Underneath eye circles and bags treatment

Underneath eye circles and bags treatments

Not much has been written about eye circles. Not much is known about them except that they are a common aesthetic problem which is difficult to eradicate. They pose great problems to many people, on an emotional and business level because they are very accentuated and are not covered up easily. That morning glance in the mirror causes daily nausea and painful routine and is followed by tons of facial powder or sunglasses. Dark circles can be somewhat covered up but puffiness cannot. Eye circles give you a tired, sick, drained and old look. Most often they give an impression of lack of sleep which makes daily functioning at work harder. It is even worse when they ask you on a daily basis did you party hard last night and then you have to explain that in fact you didn't.

What are eye circles?

Eye circles are an aesthetic issue caused by various factors which are oftentimes conjoined. It is considered that they are a consequence of various degenerative changes caused by aging. Eye circles are therefor considered one of the main signs of aging. They are present in the younger population as well but in those cases they are genetically caused. 90% of the time people estimate someone's age based on the area underneath their eyes and cheeks. Eye circles are generally recognized because of the black coloration, puffiness and pigmentation under the eyes (all these symptoms can be individual or conjoined). Mostly they appear because of bad circulation, slow metabolism, body built and skin color. Their development depends on genetics, external and internal influences.  With aging, due to lowering of the face because of the loss of subcutaneous fat tissue the gap between the lower eyelid and the cheek grows bigger and gives an impression of illness, fatigue and old age. One of the main features of a young face is fullness of cheeks with a minimal gap between the lower eyelids and cheeks. Weakening of the connective tissue causes a penetration of the fat tissue, which then fills out the eye cavity and gives that puffy look under the eyes and creates circles. 

What are puffy eyes/eye bags?

Puffy eyes are degenerative changes which appear because of weakening of the connective tissue underneath the lower eyelids which creates excess of skin. With aging fat tissue which fills out the eye cavity and supports the eye starts penetrating outwards. Oftentimes people call this condition - bags but in fact we are dealing with eye circles. Although expert literature provides different opinions. In the true sense of the word, the excess of skin creates bags underneath the eyes. 

Is there any difference between eye circles and bags underneath the eyes?

Although they sometimes look the same there is a difference, and it is in the causes and method of removal. Eye circles can appear in young people but eye bags begin to appear after you reach the age of 35. With time, because of degenerative changes, eye bags are oftentimes conjoined with eye circles. Later it is difficult to find a difference between the two. Some authors claim its the same problem. 


People often make mistakes when tear-through is in question. A tear-through appears as a consequence of your face lowering and your skin getting thinner which makes the hamstring muscles more visible and gives a dark-purple coloration. They look like a dark-purple line which diagonally expands from the inner corner of the eye towards the cheekbone. Oftentimes they end below the pupil. Apart from skin coloration a canal can also be accentuated or an indentation of skin in the area of a tear-through. Eye circles have a similar appearance but typically affect the area below the lower eyelid in the whole length of the eye. They usually appear in younger people much earlier then eye circles. 

What causes eye circles?


Real eye circles are changes caused by poor circulation and lymphatic drainage. Blood accumulates and does not flow through. Due to an enhanced hydrostatic pressure blood penetrates outside the blood vessel wall into the tissue where it dissolves. We connect eye circles with black rings and swelling underneath the eyes. Due to the blood dissolving a pigmentation is created and it accumulates with time, which gives you those dark rings underneath the eyes. Those are dark or pigmented eye circles. We can roughly compare them with a sort of a long lasting bruise. With some people only stopping changes prevail without the blood penetrating into the tissue. These are stopping eye circles which are followed by puffiness. Oftentimes because of this puffiness an excess of skin is created underneath the eyes. Later the two symptoms, puffiness and skin coloration are joined into one issue. People with allergies have puffy eyes in time when pollen is strong. 


Stronger and longer sun exposure contributes to the darkly brown coloration under the eyes. 


They appear because the face follows gravity and fat tissue penetrates from the eye socket. 


