Doctor Nguyen Ngoc Tran, a specialist in dermatology and aesthetic dermatology at Tam Anh General Hospital TP HCM, observed Ms. Ngan's moderate dark undereye circles. Her undereye area was slightly sunken, with a mild tear trough deformity, but her skin elasticity remained good.

The primary cause was volume deficit in the undereye tissue due to aging, which made the transition area between the lower eyelid and cheek appear more hollow. When light struck this hollow area, it created a shadowing effect, making the undereye circles appear darker, even without a significant increase in skin pigmentation. Consequently, topical products typically only provide hydration or improve skin surface texture, offering limited efficacy in treating dark circles and volume loss.

The doctor injects HA to treat dark undereye circles for Ms. Ngan. *Photo: Tam Anh General Hospital*

Doctor Tran prescribed cross-linked HA injections to address the subcutaneous tissue deficit, combined with non-cross-linked HA mesotherapy micro-injections to boost hydration and enhance skin quality in the eye area. Once the eye area's structure was appropriately adjusted, the shadowing effect diminished, and the dark circles also faded.

Before treatment, Ms. Ngan was quite concerned due to the sensitive nature of the eye area and apprehension about potential pain from injections. However, the procedure only caused a mild, brief stinging sensation. After about two weeks, her dark undereye circles noticeably improved, the area beneath her eyes became brighter, and her face appeared fresher. She will need a follow-up appointment for the doctor to assess her response and consider further treatment sessions if necessary.

Ms. Ngan's skin around her eyes is significantly brighter after treatment (right). *Photo: Tam Anh General Hospital*

Dark undereye circles stem from various causes, often a combination of factors. Beyond sleep deprivation, they can be associated with hyperpigmentation, thin lower eyelid skin revealing blood vessels, volume loss in the undereye tissue due to aging, congenital orbital structure, or soft tissue laxity.

According to Doctor Tran, HA injections are not a universal solution for all cases of dark undereye circles. If hyperpigmentation is the cause, patients may require treatment with laser or topical medications. For cases related to allergies, dermatitis, systemic diseases, or chronic sleep deprivation, managing the underlying cause remains the most crucial factor.

Individuals experiencing persistent dark undereye circles that worsen or do not improve despite proper skincare and lifestyle adjustments should seek medical consultation. A specialist in dermatology and aesthetic dermatology will accurately determine the cause and select the appropriate treatment method.

Minh Huong

*Character's name has been changed