Dark circles under the eyes

Medical-led treatment for under-eye pigmentation, shadows, thin skin and tired-looking eyes

At Skin and Scar Care Clinic, we offer personalised treatments for dark circles under the eyes, also known as periorbital hyperpigmentation, under-eye shadows or infraorbital dark circles.

Dark circles can make the face look tired, aged or unwell, even when you feel healthy and well-rested. The under-eye area is delicate, and dark circles can have many different causes. This means the best treatment depends on identifying the correct reason first.

Our treatment options may include:

Pico laser for pigmentation and discolouration
Viscoderm Hydrobooster for under-eye hydration and fine lines
Chemical peels for selected pigmentation concerns
Carboxytherapy for circulation-related dark circles
PRF for regenerative under-eye skin quality
Topical treatments, including hydroquinone where medically appropriate, tranexamic acid, niacinamide and arbutin
Combination treatment where suitable

Our approach is medical, cautious and personalised to your skin type, anatomy and cause of dark circles.

What causes dark circles under the eyes?

Dark circles are not all the same. They can be caused by pigmentation, visible blood vessels, thin skin, hollowing, shadowing, puffiness or a combination of factors.

Common causes include:

Genetic pigmentation
Melanin overproduction
Post-inflammatory pigmentation from rubbing, eczema or allergies
Thin under-eye skin showing blood vessels underneath
Bluish or purple vascular discolouration
Tear trough hollowing
Under-eye volume loss
Eyelid bags casting a shadow
Poor sleep or fatigue
Dehydration
Sun exposure
Age-related collagen loss
Weight loss and facial volume change
Allergies or hay fever
Sinus congestion
Iron deficiency or anaemia in selected cases
Thyroid, kidney or other medical causes where puffiness is also present

Because there are many possible causes, a consultation is essential before treatment.

Types of dark circles

Pigmented dark circles

Pigmented dark circles usually look brown or grey-brown. They may be caused by genetics, sun exposure, ethnic pigmentation, melasma, inflammation, rubbing or eczema.

These may respond to:

Pico laser
Topical brightening treatments
Tranexamic acid
Niacinamide
Arbutin
Carefully selected chemical peels
Prescription pigment control where appropriate

Vascular dark circles

Vascular dark circles often look blue, purple or reddish. They happen when blood vessels are visible through thin under-eye skin or when there is poor microcirculation.

These may respond to:

Carboxytherapy
PRF
Viscoderm Hydrobooster
Skin-quality treatments
Vascular laser in selected cases

Structural dark circles

Structural dark circles are caused by tear trough hollowing, eye bags or facial anatomy. The darkness is often a shadow rather than true pigmentation.

These may need:

PRF
Skin boosters
Careful tear trough assessment
Midface support in selected cases
Eyelid bag assessment
Surgical referral if fat pads or severe bags are the main cause

Mixed dark circles

Many clients have more than one cause, such as pigmentation plus hollowing, or thin skin plus visible vessels. In these cases, combination treatment usually works better than one single treatment.

Why proper assessment matters

Treating dark circles without understanding the cause can lead to disappointment. For example:

Pigment creams will not correct deep tear trough hollowing.
Filler will not treat brown pigmentation.
Laser may not help if the darkness is mainly caused by shadowing.
Carboxytherapy may not improve genetic pigmentation.
Skin boosters may improve texture but will not remove large eye bags.

At Skin and Scar Care Clinic, we assess:

Skin colour and undertone
Pigmentation pattern
Skin thickness
Vascular colour
Tear trough depth
Eyelid bags
Puffiness
Allergies or rubbing
Skin type and pigmentation risk
Previous treatments
Medical history and medication

If puffiness is new, persistent or worse in the morning, we may recommend GP review to rule out medical causes such as allergy, thyroid issues or fluid retention.

Pico laser for under-eye pigmentation

Pico laser uses ultra-short pulses of laser energy to target pigment in the skin. It can be useful for selected clients with pigmentation-related dark circles.

Pico laser may help improve:

Brown under-eye pigmentation
Sun-related pigmentation
Freckles or superficial pigment
Post-inflammatory pigmentation
Uneven periocular skin tone
Dull under-eye discolouration

Pico laser is particularly useful when the darkness is caused by pigment rather than hollowing or eye bags.

What to expect with Pico laser

Treatment is usually quick and has minimal downtime. You may feel a snapping or warm sensation during treatment.

Afterwards, the skin may appear slightly red or warm. Pigment may darken temporarily before gradually fading.

A course of treatments is usually required.

Pico laser safety around the eyes

The eye area is delicate and laser treatment around the eyes requires specialist care, correct settings and appropriate eye protection.

Pico laser may not be suitable for all skin types or all pigmentation patterns. In darker skin types or melasma-prone skin, there is a risk of post-inflammatory hyperpigmentation if treatment is too aggressive.

Strict sun protection is essential.

Viscoderm Hydrobooster for thin skin and fine lines

Viscoderm Hydrobooster is an injectable skin-quality treatment used to improve hydration, elasticity and fine lines around delicate areas such as the lower eyelids.

