Dark Circles and Eye Bags - Why they occur and Holistic remedies

Dark circles under the eyes are a common problem that can cause cosmetic concerns in any age group.

WHY DO THEY OCCUR?

The skin below the eyes contains fat, and proteins like collagen which act as paddings. There are also blood vessels in this area.

Aging

There is a gradual loss of fat and collagen with age. This causes the under-eye skin to become thin and loose, making the blood vessels more prominent, and the area appear dark so-called dark circles. The lower eyelids begin to sag with age, casting a dark shadow on the under-eye area. Aging also causes increased oxidative damage, less effective skin repair, and more pigment (melanin) production.

The weakening of the blood vessel walls causes them to dilate, leading to slowing down and stagnation of blood flow. This firstly increases the break-down of the blood pigment hemoglobin which leads to a more darkened appearance of blood vessels. Secondly it causes leakage of fluid into the surrounding loose area forming under-eye bags, in addition to the dark circles.

Increased Screen Time

The heat from staring at gadget screens causes dryness of the eyes and skin, and dilation of the blood vessels under the eye. This is accompanied by reduced oxygen in the under-eye blood vessels, and more stagnation of blood flow.

Blue light from gadgets especially when used increasingly post dusk, causes disturbance in the circadian rhythm (normal sleep-wake cycle of the body). This increases pigment formation, while decreasing the natural night-time skin regenerative and repair process, thereby leading to the formation of dark circles.

Lack of Sleep, Increased Stress and Fatigue

Lack of sleep and increased stress also increase oxidative damage, increase heat and blood vessel dilation and decrease blood oxygenation and flow. Sleep is an important time for efficient skin repair.

Allergies and Inflammation

Skin and eye allergies, like eczema, atopic dermatitis, and allergic rhino-conjunctivitis, lead to constant rubbing of the eyes and the surrounding area. This causes inflammation that makes the blood vessels dilate and look more prominent along with increasing the production of more skin pigment melanin, thereby darkening the under-eye area. Inflammation also makes the blood vessels leaky and the under-eye area puffy.

Other causes

Increased sun exposure increases pigment production and dark circles.

Hereditary or genetic factors, darker skin, and pigment disorders (like melasma) can also be contributory factors.

Hormonal imbalances due to menstrual problems, pregnancy or menopause, thyroid abnormalities, and iron deficiency anemia may also sometimes be causes of dark circles.

Smoking causes more oxidative damage and pigmentation, while increased alcohol consumption causes dilation of blood vessels and reduces blood oxygenation, therefore both these habits increase predisposition to dark circles.

HEALTH SOLUTIONS

LIFESTYLE MODIFICATION

1. Get adequate sleep – Ensure 8 hours of undisturbed quality sleep on most nights. Keep the bedroom cool and well darkened during sleep. (Read – How to Improve Sleep)
2. Control screen time – Reduce screen time and avoid the use of gadgets (laptops, computers, and I-pads) after dusk as much as possible. Turn on the blue light filter in mobile phones, and avoid usage around bedtime. (Read – Healthy ways to use Laptops/Computers and Mobile phones)
3. Maintain hydration – Keep yourself well hydrated at all times. Drink a glass of water at least every hour with a total of 10-12 glasses/day (2-2.5 liters).
4. Reduce smoking and alcohol consumption
5. Have a healthy and nutritious diet.
6. Get regular physical exercise preferably outdoors in fresh air for at least 30-45 minutes on most days.
7. Stress management can be beneficial.

EYECARE ROUTINES

1. Take regular breaks during gadget use. Every 20-30 minutes, look at the furthest end of the room or preferably out of the window at distant objects for 15-20 seconds.
2. Cool compress with cotton or soft cloth dipped in cold water can be placed over the closed eye and under-eye area for around 10-15 minutes, twice daily (afternoon and night). This helps to constrict the dilated blood vessels and reduce the appearance of dark circles.
3. A few simple eye exercises and massage techniques can help tighten the under-eye skin, tone muscles, and improve blood flow in the area.

• Tapping Massage – Using your index and middle finger, press lightly starting from the inner edge of your eyebrow, following the eyebrow curve till the outer edge. Then continue following the curve under the lower eyelid from outer to inner side till you reach back to the starting point of the inner edge of the brow. One cycle takes about half a minute to complete. This can be repeated 3 times and performed 3 times/day. The movements should be light pressing, without pulling or dragging.
• Eye rolling – Close your eyes and slowly roll them 5 times in the clockwise and 5 times in the anticlockwise direction. 3 sets of this exercise can be repeated 3 times/day.
• Eyebrow stretch – Place your thumb at the center of your eyebrows, then lift up the brows as much as possible, hold for 5 seconds, and release. Repeat 3 times, and do this 3 times/day.

LOCAL APPLICATION OF NATURAL SUBSTANCES

Many natural substances like vegetables, fruits, herbs, and oils are known to have beneficial effects on dark circles and under-eye bags. However scientific evidence through clinical studies is limited and most of the recommendations are based on anecdotes, individual case studies, usage experiences, and known mechanisms of action of the ingredients. Also, it is to be well understood that even when used regularly, the visible effects of these remedies take time (few to many months).

