Treatment for eye bags and dark circles

Several reasons contribute to under-eye swelling and pigmentation, but there are ways to improve the situation, say medical experts at Eagle Eye Aesthetics

Published

August 26, 2022 at 4:00 AM

Stress, late nights out, or an overnight Netflix binge – these are some of the usual suspects behind those dark eye circles and eye bags. Or so you think.

While inadequate sleep plays a part, the swelling and discolouration under your eyes – which can make you look tired and older – are also caused by a host of other factors. Knowing the contributing factors can help you treat them more effectively.

Genes are one factor causing dark eye circles and eye bags. But these conditions also get more common with age, made worse by volume loss in the face and bulging fat due to sagging skin, says Dr Stephanie Young, who is the medical director at Eagle Eye Aesthetics, as well as the director of ophthalmic plastic and reconstructive surgery at parent company Eagle Eye Centre.

She notes: “Dark circles and eye bags are usually not reversible, but their appearance can be reduced or improved with healthy lifestyle habits, using appropriate products and through cosmetic procedures. Surgical intervention may also be required.”

Dark circles and eye bags are two separate conditions, but they can appear together, especially as we age, says Dr Young.

She adds: “These conditions are generally more common in adults. However, dark circles may be found in children or younger adults due to genetics, nasal congestion or sinusitis, asthma, lack of sleep, allergies, pigmentation or anaemia. 

“Eye bags are much more commonly associated with ageing, although they may occur in younger people mostly due to hereditary reasons or predisposition of their facial structure such as hollowness in the midface.”

Dark circles around the eyes: Causes and treatment options

Dark circles are due to a multitude of issues, including pigmentation, vascular, structural or a mix. You’re more likely to notice the first signs of dark eye circles when you’re tired or unwell, which may make the darker hue under the eyes become more obvious.

A first step to reducing the appearance of dark eye circles is changing your lifestyle habits: Get enough quality sleep and do not smoke, which can age skin around the eyes. Alcohol and salty food can also worsen congestion around the eyes, especially if consumed before bedtime.

Dr Young says: “Elevate the head when you sleep to reduce congestion of the eyelids, especially if you find it’s worse in the morning. Applying cold compresses may be useful for people with more prominent blood vessels as it can minimise the blood vessels and any swelling.”

Here are some other factors causing the condition, and their treatments.

Pigmentation: This can appear as a brown hue under the eyes and is usually genetic. It is worsened by exposure to ultraviolet rays, inflammation from eyelid disorders such as dermatitis (eczema) and lifestyle factors such as inadequate sleep, a poor diet and smoking.

Treatment: The first step is to rule out any underlying conditions such as eczema and allergies. After that, eye creams with brightening and antioxidant components and retinoids; sunscreens; and even peels and lasers performed in the clinic can help.

Vascular dark eye circles: This is discolouration due to the prominence of blood vessels in the lower eyelids, which is attributed to thinner eyelid skin due to genetics, ageing or other factors. Unlike pigmentation, these have a blue to pink-purple hue. In addition, congestion or an infection in the sinus can result in congestion in the small veins under the eyes. The blood pools under the eyes and these swollen veins dilate and darken, contributing to the appearance of undereye dark circles and puffiness. 

Treatment: Start with eye creams that support collagen production and help to reduce congestion in the blood vessels. If suitable, fillers can help to even out hollowness in the face. For eligible patients, laser or light therapy such as Eagle Eye Aesthetics’ Sciton BBL Hero helps reduce pigmentation and constrict vessels while also tightening and lifting the skin. This is a non-invasive option that requires little to no downtime.

Facial contours: They give the illusion of shadows, which might give the appearance of dark eye circles. This is often genetic, but could worsen with age due to volume loss in the face, as well as changes in facial fat and bone structure.

Treatment: Injectable fillers can help those experiencing volume loss in the face, which is a structural issue. However, not everyone qualifies, says Dr Young, adding: “There may be some patients who would benefit more from a surgical eyebag removal rather than filler injection.”

Other treatments that might also help improve the appearance of dark eye circles include injecting anti-inflammatory and tissue repair-stimulating agents to support skin healing and collagen stimulation for the delicate skin around the eyes.

Eye bags: Causes and treatment options

Eye bags appear when the tissue and muscles around our eyes weaken, which can cause skin to sag, and fat around the eye to bulge. The effect worsens when combined with factors such as fluid retention (causing puffy eyes), lack of sleep, allergies, smoking, genetics and medical conditions, such as dermatitis and thyroid eye disease, says Dr Young.

Some early signs due to genetics could be a mild bulge under the eyes – even in younger people – while severe eye bags (usually in older people) present as bulges that extend from the lower eyelid to the cheek.

As eye bags appear more obvious when combined with puffy eyes due to water retention, some ways to reduce the swelling temporarily include applying a cold compress  – yes, even chilled cucumber slices or chilled tea bags work – or applying products such as eye creams with caffeine as this constricts blood vessels.

Non-surgical options that help to smoothen the undereye area include fillers to the under tear trough (junction where the undereye area and cheek meet) or mid-face regions, and laser resurfacing to improve skin texture and support collagen growth. One might also try chemical peels to remove wrinkly layers of under-eye skin, or microneedling radiofrequency treatments such as Morpheus 8.

“Morpheus 8 can be used to treat the whole face, including the delicate upper and lower eyelids,” explains Dr Young. “Combining microneedling and fractional radiofrequency energy, it stimulates increased collagen production and new cell growth to create a more youthful look with improved elasticity and an overall smoother, tighter and more even appearance.”

Dr Young adds: “Morpheus 8 is an increasingly popular treatment in our clinic for patients opting for a lifting or tightening effect to the eyelids and face. While surgery remains the gold standard, there are patients who want a non-surgical or scarless option with minimal downtime.”

As for surgical treatments, an ideal option for moderate to severe eye bags is a lower eyelid lift (blepharoplasty). It is an outpatient or day surgery procedure in which the surgeon removes or readjusts the fat in the lower eye area and tightens the muscle and skin to create a smooth appearance in the lower lids.

A treatment such as Morpheus8 for eyelid tightening may be recommended before and after the surgical procedure to help tighten the skin before the surgery and for maintenance after to prolong and improve the effects of surgery, says Dr Young.

Eagle Eye Aesthetics is led by ophthalmologists who have trained in the unique subspecialty of oculoplastic surgery, including delicate procedures involving the tear duct and eye sockets, as well as cosmetic and reconstructive eyelid surgery. 

On top of eye treatments, Eagle Eye Aesthetics also offers rejuvenative treatments for the face, neck and hands. Visit https://eagleeyeaesthetics.com.sg/ to find out more.