Do you suffer from dark circles under your eyes? Is there a cure?

Do you suffer from dark circles under your eyes? Is there a cure?

Dark circles under your eyes is referred to as ‘cernes’ (circles) in French, ‘sawad’ in Arabic (darkness), and ‘raccoon eyes’ in English. Dark circles under your eyes is a common inconvenience to many people and often contribute to insecurities regarding one’s looks and appearance. My own daughter who lives in Dubai, struggled with dark circles under her eyes, and would complain about having to use different forms of make-up in her daily routine just to cover them up. I treated her under-eye circles with sclerotherapy, and since then, she is happily make-up free. So afterall, there is a cure for Dark circles under the eyes in Dubai, or unwanted face veins in Dubai.

Basic facts you need to know about dark circles under the eyes:

1. Dark circles under the eyes are very common – 9 out of 10 people have them in varying degrees.
2. There are two main causes for dark circles under the eyes:
   1. Unattractive blue veins located around the eyes are one of the main causes for dark undereye circles. When blood vessels of that facial area become dilated, they start showing through the face’s delicate skin, giving people an unsightly racco0n-eye look. These are referred to as periorbital veins. Periorbital veins are similar to reticular veins on the legs (the blue-green vein most commonly behind the knees that people sometime mistakingly refer to as varicose veins).
   2. Increased melanin deposition in the skin is also a cause of dark undereye circles. This is usually a predetermined genetic characteristic. The skin in the area below the eyes is the thinnest in the body, so naturally it is not forgiving to the consequences of increased melanin.

What are the lifestyle factors and medical conditions that make the conditions of dark under eye circles worse?

1. Lack of sleep or too much sleep causes blood vessels to become more visible through the skin.
2. Sun exposure- can trigger “age spots” around the eyes and weaken the skin which can contribute to dark circles.
3. Increased fluid retention- the blood vessels under the eyes can retain fluid and become engorged and dilated. This can be caused by dietary salt.
4. Aging- causes the fat pad below the eye to thin, thus making veins more visible.
5. Extreme weight loss – can cause a sunken look of the eye; which has the same explanation as aging.
6. Iron deficiency anemia: iron carries oxygen and lack of it results in less oxygen and thus darker color of blood.
7. Smoking: this bad habit also contributes to dark undereye circles in a combination of 3 ways. Firstly, the smoke from tobacco damages human skin. Heavy smokers usually develop a form of hypertension that affects the veins of the upper body called pulmonary hypertension. Hypertension of veins results in dilatation of veins ( note that this is different from hypertension that we all commonly know it which affect arteries not veins). Lastly, smokers tend to have higher levels of hemoglobin. Hemoglobin is a protein that is dark in color.
8. Allergies and nasal congestion: these cause the veins around the sinuses to dilate

Is there a cure or an effective treatment for dark under eye circles?

First step is to avoid and stop the lifestyle habits that makes the condition worse (i.e. smoking, over exposure to sun etc…), please refer to the previous section for more information on this. Also one should seek advice of his/her doctor to treat the medical conditions that can be associated with this problem (i.e. nasal congestion, anemia, etc…). These steps will help and improve the conditions of under eye circles, but they do not serve as a comprehensive cure.

There are few often mentioned and sometimes falsely promoted therapies that claim to cure for dark circles under the eyes as effective treatment. The main falsely-advertised remedies are: LASER, Sclerotherapy, concealers, lightening creams, Chemical Peels, carbon dioxide therapy, fillers, and PRP.

LASER: The aim for this treatment is usually to diminish blue vessels and to prevent them from resurfacing on the skin, but laser treatments for areas around the eyes is not recommended for 2 reasons. First: the skin in these areas is the thinnest in the body and thus the most prone to the most feared complication of transdermal laser (skin burns). Second reason: There is always the issue of how to protect and shield the retina from damage from forceful laser energies. Laser goggles are impractical in this setting and one has to resort to placing an intraocular shield that come in touch with the cornea; also requiring anesthetic eye drops.

IPL: The complications of IPL are similar to those of laser treatment.

Fillers: Injectable fillers or fat transfer procedures do have a role when the dark circles are associated with sunken areas under the eyes. However they do not solve the problem when the cause for the dark circles are blue veins. They also can be of benefit when the cause of the problem is loss of fat associated with aging.

Creams: From lightening formulas, to anti-cernes creams, to Vitamin K containing preparations, to “eye illuminating creams”, the list goes on and on. There are many cosmetic companies out there promising miracle cures. But you should always be skeptical about these claims. Simply, there is little empirical evidence for the effectiveness of most over-the- counter products.

Concealers: As the name implies, these allow you to cover and mask the darkness without providing a remedy to the problem, concealers also need to be applied and reapplied frequently.

Chemical Peels, PRP (Platelet Rich Plasma), Carboxytherapy: I lumped these together because they share the same principle which is that they are skin rejuvenation procedures. They do have a role and may be effective treatments for lightening the skin under the eye for some patients. They do not serve, however, as cures for under eye circles, and their efficiency varies from patient to patient.

Sclerotherapy of the blue veins under the eyes: I intentionally left this modality of treatment for last. It is least known to patients and to even many doctors dealing with this problem. However, sclerotherapy of veins under the eyes, when the latter is the major cause for the darkness under the eyes can actually be a permanent cure.

Sclerotherapy is a procedure that involves the doctor injecting a medicine directly into the veins of the patient, with the aim of permanently closing the veins. This is the gold standard treatment for varicose veins, reticular veins, and spider veins of the legs.

There is a misconception and fear among doctors and patients alike that the injected solution may enter into major veins of the eye, possibly damaging the eye. However, this concern is unfounded. Periorbital veins drain into the external jugular veins (the large veins in the neck that pop out and become most visible when the neck is strained) and NOT into the retinal veins inside the eye. So any excess solution form sclerotherapy gets quickly diluted when it reaches the jugular veins and actually, none of it drains into the veins of the eye.

Still, the technique for sclerotherapy of periorbital veins and veins under the eyes to treat dark under eye circles needs to be done skillfully and meticulously as it is different from the treatment of leg veins. The doctor must take into consideration the concentration of the medicine used, the amount injected, and the pressure of the injection.

The same technique can be used for treating the veins on the temple that many women complain about making them appear older, and for forehead veins (i.e. the famous Angelina Jolie and Julia Roberts veins of the forehead).

In the hand of an experienced doctor in the treatment of periorbital veins, sclerotherapy is a safe cure for many patients suffering from dark circles under the eyes. Just ask my daughter for her testimony on that. So, if you suffer from dark undereye circles, there is no need to feel trapped or find yourself constantly applying and reapplying make up to cover them up. Sclerotherapy is a proven remedy for undereye circles, and the most efficient therapy to date.

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