We are not talking about the dark circles that already include “folds” of extra skin. They require surgical treatment.
But for those that only darken the area there are highly efficient non-surgical therapies! We are talking about injecting a pellicle of hyaluronic acid that will interpose between the vascular structure and the skin, or about the improvement of the skin by mesotherapy procedures.
The latter mentioned can correct the excesive skin laxity, thanks to the remodeling major effects and to the stimulation/acceleration of the natural process of supporting fibers synthesis.
Thus, the skin re-becomes elastic, firm and tonified.
Mesotherapy means introducing, by microinjections, of a cocktail of substances, established by the physician depending on the needs and specifics of the patient, containing vitamins, minerals, amino acids, enzymes, hyaluronic acid, oligoelements, etc.
On the other hand, the injection of hyaluronic acid for correcting the dark circles must be carried out by physicians with a wide experience in this field, as we are talking about a delicate procedure that requires a lot of attention.
For a better correction, on the long run, this is associated with platelet-rich plasma infiltration (P.R.P., plasmolifting) of the affected area.
This will result in the regeneration of the skin tissue, affected in time by the poor oxygenation.
Mesotherapy presents minimal risks, and the side effects are low; small bruises or haematoma can occur in the laxity areas, or redness, local pain, burn sensation, pruritus, or a local minor allergic reaction.
Dark circles represent a multifactorial pathology, being a challenge in the world of medical aesthetics. These are the result of a multitude of factors, such as face anatomy, changes in soft tissue, and changes in the skin. There is a wide range of treatments available, requiring customized therapy based on the characteristics of each patient.
The origins of the dark circles are causal factors that include both endogenous factors (anatomic features, sex, genetic predisposition, physiological aging, atopic dermatitis, cutaneous xerosis, etc.) as well as exogenous factors.
The anatomical features of each patient can cause infraorbital pigmentation due to changes coming with aging, loss of volume in cheekbones, retraction of the inferior margin of the orbital fossa and stiffening of the ligaments, resulting in deepening of the dark circles and their shading.
The thickness of the skin at the eyelid level is minimal, being one of the thinnest regions of the body, thus, through its transparency, allows the subcutaneous structures to be visible, a visibility that increases with the physiological aging by the loss of elasticity associated with a low production of elastin and collagen.
The first step in the management of dark circles is to establish the particularities of each patient in order to be able to choose the optimal treatment.
The Q-switched lasers are an efficient method for the treatment of dark circles that are mainly based on hyperpigmentation of the infraorbital area, being a safe option for the selective treatment of melanocytes with minimal touch of the surrounding structures.
In the Skinmed Clinic we use the Q-switched Nd: Yag laser, with a wavelength of 1064nm, which has the ability to act deep in the dermis, with a minimal effect on melanosomes, being safe to use even on the patients with dark phototypes (as opposed to other types of laser).
The treatment is painless, does not require anesthesia, the patient feels a pleasant, warm feeling at the level of the treated area. The recovery time is virtually non-existent, the patient being able to resume his / her daily activities immediately after the procedure.
PDL (Pulsed Dye Lasers)
PDL technology is indicated in the treatment of dark circles with an accentuated vascular component, acting by selective thermolysis at the level of hemoglobin in the tissue. PDL is recommended to phototype I-III patients, in general in a 3 session series, every 4-6 weeks.
They can be used either alone or in combination with other procedures in the treatment of dark circles. They are indicated for the patients with cutaneous phototype Fitzpatrick I-III.
Fillers with hyaluronic acid gel
It is one of the treatments most commonly used in dark circles management. It uses a hyaluronic acid gel, molecules with a very similar structure to those naturally occurring in the body, thus minimizing the risk of allergic reactions, and having a long-lasting effect, however without being permanent. By increasing the concentration of hyaluronic acid in the skin, the fillers have the property of revitalizing, restoring the volume of the skin while at the same time relieving fine lines and wrinkles. Dark circles treatment by injection of hyaluronic acid is an easy method. The filler will be injected at the level of the dark circles using a fine needle or canula after applying local cream anesthetics on the area. A treatment session usually lasts between 15 and 30 minutes.
PRP (Platelet Rich Plasma) or Platelet Thrombocyte Enhanced Plasma Therapy, also called Vampire Therapy, is an injectable treatment that is based on the patient’s blood. Platelets play a vital role in the tissue repair and growth process of newly formed cells. Thus, PRP stimulates collagen secretion, regenerates skin tissue, helping to rejuvenate cells. Also, growth hormones are released into the tissue, which amplifies the healing and regeneration process.
The blood of the patient is the base of the patient’s own blood plasma therapy so that it is harvested before the procedure with a syringe, under the most secure conditions. The blood thus harvested is introduced into a centrifuge which will separate its components. The resulting plasma, enriched with platelets, will then be reinjected, either by mesotherapy or by microneedling, into the patient’s skin.
The PRP used for cosmetic purposes is a safe procedure, with a very small number of contraindications for performing the procedure. The most common undesirable reactions are redness and mild to moderate edema of the treated area, which persist for a very short period.
Microneedling is form of mesotherapy that is carried out with the help of a specialized device, instead of the traditional syringe. The microneedling devices are transdermal penetration devices that have two effects at the skin level: a superficial reversible lesion that triggers a healing response with stimulation of collagen and elastin synthesis, and the second effect is the creation of multiple permeable channels for active substances applied to the skin during the procedure.
Usually 4-6 sessions of 4 weeks are required for optimum results; during the initial consultation with the dermatologist she/he will establish the treatment protocol.