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Six Types Of Under-The-Eye Circles—And How To Treat Them

Circles under the eyes are frustrating and can be a challenge to treat!

There are a lot of reasons why we get dark/puffy circles under our eyes, ranging from genetic to environmental to skin-related.  Sometimes we have a combination of under-eye circles–all of them with their own unique cause.

Here’s your quick guide to those circles, the differences between them, and common treatments.

1. “Eye Bags”

Eye bags, or protrusion of the fat under the eye (infraorbital area) occurs when there is prominence of the “fat pad” under the eye, which can come from genetics as well as time.  When this condition is more advanced, the most effective treatment is a surgical procedure called blepharoplasty.  When the protrusion is mild, we can use cosmetic fillers in the “tear trough” area to help smooth the transition between the fat pad and the cheeks– which helps to mask the protrusion.  Another option for mildly loose skin associated with “bags” is radiofrequency laser, which can help tighten the skin.

2. “Puffiness”

Puffiness, or infraorbital edema occurs when fluid collects under the thin eyelid skin. Seasonal allergies, sinus infection, crying or water retention (from high blood pressure, excess salty foods, or alcohol) can all contribute. Another cause is gravity! People who sleep on their stomach or side may have increased collection of lower eyelid fluid. Treatments are targeted at the cause, such as antihistamines for allergies, etc.  There are some other strategies to improve edema: 1) sleep on your back with the head raised with an extra pillow. 2) avoid rubbing the eyes. 3) avoid irritants to the eyelids, such as products that itch or make the eyelids red; make sure you wash your makeup off before sleeping. 4) cold packs, a cool tea bag, cucumber slices, or certain eye creams can help constrict leaky blood vessels to lessen the edema. See: Eye Creams

3. “Dark Circles”

Dark circles, or periorbital hyperpigmentation is a common issue.  Darkening occurs commonly in skin of color because of the increased melanin (pigment) content.  Darkness under the eyes can result from frequent rubbing and rashes. When irritation and rubbing lead to thickened dark skin, retinoic acid or hyaluronic acid creams can help soften and exfoliate this thickened, dark skin.  Light chemical peels and skin lightening creams with hydroquinone, azelaic acid, kojic acid, or glycolic acid can also help. There are also some laser treatments that have shown benefit -ask your dermatologist about these.

Stay tuned for next week’s post where I’ll cover Eyelid Hollows, Sallow eyes, and Crows feet .

 Rehana Ahmed, MD, PhD

Rehana Ahmed, MD, PhD

Dr. Rehana Ahmed’s clinical expertise includes pediatric, general, surgical and cosmetic dermatology with special interests in skin cancer surgery/Mohs micrographic surgery, laser treatments and cosmetic procedures, including BOTOX®, Radiesse, Sculptra, Juvederm, Voluma, and CoolGlide laser hair removal.  Dr. Ahmed is available for appointments in our Minnetonka and Burnsville locations.

Dr. Ahmed attended the Johns Hopkins University and graduated Phi Beta Kappa with a BA in Behavioral Biology. She graduated from the University of Minnesota School of Medicine, Alpha Omega Alpha. She completed her internship in Internal Medicine and her residency in Dermatology at the University of Minnesota. Dr. Ahmed is certified by the American Board of Dermatology and is an Assistant Professor of Dermatology at the University of Minnesota, where she is active in research. Dr. Ahmed was born and raised in Minneapolis. She enjoys traveling, cooking and spending time with family and friends. She is married and is the proud mother of a sweet baby boy.