Dark Eye Circles - SkinMiles South Africa

Dark Eye Circles

Find Out What Dark Circles Are And How To Treat Them by Dr Alek Nikolic

I get asked fairly often by my patients “How do I look less tired?” or “How do I get rid of dark circles around the eyes?” or “How do I get rid of my bags?”

I have been treating this area for over ten years and during this time I have learnt what the best treatment options are. Furthermore there is a lot of confusion with dark eye circles and specifically how to treat them and what to do about them so I thought it would be great to write an article to help guide people in the right direction. Dr Alek Nikolic

To understand how to treat the above concerns let’s take a brief look at the causes:

  1. Bags are caused by:

    • Excess skin
    • Ligament laxity
    • Accumulation of fat
  2. Dark rings or circles are caused by:

    • Pigmentation
    • Increased vasculature or visibility of fine veins
    • Tear trough: a depression created by fat loss causing the skin to fall against the bone resulting in less light reflection producing a shadow effect
    • All of some of the above
  3. A tired appearance is caused by a combination of the above list

  4. Other causes:

    • Allergies & Irritations
    • A build-up of dead skin around the eyes and eyelids
    • Sun damage

Unfortunately there are no skin care products that are currently available that can completely tackle or treat most of the causes of dark circles or bags. Products do exist that will help reduce their appearance and help with inflammation in this area but to get complete resolution and improvement other treatments may need to be considered.

Tackling Dark Circles

There are a number of treatment options for the eye area including dark circles and the ‘tired eye-bag’ look. Dr Alek Nikolic

Treatment Options:

  1. Surgery: blepharoplasty (where excess skin and the bag is removed) and dermal fillers (see below) or fat to lift the skin off the bony area may be the only option for some of us
  2. Lasers: some lasers like the V Beam Perfecta can remove both pigmentation and fine veins while other lasers such as the CO2 laser can ablate excess skin and cause some tightening and removing excess skin (expect a max 30% improvement)
  3. Dermal fillers:
    1. These can be used to lift the skin out of the tear trough allowing light to reflect and hence take away the shadow effect (dark circle)
    2. They can also be used in the eyebrow and temple area to further enhance, lift and improve excess skin of the upper lid
  4. Medication:
    1. Allergies: always consult your doctor first but anti-histamine s may be a good idea if the dark circles are caused by inflammatory or allergic conditions
  5. Topical products:
    1. Sun Screen: my preference is a sunscreen that contains zinc oxide and/or titanium dioxide; these minerals reflect UV light giving you maximum prevention
    2. Always try to wear sunglasses and a hat or cap when outdoors especially in the hot summer months
    3. Use a concealer
    4. Skin brighteners: see below
      1. If the darkness is caused by pigmentation and/or sun damage then skin brighteners such as Vitamin C and Vitamin A or Retinol may be the answer
      2. Alternatively use the Vitamin C during the day and the retinol at night giving twice the effect on this area

Product Tip:

The SKINCEUTICALS PHYSICAL EYE UV DEFENSE SPF 50 contains both mineral block and a slight concealer

  1. Combination treatments:
    1. Combining treatments always gives the best results. Some of us may get excellent results with laser, dermal filler and a vitamin C and Vitamin A or retinol topical product

Recommended Reading:

Vitamin A & Retinol: please click here

Vitamin C: please click here

Skin Brighteners



  1. Infraorbital Dark Circles: Definition, Causes, and Treatment Options. MI RYUNG ROH MD andKEE YANG CHUNG MD, PHD. Version of Record online: 15 MAY 2009. DOI: 10.1111/j.1524-4725.2009.01213.x The American Society for Dermatologic Surgery, Inc. Dermatologic Surgery Volume 35, Issue 8, pages 1163–1171, August 2009
  2. What causes dark circles under the eyes? Fernanda Magagnin Freitag MD andTania Ferreira Cestari PhD. Version of Record online: 24 AUG 2007 DOI: 10.1111/j.1473-2165.2007.00324.x Journal of Cosmetic Dermatology Volume 6, Issue 3, pages 211–215, September 2007




Dr Alek Nikolic

Dr Alek Nikolic was born in South Africa and received his MBBCh (Wits) in 1992 and in 2000 he received his MBA (UCT). He has been in private practice for 24 years and is the owner of Aesthetic Facial Enhancement, which has offices in Cape Town.

Dr Nikolic specialises in aesthetic medicine and is at the forefront of the latest developments in his field. He is very driven and has lectured extensively and has performed live demonstrations throughout South Africa and Internationally including Bangkok, Rome, Paris, Monte Carlo, Prague, and Warsaw. Dr Nikolic’s focus is on skin care, skin ingredients and cosmetic dermatology treatments such as lasers, chemical peels, Botox, and Dermal Fillers. He has performed over 20 000 procedures to date and as such is responsible for training numerous medical practitioners both in South Africa and internationally.

Dr Nikolic is one of the founding members of the South African Allergan Medical Aesthetic Academy and chaired its inaugural launch in 2012. The Allergan Academy provides essential training to keep up with the latest technology in aesthetics. Dr Nikolic holds the advisory position of Allergan Local Country Mentor in Facial Aesthetics and is the Allergan Advanced Botox and Dermal Filler Trainer. He is Vice President of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA) and is an Associate Member of the American Society of Laser Medicine and Surgery (ASLMS).

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