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As you age, your skin thins and your face loses fat, collagen, elastin, and hyaluronic acid. All of these substances contribute to the skin’s fullness, support, and spring. This decrease in volume makes the reddish-blue blood vessels beneath your eyes more obvious. What appear to be dark circles can sometimes be shadows cast by puffy lids or under-eye hollows. Restoring the volume lost with dermal fillers can restore volume and improve the appearance of puffiness or hollows.
Hollow eye syndrome is not your typical dark circles, but a condition in which the entire lower eyelid appears sunken in. This can be a natural change that develops over time or can be caused by other factors such as trauma or following a lower eyelid blepharoplasty where too much lower eyelid fat has been removed. To correct this, the missing volume under the eye needs to be replaced. This can be obtained with dermal filler, surgically correcting the fracture and rearranging the fat or a fat transfer procedure.
Arcus marginalis deformity is a deep depression beneath the lower eyelid that many people have. It’s first noticed in childhood and usually inherited. The arcus marginalis muscle anchors the the lower eyelid skin to the bone of the eye socket. The skin of the eyelid above this muscle falls over and downward creating a deep shadow, or dark circles, under the eyes.
Dark circles under the eyes can happen when the nasal passages become congested, which is a common symptom of allergies. When the nose is clogged, the veins around the nose become inflamed and blood flow slows down. The veins underneath the eyes may appear darker and show through the skin as the blood slows from congestion. In addition to allergies, colds and any other condition that causes nasal congestion may be the cause of dark circles under the eyes. In some instances, antihistamines and/or decongestant medications could be useful in alleviating these changes.