Oftentimes, we see our appearance older than what our actual age is. This often cause us to feel insecure with our physical looks.Mind you that, skin ageing is common and you are not alone. According to experts, People, especially Asians, has seen dark undereyes as the leading signs of ageing.
Why Dark Undereyes is Common?
The area around the eye is the first part of the face to show ageing. This is largely due to the thin skin around the area, as well as the complex anatomy and dynamics of its structural bone, ligamental and fatty support. Ageing brings about thinning skin, volumetric loss in bony and certain fat compartments, resulting in a myriad of things that produces what we see – a tired, drooping and darkened peri-orbital area.
What Are The Best Treatment For Dark Undereyes?
To select the best treatment for the undereye area, we first have to understand what our main issue is. These are usually one of the few, but usually a combination of:
i) Increased pigmentation along the skin around the eye
ii) Thinning of the undereye skin with visible muscle hue
iii) Volume loss with increasing hollowness under the eye
iv) New bulging from eye bag fat herniation
v) Skin wrinklingWhile each shall be described individually, the likely scenario is a combination of the above, and optimal treatment revolves around selecting treatments that would have the most outcome for the problems at hand.
Treatments today
Before diving into that, however, let’s look at the treatments available, and the proposed mechanism through which each helps.
Lasers
Lasers are a broad category of tools, and depending on the type of laser, the target and hence outcomes are different.Pigment lasers, such as the Fotona Starwalker MaQX (Nanosecond or picosecond lasers) help by selectively breaking down excess pigmentation. Done over several sessions, larger pigments are shattered and removed by the skin, leaving behind a fairer, less dusky appearance.
This helps more predictably with superficial pigments, while deeper pigments tend to have a slightly more protracted course and requires a more patient approach.
Ablative lasers, such as the carbon dioxide eCO2 laser or erbium lasers, help by tightening skin and stimulating collagen production over time. These are perfect and the gold standard for scars as well as superficial wrinkling, but do bear in mind that results are typically seen after several months and sessions as collagen is remodelled.Long pulse lasers are sort of an in-between – they can help with tightening of skin with the benefits of minimal or no downtime, but results are slow to show and more sessions are required to achieve appreciable tightening of the skin.
Microneedle Radiofrequency
Device such as the Morpheus 8 are what we call fractional radiofrequency (RF) devices – RF is delivered via small needles and heat is generated in, or deep to, the skin. This produces an intense stimulation that causes immediate tightening as well as a protracted remodelling effect that continues to improve textural issues in the skin.rf microneedling in singapore is one of the most common anti-ageing procedures, best suitably to treat dark underyes.
Fillers
Fillers are a broad group of injectable tools that help to volumise, structure, define and hydrate the skin. They consist of various materials and properties (viscosity, rigidity, elasticity, so on) and are chosen based on their indication for use.
The undereye requires a softer, easier-to-blend hyaluronic acid type filler. Used at the undereye, this minimally-invasive technique helps to volumise deep tear troughs as well as blend any contours from bulging. Some, like Redensity II, help nourish the skin with a cocktail of vitamins and essential amino acids!
Rejuran
Rejuran is essentially a purified DNA cocktail that is salmon-derived. These polydoxyribonucleotides molecules provide the building blocks for regeneration, while also stimulating the process when injected. This essentially helps with skin quality, producing a thicker and more structurally capable dermis.
Ultherapy
The most precise and efficacious high intensity microfocused ultrasound (HIFU) modality in the market, Ultherapy works similarly to fractional radiofrequency devices in that it generates heat at specific depths of the skin to tighten and start a prolonged stimulatory effect, except it is non-invasive and has minimal to no downtime.
These generally cover all the effective tools in the market… so how do we now decide what helps best?
Undereye types and Treatments Best Suited
1. Increased pigmentation (hyperpigmentation) around the eye
Pigmentation collections around the undereye can produce a darkened appearance, creating the typical panda-like eyes. This typically results from age and UV-related damage accumulated over the years.
The best option for this would be to remove the excess
pigment, and is typically where lasers come in.
These include the use of lasers such as the Starwalker, and sometimes chemical peels in combination.
Maintenance with skincare and sunscreen are essential.
2. Thin undereye skin
The undereye skin is the thinnest in the whole body! Coupled with
the fact that there is virtually no fat under the skin, the muscle
just beneath it easily shows through as a dark-purple hue.
This is commonly found even in young individuals, but worsens
with age as the skin continues to thin and lose its supporting
framework.
Options for this include devices that stimulate collagen
remodelling, such as ablative CO2 lasers, or injections with
stimulatory products such as Rejuran.
Good placement of hyaluronic acid fillers can also help reduce muscle hue by influencing reflectance and refraction of light off the skin.
3. Volume loss with visible troughs
Another common issue both in the young and worsening with age is that of prominent tear-trough ‘deformities’. These can be a trait from young, and are indeed normal, or can develop with age as volume is lost around the eye.
Whichever it is, the shadowing created by the hollowing creates an aged and unrested appearance, and management with hyaluronic acid fillers produces an immediate and lasting result!
The undereye, however, is a tricky and delicate area, and placement must be done slowly and well to avoid complications such as visible product or bulges.
4. Eye-bag show
As bony and deep tissue support for the eye wanes, fat supporting the eyeball bulges against a weakened septum and shows as a typical eye-bag.
This too, can be genetic, and can be present from young in some, while others get it as they age.
Individuals with this issue can benefit from blending of the undereye and cheek with fillers, though best candidates are those who have mild to moderate bulging. Patients who have severe forms of eye-bag herniation, such as in this case above, will benefit most from surgical reduction of the fat.
5. Skin wrinkling
Using the same example above, the skin can be seen to be visibly wrinkled and thin. This is the inevitable result of age and sun exposure and creates a crepey appearance, accentuating the shadowing and darkness of the undereye.
This issue is best ironed out with energy-based devices that stimulate and tighten, including lasers, Morpheus 8 fractional radiofrequency, and Ultherapy.
Regular maintenance is typically required every few months, and sun protection is particularly important.
So then, is a one modality treatment realistic a promise?
As can be seen in the pictures above, most individuals will have a combination of the above.
While in an ideal world we would dish out all the modalities to get the best outcome, my aim most of the time is to help patients prioritise the deficit which is causing them the most concern, then managing that first. Understanding the dynamics of the peri-orbital area and the effects of each treatment is the first step to a good outcome.
This invariably maximises one’s satisfaction while saving money in the process.
Expectations should, however, be thoroughly discussed, as a few patients may benefit minimally from non-invasive procedures and inevitably require a surgical approach.If you feel you need a discussion on your issue at hand and would like to know what might help you best, feel free to drop us a text at +65 88796688!