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Millions of people have dark circles under eyes. Most have inherited the color and characteristics of their lower eyelid from their parents. Dark circles under eyes often appear during childhood, many people telling me they first noticed their dark circles when they were 9 or 10 years old.
There are many causes of dark circles under eyes, but in this article I am going to focus on broken blood vessels, small vascular (blood vessel) structures in the lower eyelid skin. Broken blood vessels are the easiest cause of dark circles under eyes to treat and correct.
How Broken Blood Vessels Cause Dark Circles under Eyes?
Actually what most people call broken blood vessels are not really broken blood vessels. What most people see are visible blood vessels (vascular structures) on the skin in areas that they do not expect to see blood vessels. These small vessels are arterioles, venules, and capillaries. Arterioles carry fresh blood to the skin and venules take old blood away from the skin, back to the heart and lungs to be refreshed with oxygen. Capillaries connect the arterioles and venules.
Normally blood vessels are deeper in the skin and not visible. Visible or broken blood vessels become noticeable in the following situations:
o Thin Skin- The eyelid skin is the thinnest skin in the body. The eyelid skin is only 1/6 the thickness of the skin on the rest of the face. The skin is so thin that you can see through it. You can actually see the small arterioles and venules in the skin of the eyelid. These same structures are present in all skin but are not visible in thicker skin elsewhere in the body. The lower eyelid muscle is purple, and this color is visible through the eyelid skin. That is why all lower eyelids have a darker color. This color is what most people refer to as dark circles under eyes.
o Telangiectasias or Spider Veins- The arterioles, venules and capillaries in dark circles under the eyes can be dilated or enlarged a condition called telangiectasia or often referred to as spider veins. Telangiectasias are most often caused by heredity. However, aging, pregnancy, use of topical steroid cream, excessive exertion such as weight lifting, and Rosacea also can cause telangiectasia.
o Aging and Inflammation- Ultraviolet radiation and other skin aging factors produce inflammation or irritation of the skin, especially the thin skin around the eyes. When eyelid skin is inflamed, new arterioles, venules and capillaries vessels grow into the skin to repair the damage. These new structures stay in the skin and are visible. The presence of these vascular structures darkens the color of the lower eyelid skin and can appear as dark circles under eyes.
How to Remove Dark Circles under Eyes Caused by Broken Blood Vessels
Lasers can remove Telangiectasias, and small vascular structures under the eyes, but newer light based treatments are safer and better. The newer technique called Intense Pulsed Light (IPL) or photo facial is a much gentler procedure that is very effective and does not leave marks or white areas under the eye, a major problem with older laser techniques.
o IPL- Photo Facial-Intense pulsed light (IPL) is not a laser. IPL uses a bright flash of visible light which is tuned to be absorbed by the specific color of blood. The light passes through the skin without injuring the skin and is preferentially absorbed by the blood in the small Telangiectasias, venules, arterioles and capillaries. The light energy causes the blood to boil and the heat causes the wall of the structure to shrink and close. The process takes about 6 weeks.
Usually 3 IPL treatments scheduled 6 weeks apart are required to lighten the color of the skin causing the dark circle under the eye. Eye shields must be placed on the eye to protect the eye from the light. IPL is the best treatment for Rosacea.
o Laser- Two laser wavelengths are specifically absorbed by blood -the 532nm and 1064nm laser wavelengths. The 1064nm laser is usually too strong to be used on the eyelids. The 532nm laser is the one more commonly used on the lower eyelids. However, because the laser is so strong, the eyelid skin is often damaged and a scar or white area on the eyelid skin can occur.
Since IPL has been developed, the laser is no longer the choice for treating the eyelids. Eye shields must be placed on the eye to protect the eye from the laser.
o Vein Injections- Very large and noticeable veins on the lower eyelid can be closed by injecting a sclerosing solution that is most commonly used on the lower legs to treat spider veins. This is a very tricky procedure and should only be done by an expert experienced in this technique.
o Fractional laser resurfacing to thicken skin- New fractional laser resurfacing techniques are safe to use on the eyelids with eye protective shields in place. These new fractional laser techniques plump or thicken the lower eyelid skin and lighten the color. Thicker lower eyelid skin helps camouflage the vessels and Telangiectasias.
Prevention
Inherited eyelid skin color cannot be prevented. However there are things we can do to prevent new telangiectasia and vascular structures from forming and making the skin color darker. Since Ultraviolet radiation from the sun causes inflammation and new vascular growth, sun protection is the most important.
o Sun block- Always make sure that you apply sun block to the eyelids when you apply sun block to your face.
o Eye protection-Always wear protective sunglasses that cover the crow's feet areas as well as the eyes.
o Anti-inflammatory-Medical grade topical Vitamin C Serum is a powerful anti-inflammatory medication. Its use on the face and eyelids can help reduce inflammation which can cause telangiectasia and new vascular growth on the facial and eyelid skin.
If you are not happy with the color of your lower eyelids, IPL may be the answer you are looking for.
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Source by Brooke R. Seckel, M.D., FACS
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