- Dark circles can be addressed with dermal fillers, depending on their cause.
- Fillers have little to no recovery time; side effects include bruising and swelling.
- Over-the-counter options are optional treatments to treat dark under-eye circles.
Dark circles under the eyes can be divided into two categories: those resulting from hyperpigmentation, and those caused by thinning skin and visible veins. For the latter, dermal fillers can be used to plump the under-eye area to reduce the appearance of dark circles.
Can Dermal Fillers Treat Dark Circles?
“Dark circles are visible when the lower eyelid skin is thin enough that it is translucent and shows the color of the underlying muscle,” says Dr. Steven Goldman, MD, a plastic surgeon experienced in injectable treatments.
Dermal fillers instantly add volume below the eyes to fill out eye hollows that occur when the tear trough (the ridge of bone under the eyes) is especially prominent and casts a shadow on the under-eye area.
Bulging fat pads below the eyes can also contribute to dark circles. With age, the muscles surrounding the eye weaken, causing fat in the area to lose the structure that held it in place. This loose fat collects beneath the eyes, leading to the formation of bags. Puffy eyelid bags cast a shadow onto the upper cheek making the area appear darker than it actually is.
“Fillers can be used at the junction of the lower eyelid bag and the cheek to make the dark circles less noticeable,” says Dr. Goldman. This process fills the area below the lower eye bag to smooth out the face and reduce shadowing.
However, dermal fillers cannot treat dark circles caused by hyperpigmentation, which require other modes of treatment.
Most fillers used to treat dark circles are hyaluronic acid-based. A few well-known brands are Restylane, Juvederm, Voluma and Belotero.
The best candidates for under-eye fillers are those with naturally pronounced tear troughs whose dark circles are unrelated to lifestyle habits. Fillers are also appropriate for people who have experienced volume loss and fat pad bulging under the eyes as a result of aging.
What to Expect During the Procedure
“Prior to the procedure, a consultation session is held with the patient and a physical exam is performed,” says Dr. Goldman. “On the day of the treatment, the injection site is cleaned and the appropriate filler is injected to augment the upper cheek and fill the area under the muscle in the lid-cheek groove.”
Different fillers are selected based on the specific injection site. “Thicker fillers may be used for cheek volume, thinner for under the muscle, and superficial fillers on top of the muscle using small amounts in the tear trough and lid-cheek groove.”
The provider injects the filler using either a needle or a tiny tube called a cannula. Small amounts of filler are injected at a time until the desired result is reached; injecting too quickly can traumatize the delicate tissue and increase swelling.
The provider may also shape the filler under your eyes with their fingers before it settles. They then apply an ice pack to the area to minimize bruising and swelling.
To reduce pain throughout this process, a topical numbing cream is typically applied to the under-eye area during the procedure.
Recovery and Results
After receiving an injectable filler, your eyes will feel tender for the rest of the day. Regularly icing the area can help reduce any discomfort and swelling. Avoid touching the under-eye area as much as possible, and do not apply makeup.
“Patients can return to work and exercise the same day,” explains Dr. Goldman. “However, as with any filler, bruising can appear and can last 2–3 weeks.”
The final results will be visible after one week. Dermal fillers can last up to one year, but many people go for touch-ups every few months.
Before and Afters
Side Effects and Safety Considerations
Under-eye fillers are generally considered safe. However, the under-eye area is also one of the riskier areas to inject a filler.
“It’s an area in which patients are more likely to experience puffiness and bumpiness, so patients must be properly selected, and filling must be performed in a meticulous fashion,” says Dr. Goldman. As such, the procedure should only be performed by a plastic surgeon, dermatologist or experienced medical doctor.
Other side effects include infection, which can occur even months after the procedure should your body develop a sensitivity to the filler. “Occasionally, infection can occur around fillers,” says Dr. Goldman. “Although rare, skin necrosis is also a complication of any filler used in the face.”
Occlusion is another risk, in which the filler enters a blood vessel and blocks it. This is usually treatable, but in extremely rare cases, can lead to blindness.
Cost of Fillers for Dark Circles
Dermal fillers can cost from $300 up to $1,500 per syringe, depending on the brand and your location. Most people can achieve their desired results with only one syringe, but others may require two or three to adequately address their tear trough shadows.
Alternatives to Fillers for Dark Circles
Many over-the-counter (OTC) skin care products are formulated to get rid of dark circles. Eye creams and serums containing retinoids, antioxidants, hyaluronic acid and peptides have been shown to improve the appearance of dark circles
These active ingredients promote collagen production and hydration in the tear trough area. By restoring hydration and volume, dark circles can be minimized or eliminated altogether.
For an instant but temporary solution, application of a concealer below the eyes can hide the appearance of dark circles.
While skin lightening creams may seem like a natural addition to your routine, they may not improve your dark circles. “Hydroquinone can lighten pigment, but dark circles are not typically from pigment, so lightening creams are usually not helpful,” says Dr. Goldman.
In the long term, getting a good night’s sleep, staying hydrated and eating well can be your first defense against dark circles under the eyes. Adopting these healthy habits may eliminate your dark circles without further intervention.
Surgical options are also available to address dark under eye circles. “A lower eyelid blepharoplasty (lid lift) will almost always be more effective and long lasting than injections,” explains Dr. Goldman. “However, this procedure requires anesthesia, recovery time and greater up-front cost.”
For dark circles caused by pronounced tear troughs and fat pad bulges, dermal fillers can be an effective temporary solution. The procedure is quick with little downtime. Dermal fillers below the eye are generally considered safe, but the rare complications associated with them are serious and can lead to blindness.
As an alternative to dermal fillers, many OTC treatments are available to hydrate and plump the under-eye area, helping to reduce dark circles and prevent their appearance in the long term.
- Berguiga, M., & Galatoire, O. (2017). Tear trough rejuvenation: A safety evaluation of the treatment by a semi-cross-linked hyaluronic acid filler. Orbit, 36(1), 22–26. https://doi.org/10.1080/01676830.2017.1279641
- Hwang C. J. (2016). Periorbital Injectables: Understanding and Avoiding Complications. Journal of cutaneous and aesthetic surgery, 9(2), 73–79. doi:10.4103/0974-2077.184049
- Rzany, Berthold MD, ScM; DeLorenzi, Claudio MD. (2015) Understanding, Avoiding, and Managing Severe Filler Complications. Plastic and Reconstructive Surgery: November 2015 – Volume 136 – Issue 5S – p 196S–203S. doi:10.1097/PRS.0000000000001760