It is not a traditional filler and is not designed to create heavy volume. Instead, it helps improve the skin quality itself.

Viscoderm Hydrobooster may help with:

Fine lines under the eyes
Crepey under-eye skin
Thin or dehydrated skin
Mild textural shadows
Early under-eye ageing
Skin elasticity
Dull, tired-looking eyes

What to expect with Hydrobooster

Small injections are placed carefully around the under-eye area.

Possible temporary effects include:

Small bumps
Mild swelling
Bruising
Tenderness
Temporary puffiness

A course of 2 sessions, usually spaced around 4 weeks apart, may be recommended.

Hydrobooster is best when dark circles are partly due to thin, crepey or dehydrated skin, rather than deep pigmentation or large eye bags.

Chemical peels for under-eye pigmentation

Chemical peels can help improve selected pigmentation concerns by encouraging controlled exfoliation and skin renewal.

For the under-eye area, only carefully selected superficial peels should be used due to the delicate nature of the skin.

Chemical peels may help with:

Brown pigmentation
Post-inflammatory pigmentation
Dull under-eye skin
Uneven tone
Mild texture concerns

Important safety note

The under-eye skin is thin and sensitive. Chemical peels around the eyes must be carefully selected and professionally applied.

We do not recommend using strong acids, TCA, retinoids or unregulated peeling products around the eyes at home.

Chemical peels may not be suitable for darker skin types, active eczema, sensitive skin, recent sun exposure or melasma-prone skin without proper preparation.

Strict SPF and pigment-control skincare are essential before and after peel treatment.

Carboxytherapy for vascular dark circles

Carboxytherapy involves placing small controlled amounts of medical carbon dioxide gas under the skin.

It may help improve circulation and tissue oxygenation in selected cases of under-eye darkness.

Carboxytherapy may be useful when dark circles are caused by:

Bluish or purple discolouration
Poor microcirculation
Thin skin with vascular colour
Tired-looking under eyes
Mild under-eye dullness

What to expect with carboxytherapy

A fine needle is used to place carbon dioxide gas under the skin. You may feel pressure, warmth, tightness or a temporary bubbling sensation.

Temporary under-eye swelling or puffiness can occur immediately after treatment and usually settles quickly.

A course of 4–8 sessions, often spaced 1–2 weeks apart, may be recommended.

Carboxytherapy is not suitable for all types of dark circles. It may not help if the main issue is brown pigmentation, deep hollowing or true under-eye fat pads.

PRF for dark circles and under-eye skin quality

PRF, or platelet-rich fibrin, is a regenerative treatment made from your own blood.

A small blood sample is taken and processed to create PRF, which contains platelets, fibrin and growth factors. This is then placed carefully into the under-eye area to support tissue quality and regeneration.

PRF may help with:

Thin under-eye skin
Crepey texture
Mild hollowing
Tired-looking eyes
Vascular dark circles
Skin quality
Fine lines
Regenerative support

PRF is often chosen by clients who prefer a natural regenerative treatment and want to avoid dermal filler.

What to expect with PRF

PRF usually requires a course of treatments. We commonly recommend 2–3 sessions, spaced around 4–6 weeks apart.

Possible temporary effects include swelling, bruising, tenderness and mild puffiness.

Results are gradual and usually develop over several weeks to months as skin quality improves.

PRF is not a replacement for surgery or filler when there is significant tear trough hollowing or fat pad bulging.

Topical treatments for dark circles

Topical skincare can be helpful when dark circles are caused by pigmentation, inflammation, sun exposure or poor skin barrier function.

Topical treatments work gradually and must be used consistently.

Hydroquinone

Hydroquinone is a pigment-reducing ingredient that may be used for selected pigmentation concerns under medical supervision.

Important points:

It should not be bought from unregulated skin-lightening products.
It should not be used around the eyes without professional guidance.
It is not suitable for everyone.
It can irritate the skin and may worsen pigmentation if used incorrectly.
It is usually used for limited treatment periods.

Hydroquinone is not a routine cosmetic eye cream. It should only be considered after proper assessment.

Tranexamic acid

Topical tranexamic acid can help reduce pigmentation pathways and may be useful for melasma-prone or stubborn pigmentation.

It may help with:

Brown discolouration
Melasma-related pigmentation
Post-inflammatory pigmentation
Uneven tone

It is usually combined with SPF and other pigment-control ingredients.

Niacinamide

Niacinamide is a gentle brightening and barrier-support ingredient. It may help improve:

Uneven tone
Skin barrier function
Mild pigmentation
Redness
Dullness
Skin texture

It is often suitable for sensitive skin when introduced slowly.

Arbutin

Arbutin is a brightening ingredient that can help reduce the appearance of pigmentation.

It may be useful for:

Mild under-eye pigmentation
Uneven tone
Brown discolouration
Maintenance after laser or peel treatment

SPF is essential

No pigmentation treatment works well without sun protection. Daily broad-spectrum SPF 50 and sunglasses are important for preventing recurrence and worsening of dark circles.