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There are many reason for dark eye circle from medical perspective.
Generally it can be divided into three categories:
1. The most common reason: because of the bulging fat pad in lower eyelid,
2. The capillary network can be seen through very thin skin, which make the skin looks blue or purple.,
3. Because of the pigmentation.
The most common reasonfor dark circle is because of the bulging fat pad in lower eyelid. As aging, the strength of skin and muscle will become loose and weaker, which can make the fat compartment bulge out and form the dark circle. The treatment plan will be various depending on if there is only fat bag bulging or company with the skin slackness.
If there is only fat compartment bulging out, a simple fat bag remove surgery though the mucosa incision will be performed. There is not skin incision on the lower eyelid and 2-3 days will be recovered postoperatively.
The reason for capillary network dark circle is very thin skin cover, which will make the capillary network visible though the skin. The lower eyelid skin will look dark and pale if the venous flow inside the adipose tissue become slow when people are tired, severe dehydrate, or leukemia. In this condition, special laser to destroy the vessels will be helpful. V-beam or Alexandrite Laser is recommended for dark circle because the vessels is thicker. The treatment should be performed once a month, 3-5 time in all.
Pigmentation dark circle is because there is some pigmentation in the lower eyelid skin, which may related to ethnic group, genetic background, some skin disease such as eczema, PIH, etc.
For this kind of dark circle, the treatment plan can be applying whitening cream or paste to lower eyelid, 1-2 times a week, or inject some collagen or other whitening medicine into the skin to enhance the effect.