Why are my under-eyes darker than the rest of my face?

The skin under the eye is thinner than anywhere else on the face — sometimes a quarter of the thickness. Whatever is beneath it (vessels, pigment, or shadow from a hollow) shows through more visibly.

Will tear-trough fillers help if my dark circles are vascular?

Filler is most effective for structural (shadow-cast) dark circles. For purely vascular or pigmentary types, filler alone may not help and can sometimes make the picture look worse. A 4D assessment establishes which type you have before recommending filler.

Often, particularly the pigmentary type. Genetic predisposition doesn't mean it can't be treated — but it does affect expectations of how completely the picture can resolve.

How long do results last?

Filler results typically last 9–18 months; regenerative treatments work cumulatively. Lifestyle drivers (sleep, hydration, allergies) need ongoing management.

Is treatment safe in skin of colour?

Yes, with appropriate device selection and clinical judgement. The risk of post-inflammatory pigmentation is the main consideration; treatments are sequenced and graded accordingly.

Vascular, Pigmentary, or Structural?

Dark Circles

Three different underlying causes. Using the wrong treatment is the most common reason dark-circle treatment fails.

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Your Concerns

What Is It?

Dark circles look the same on the surface but have three different underlying causes — vascular (visible blood vessels through thin under-eye skin), pigmentary (excess melanin), and structural (tear-trough hollows that cast shadows). Each responds to different treatments; using the wrong one is the most common reason dark-circle treatment fails. At 23MD, the under-eye area is assessed under the 4D Approach to identify the dominant driver before any plan is recommended. Allergic and lifestyle contributors are also considered.

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