Vegetables and Fruits

Cucumber, a common sight in parlors and beauty treatment photographs, has a scientific rationale behind worth knowing. Cold sliced round cucumber pieces (refrigerated for 30 minutes) when kept over the eyes for 10-15 minutes, cause constriction of blood vessels, and make the darkness less prominent. Round cotton pads dipped in cold water can serve the same purpose, however, cucumber also contains antioxidants including vitamin C, which may help reduce pigmentation over a period of time. Chilled potato slices can also have a similar effect.

Tomato juice contains the antioxidant lycopene, as well as good amounts of vitamin C and vitamin K which help to strengthen the blood vessel wall and improve circulation. Tomato juice can be combined with lemon and orange juice to enhance the vitamin C effect. This can be applied with the help of cotton, kept on for 15-20 minutes and then washed off.

Herbs

Tea contains tannins that help to remove excess fluid and tighten the skin, along with caffeine and tannic acid, which constrict the blood vessels. Immerse black tea bags in warm water for a few minutes, and then refrigerate for a few hours. Then place them on the closed eye and under-eye area for 15-20 minutes. Rosewater kept cold, also helps to tone skin, remove puffiness, and make dark circles look less prominent.

Aloe Vera has anti-inflammatory and soothing properties and improves skin moisturization. It is part of many gels for dark circles. Turmeric can be applied as a paste (by mixing with curd), and it contains curcumin which has good anti-inflammatory and anti-oxidant properties. The same is also seen with a paste of crushed mint leaves. Parsley also has lightening effects due to the presence of vitamin C and K.

Oils

Almond, avocado, argan, or olive oils, and shea butter are part of commercial creams for dark circles, as they are rich in antioxidants like vitamin E and A, improve skin repair and provide moisturization. Glycerin is also often added for its hydrating and moisturizing properties.

Gels and Creams

Most creams and gels available over the counter or online for dark circles contain combinations of the above substances (fruits, vegetables, herbs, and oils), or their extracted components.  Arbutin, extracted from the bearberry plant has properties to lighten dark circles by reducing the synthesis of melanin skin pigment. Luteolin is an antioxidant and anti-inflammatory substance of the flavone class, which is extracted from many fruits and vegetables.

Some of these preparations also contain retinol (a milder form of retinoids which are prescription medicines), kojic acid which reduces pigmentation and inflammation as well as ‘chelates’ (removes) breakdown pigments of hemoglobin, and substances which improve skin suppleness and tightness like collagen proteins and hyaluronate. Exfoliating agents that remove the outer pigmented dead skin layer (like glycolic or lactic acid) are also added in these preparations for enhancing the skin lightening effects.

Products for dark circles are best applied at night.  If a lot of sun exposure is inevitable, it is advisable to use sunscreen (at least 30 SPF or higher, and PA++ or PA+++) on the face during the day. Mattifying concealers with sunscreens are also available for improving cosmesis during the day.

MEDICAL TREATMENT

In severe and non-responsive cases, when cosmetic disfiguring is of high concern especially in pigmentary disorders like melasma, medical treatment is recommended in consultation with a dermatologist. Investigations to rule out anemia, thyroid and other hormonal imbalances should be done.

Creams or gels containing hydroquinone, retinoids (tretinoin), and corticosteroid drugs are the medicines sometimes prescribed. It is to be noted that these are strong drugs and have to be used only under the prescription and monitoring of a qualified dermatologist, in the specific amount, frequency and duration recommended. These drugs can have side effects like skin dryness, irritation, redness, patchy pigmentation, or skin degeneration (atrophy), if used inappropriately.  These drugs are usually used as initiating therapy and tapered off while the more natural products are continued long term. Often these drugs are combined with kojic acid, or herbs/oils/natural substances mentioned above.

In case of skin thinning and loosening due to loss of fat or collagen padding (as often seen with aging), injection of dermal fillers is done in one or more sittings. These fillers may be made up of fat, collagen, hyaluronate (hyaluronic acid), and polymers like cellulose or polymethylmethacrylate (PMMA). Such cosmetic procedures are now combined with other skin tightening and wrinkle removal procedures like Botulinum (Botox) injections. Other procedures include carbon-dioxide infusion (carboxytherapy), laser treatment, chemical peels, and mesotherapy (the technique of injecting vitamins, enzymes, hormones, and plant extracts to tighten and rejuvenate skin).  All these procedures are performed by experienced cosmetologists.

Further reading –

Hyperpigmentation – Understanding Dark Patches on Skin

Not getting enough sleep can be detrimental to health: Tackling Insomnia

Laptop and Computer use – solutions to reduce adverse health impact

Sunscreens – Important Points, Types and Protection

Swollen Eyelid – Know the causes, remedies and alert signs

For any query, additional information or to discuss any case, write to info@drvarsha.com, and be assured of a response soon.

References:

Infraorbital dark circles: A review