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International Academy of Cosmetic Dermatology


Dark circles under the eyes represent bilateral, round, homogeneous hyperpigmentation in the infraorbital regions. The intensity of the darkness fluctuates according to fatigue and/or lack of sleep; the condition appears worse with aging due to skin sagging and abnormal lipid deposits.  Dark circles have been regarded as a mere physiologic phenomenon; however, when very pronounced, they interfere with one’s general appearance, giving a tired, sad, and  even hangover appearance.

They are caused by multiple factors:
  • Dermal melanin deposits
  • Translucency of the skin – The bluish color, commonly seen in fair skinned individuals, is secondary to the dermal capillary network visible through the skin.
  • Accumulation of fluid in the periorbital region – It occurs mostly in allergic individuals whose habit of rubbing and scratching the skin around the eyes also leads to postinflammatory hyperpigmentation.
  • Aging – This process aggravates the tear trough depression, caused by the prolapse of infraorbital fat, loss of subcutaneous tissue, and general thinning of the skin.
The easiest way to disguise dark circles is camouflage make-up.  For those patients who want a more definitive solution, there are some alternatives:
  • Bleaching agents
  • Chemical peels
  • Fillers
  • Laser therapy
  • Retinoids, topically
There is no evidence that steaks or lemon juice, applied to the areas, will reduce the darkening.

Fernanda M Freitag, MD
Tania Cestari, MD, PhD
Porto Alegre, Brazil

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