With kidney and thyroid gland disorders liquid is contained and stopped. 

What are the other causes of eye circles?

  • Thin skin under which muscles and veins are showing giving the skin a bluish color, which is often with neurodermatitis;
  • Blood vessels in the vicinity and just below the eye are oftentimes confused with eye circles;
  • Aging: metabolism is slowing down, nutrients have a harder time reaching certain areas and harmful substances take longer to eject, all of which induces degenerative changes. 

Eye circle types

There is a generally acknowledged dividence of eye circles and this is just a simplification!

  • Pigmented (dark)
  • Puffy or stopped
  • Combined
  • Caused by the lowering of cheeks due to loss of fat tissue 

Does lack of sleep affect the development of eye circles?

Usually it affects the puffy eye circles while on other types it has minimal effect. 

On what does the success of the treatment depend?

  • Do eye circles run in the family
  • type
  • Length of the treatment
  • Is pigmentation present
  • The accentuation of eye circles
  • Number of factors which induce eye circles
  • Condition and quality of the skin under one's eyes
  • The ability to affect the provoking factors
  • Presence of eye bags
  • Accompanying diseases: allergies, thyroid gland, heart, kidney
  • The amount of fat that has penetrated from the eye socket
  • Loss of subcutaneous fat tissue 

Do creams help and what else helps?

For certain types of eye circles creams have no effect or the effect is poor. At this moment it appears that with pigmented and puffy eye circles creams based on vitamin A, C and K help the most. Some other ingredients help as well. A cold compress can help in case of  puffy eye circles. Massages few times a day from th inner eye angle towards the outer eye angle help with colored and puffy eye circles. Sun protection is advised. Do not rub your eyes because it induces pigmentation. 

Is surgery a solution?

The most common surgery is blepharoplasty and lifting of the middle facial area. Surgeries give excellent results but can seriously deteriorate your looks if done wrong. Blepharoplasty has a goal to remove the excess skin and fat tissue which penetrated outside the eye socket. The greatest danger is to remove too much fat when treating younger people. In that case the results will be good the next 5-10 years but the face will suddenly deteriorate with additional loss of fat tissue due to aging. Later the face appears hollow, tired, sick and old. The skill is to remove just enough fat tissue or to compensate for the volume loss by surgery. To compensate for the volume, fillers based on hyaluronic acid are used, as well as fat tissue or blood which is specially treated. Surgery is recommended only in advanced stages with great excess of skin or great penetration of fat tissue from the eye socket. When lifting the middle facial area facial ligaments which have weakened are corrected and now cover up the eye circles. 

What is the treatment's goal and to what should you pay attention to?

A strictly individual approach is needed, taking into account the type and causes of the eye circles. Sometimes a combination of treatments is needed because simultaneously there are more factors which create the condition. Eye circles are not unsolvable and today a correct approach can do wonders.

  • Strengthening of circulation and lymphatic drainage;
  • Removal of pigmentation;
  • Enhancement of collagen development and thickening of skin;
  • Skin tightening under the eyes;
  • Other causes should be ruled out: heart, kidney, thyroid gland disorders and allergies;
  • Compensation of volume;
  • Correction of the penetrated fat tissue from the eye socket, it is either removed or used to fill out the gap underneath the lower eyelid to compensate for the volume loss. 

Significance of the eye circle removal treatment

We state that this is the most important rejuvenation treatment. Without this treatment you will not be completely satisfied because you will see that something is missing. The reason is that eye circle correction is a minimal change which in return completely improves the look of your face. Oftentimes changes are not immediately visible and days are needed. It is because you still see yourself like you were in the youth. This correction is the one that will bring back the look you had 10 or more years ago. Take a before photo and once you take a look in the mirror you will immediately see a change. Eye circle correction gives you a natural, fresh and rested look. You will notice this because make up will no longer be needed or will be minimally applied. 

