The Causes of Undereye Puffiness and Dark Circles

Author: Dr. Bobby Buka

The under-eye is THE most common area of the face that I get asked about in my practice! It seems to be everyone’s least favorite part of the aging face. In order to improve under-eye puffiness and darkness, we must first look at what creates this unwanted look.

First the puffiness. Our dermis ranges in thickness from 0.3-4mm, a tremendous variation that accounts for the resiliency of our skin in certain areas and relative fragility in others. The backs of the hands and infraorbital (undereye) skin are both areas where the skin is exceptionally thin. It is no coincidence that these are the first areas we can appreciate early signs of aging and chronic ultraviolet exposure. These areas are constantly exposed to environmental radiation that leads to the breakdown of dermal components, such as elastin and collagen fibrils. With weakened elastin, the dermis begins to sag, unable to fight the force of gravity tugging at the upper face. A metaphor I often use with my patients is to imagine a sail without a mast that billows, flaps, and sags in the wind.

Next the dark circles. This one is actually very easy to explain. As the infraorbital skin begins to weaken from the loss of elastin and collagen, it thins even further. The dermis under the eyelid, once only 0.3mm in thickness now drops further to 0.1-0.2mm! The result is near-transparency of the skin, like looking through a sheet of wax paper. So what’s behind the dermis that gives that darkened appearance? Blood! Its dark and not bright red because it’s venous blood and when viewed through paper thin skin, takes on a nearly blue appearance.

What to do:

1) Avoid the further breakdown of elastin and collagen within the dermis by using a broad spectrum sunscreen every day.

2) Hydrate the infraorbital skin to help thicken the dermis so you cannot see through it. The only difference between a raisin and a grape is….water! Plump up that dermis!

3) Prevent UV induced free radical damage by selecting an under-eye product chock-full of anti-oxidants. Also look for a product that can help mask bluish discoloration by constricting blood vessels (i.e. caffeine) in the infraorbital area.

4) Sleep and general health. We all know it to be true, but scientists haven’t quite figured out why just yet. Theories include the collection of lymphatic fluid in this area that cannot fully drain without rest as well as the dependent gravity effects of an extended night without rest.