If you missed Dr. Strachan’s appearance of Brooklyn Savvy (aired on April 25) you can watch the video here: http://vimeo.com/40756711

Not uncommonly patients come in frustrated at trying to treat dark circles around their eyes.  They’ve tried multiple creams but nothing seems to work.  Dark circles around the eyes can, indeed, can be challenging to treat primarily because there are multiple reasons people get them.  If the treatment selected does not address the actual cause then little improvement will be observed.  Sometimes the skin is, in fact, darker.  In other cases the skin of the area appears darker because of another physical change.  Below is a list of some reasons why a person might have the appearance of dark circles around the eyes and what could possibly be done to address them.

1. genetics-  In some families the skin around the eyes gets darker over time.  This is not a sign of a disease, being tired or any other abnormality.  In this case the skin is, in fact, darker.  Although genetics can be hard to fight wearing sunscreen and sunglasses can be helpful in preventing and reducing the darkening.  Products that contain exfoliating ingredients and brightening agents may help.   Some chemical peels, such as the Enerpeel EL system by Glytone, which is a peel specifically designed to be used on the eyelids, may also reduce the darkening of the skin.

2. allergies- Constant rubbing or scraching of the skin around the eye can result in a darkened, thickened appearance called an “allergic shiner.”  Treatment of the allergy or eczema around the eye will help treat and prevent this problem.  The remaining hyperpigmentation once the medical issues are addressed can be treated with sun protection, brighten agents or peels as described above.

3. thinning of the skin with age- Like on other parts of the body, delicate eyelid skin also thins with age.  When this happens underlying structures such as the dark, red eye muscle or blood vessels become visible resulting in a darkened apprearance of the eyelids– especially in people with fair skin.  Thin skin that folds on itself can also appear to be darker.  Again, sun protection is important in preventing photoaging.  Eyelid creams and peels that stimulate collagen production resulting in the skin being thicker and less transparent may help.  Injection of soft tissue fillers such as Juvederm or Restylane into the eyelid areas or cheeks can also help pull the skin up away from underlying structures resulting in a less darkened appearance.

4. Bony changes- Just as our bones become less dense with age in other parts of the body,  we lose bone around our eyes over time resulting in a sunken, darkened appearance of the eyelids.  The soft tissue fillers mentioned abovecan also be helpful, again in this case, to revolumize the area and address dark shadows.

Although addressing dark circles around the eyes can sometimes be frustrating, when the cause is identified and the person is directed to the right treatment improvement in the appearance around the eyes can be achieved.

Look for Dr. Strachan talking about medical and cosmetic dermatology on Wednesday, April 4, 2012 on NYC television’s Brooklyn Savvy.  The show will air at 3:30 pm on channel 25.   Find out more about Brooklyn Savvy here: http://www.nyc.gov/html/media/html/tv/nyctv_life_brooklynsavvy.shtml