Treatment types: 


For now the only therapy that affects most causes of eye circles and not the consequences. It affects circulation and the development of new collagen. The method is not painful but is described as a weird sensation and uneasiness. In the treated area a puffiness will remain for up to 15 minutes, 1 day at most. In any case, you can go back to work the next day or count on a light swelling underneath your eyes (usually under one eye). No recovery period is needed nor will you have any permanent consequences such as scars. Sometimes a bruise, which will heal, can appear. About 5 treatments are needed and the number can vary (one treatment more or less). The interval between the treatments is 10 to 30 days along with 1 or 2 maintenance treatments a year. Results are visible a few weeks after the treatment, and in the following months they will get better and better. 

Fillers based on hyaluronic acid

The goal is to inject the basic constructional skin ingredient which compensates for the lost volume, covers up the pigmentation and induces the development of new collagen which thickens the skin. 1 treatment is needed. Sometimes temporary bruises can appear. Results are visible immediately or after a few days (after the swelling passes), and in average last 9 to 12 months. With maintenance treatments once every 1 to 2 years results are better and last longer. It is advised not to take Andol and similar substances 7 days before the treatment. WITH PEOPLE WHO HAVE A TENDENCY OF EYE CIRCLE SWELLING THE FILLER TREATMENT IS NOT RECOMMENDED SINCE IT COULD ONLY ENHANCE THE SWELLING. IN THAT CASE A PRP TREATMENT IN COMBINATION WITH SKIN TIGHTENING TREATMENTS IS RECOMMENDED. 

PRP (plasma rich platelet)

PRP treatment is based on use of your own blood which is prepared in a way so that the liquid is separated from the plasma part with platelets, stem cells and growth factor. The idea is that the stated ingredients induce the growth of new collagen with the effect of skin rejuvenation and a reduction of wrinkles around the eyes and initial bags. In average one treatment is needed but sometimes 2-3 treatments are needed, especially in cases of colored eye circles which are oftentimes hereditary. Results are visible 2-3 months after the treatment and they get better with time. In average the results last around 20-24 months and in cases of colored eye circles not as much. This is a treatment of choice with colored eye circles especially with those prone to swelling and with slight and moderately accentuated eye circles with a loss of volume. If loss of volume is strongly accentuated prp treatment can be combined with fillers. 


Circulation and lymphatic drainage is amplified with electro-magnetic energy, along with the development of new collagen and thickening of skin. 3 treatments are needed, and the results are visible after a few months and get better in the following 12 months. No recovery period is needed. The treatment is beneficial for removal of fat tissue underneath one's eyes and tightening of skin. There is no recovery. 

Fractional radio-waves

The treatment induces microscopic damages underneath your skin which then get ejected and are compensated with new tissue. Its a process that lasts 12 months. Thicker and tighter skin without pigmentation is the result. 1 to 3 treatments are needed. Initial results are visible few months after the first treatment. Usually no recovery time is needed, except in cases with temporary swelling. After the treatment the eyelids become dark red, which in average lasts 2 to 3 days, but can be covered up with make up after the initial treatment. 

Fractional ablative erbium laser

The goal is to induce microscopic damages underneath the surface which are then replaced with new tissue in the following 12 months. 2 to 3 treatments are needed, and initial results can be seen several months after the first treatment. Recovery period lasts 2 to 5 days. This treatment removes pigmentation and thickens the skin. Recovery takes 3 to 7 days. 

Fractional ablative Co2 laser

Works like the above mentioned laser, needs 1 to 2 treatments and a recovery time from 2 to 7 days. This treatment along with pigmentation removal improves the look and the structure of skin with a strong tightening effect. 

Fractional non-ablative laser

Works as the above mentioned laser, but with a heating effect. 1 to 3 treatments are needed and serves for pigmentation removal and skin thickening. Your skin will be red in the next 2 to 3 days but recovery is mostly not needed. 

Erbium laser

The laser induces a mechanical removal of skin layers and with that of the pigmentation with wrinkle reduction. 1 to 2 treatments are needed, and recovery lasts from 5 to 10 days. 

Q-switched laser

This is a laser used for pigmentation. 2 to 5 treatments are needed and recovery takes 3 to 5 days.

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