags) and loss of fat in the under-eye with prominent bone.
• Mixed: 
  • Pigmented-vascular
  • Pigmented-structural  
  • Vascular-structural 
  • Combination of pigmented, vascular and structural pigmentation

From genetics to habits, there are many reasons that could lead to dark circles in a person:

• Genetics: Dark circles have a genetic predisposition. If your mother has dark circles, then you are more likely to have them too. 
• Dehydration: When the body does not receive the proper amount of water, the skin beneath the eyes begins to look dull, thus giving a sunken look.
• Inadequate nutrition: Vitamin deficiencies, especially Vitamin K (also known as the beauty vitamin), can cause dark under-eye circles. Eating a well-balanced diet, filled with green vegetables, carrots, citrus fruits and nuts, can give you a healthy complexion and minimize the appearance of dark circles. 
• Strain or fatigue: Continuous looking into a screen, sleep deprivation and sometimes even oversleeping can cause fatigue to your eyes and skin, thus giving the skin a pale look along with dark circles.
• Congestion of nose: During sinusitis (inflammation of the sinus) or nasal congestion, the angular veins that drain from your eyes and nose darken, thus giving the appearance of dark circles.
• Ageing: The lower eyelid skin is one of the thinnest parts in the body and gives a see-through appearance to the underlying features, especially the under-eye muscle, orbicularis oculi and the veins. With age, the skin naturally becomes thin, thus making blood vessels and veins more obvious.
• Habits: Harmful habits like smoking, alcohol and excess caffeine consumption harm the skin and make the appearance of dark circles more noticeable. Another habit of repeatedly rubbing the eyes could create friction leaving the skin more stressed, thus making it look darker. 
• Suntan: The harsh rays of the sun not only tan your body, but also the skin under your eyes, making dark circles even darker, especially during winters.
• Medication: Some medications like birth control pills can generally expand (dilate) the blood vessels. Since the skin under the eyes is thin, these dilated blood vessels give the appearance of dark circles.

Treatment for dark circles can be done both conservatively and invasively. Some home-based treatments that could actually work for your dark circles are:

• Masking dark circles: Concealers and cosmeceuticals are the most conservative option for the treatment of dark circles. This is not exactly a treatment but an effective way of getting rid of the dark pigmentations.
• Teabags: Applying cold tea bags to your eyes can improve their appearance. Tea contains caffeine and antioxidants that can help stimulate blood circulation, shrink your blood vessels, and reduce liquid retention beneath your skin. 

Medical treatment for dark circles include:

• Topical agents: Topical depigmenting agents, such as hydroquinone, kojic acid, azelaic acid, topical retinoic acid are basically bleaching agents which help in reducing the dark pigmentation around the eyes. These bleaching agents basically inhibit the tyrosinase enzyme (the enzyme that converts DOPA into melanin, thus causing pigmentation), so the melanin deposit reduces in the second layer of the skin (epidermis).
• Topical vitamin C: Vitamin C is an antioxidant and is popular for its bleaching effect. Application of Vitamin C not only promotes collagen production but also conceals colour of blood stasis (blood that is not flowing), so it is widely used for the treatment of hyperpigmentation.
• Chemical peels: Glycolic acid is the most widely used alpha hydroxy acid for chemical peeling. The peeling agents remove melanin from superficial layers of the skin (stratum corneum and epidermis) whereas deeper peels modulate the melanin content in the deeper layer of the skin (dermis).
• Lasers: People are getting rid of their dark circles with the use of non-invasive lasers that target specific pigments and dark vessels. Conventional lasers that have been used for treating dark circles are Q switched ruby laser (694 nm), Q switched Alexandrite laser, and Nd: Yag laser (1064nm). Despite their effectiveness, doctors avoid the use of these lasers due to complications like prolonged erythema (redness), pigmentation, and infection. Lasers like pulsed dye laser, diode laser, 1064nm Nd: YAG laser, 1320nm Nd: YAG laser, 1540nm erbium glass laser, and intensed pulsed light laser sources are being used widely due to lesser side effects.
• Fat transplant: Autologous fat transplantation is done in cases where the appearance of dark circles is due to thin and translucent lower eyelid skin that covers the underlying muscle of the eye (orbicularis oculi). Fat is injected into the lower eyelid skin which provides volume and effaces the facial hollow, thus giving a smoother lower eyelid-midface contour.
• Fillers: Fillers give volume to the sheer skin present in the lower eyelid area. Hyaluronic acid gel is the most widely used filler for the treatment of dark circles. 
• Platelet-rich plasma (PRP): Injecting PRP into the skin under the eye has proved to reduce the pigmentation of the skin and also decrease the signs of ageing (wrinkles and fine lines).
• Optical light diffusers: Optical light diffusers are composed of micronized mineral particles that are designed to reflect light away from the skin. This treatment option is used in the case of structural dark circles. These molecules utilise large-sized molecules to fill the depressions in the skin and smaller particles to rest on the areas of elevation.
• Surgery: Surgical treatment, blepharoplasty, is usually done to eliminate dark circles caused by shadows formed due to fat deposits or excess skin in the lower eyelid area. Blepharoplasty is commonly performed to enhance the lower eyelid margin to reduce the dark circles.

There are no effective measures that can help prevent dark circles, but these minor routine changes could prove to be effective for some:

• Get enough sleep to prevent the eyes from getting strained, thus preventing the occurrence of dark circles.
• Quit smoking and reduce alcohol consumption as it speeds up the ageing process, making your skin look dull and full of pigmentation.
• Dermatologists recommend using sunscreen even in winter with an SPF rating of at least 30, which blocks 97% of the sun's UVB rays and also protects from skin tanning.