Tired eyes - how do I get rid of them?

Dark circles are VERY hard to treat. Occasionally, some topical steroids with or without bleaching agents, such as hydroquinone, can help.

The cause is weak/fragile lakes of blood vessels that essentially stain the extremely thin skin of the lower eyelids. HOWEVER....

• The dark circle and the shadow lines that can exaggerate the tired look can be effectively treated with release of a ligament that holds the eyelid skin and muscle tight against the bony rim around the eye.
• This ligament known as the orbicularis retaining ligament (ORL) allows fat to essentially herniate above and below it to give the appearance of bags and a trough ("tear trough")or depression near the nose.
• Furthermore, the muscles around the eye attached to this ligament may also lose there strength and tightness so that they need to be occasionally repositioned to blend and camouflage the harsh shadows and bags related to them.

It is important that you select a surgeon that understands this anatomy and has experience with eyeld surgery. The lower eyelids are an extremely delicate area and this area is prone to complications if certain preventative measures are not taken during your eyelid procedure(s).

Dark circles, wrinkles, and bags under the eyes are typically caused by more than one factor. So, it is very important to be seen by a dermatologist for evaluation of underlying causes, which may include:

• Allergies
• Sleep deprivation
• Thyroid problems or other disease states
• Environmental exposures
• Stress
• Dietary deficiencies
• Dehydration
• Genetic factors

My approach is, to begin with, a holistic evaluation of the patient for various vitamin and mineral deficiencies, lifestyle and dietary factors, or other co-existing illnesses. If a patient has a history of allergies, we can also evaluate these with a single blood test to determine if there are environmental allergens that can be eliminated and/or treated.

Since there is often more than one cause for a “tired look,” a combination of treatments is often needed, both medical and cosmetic.

For cosmetic improvement, Botox provides wonderful results around the eyes, in order to make one look less tired and more refreshed. In addition, laser skin-tightening treatments can be used adventitiously. There are also various laser therapies for pigmentation problems and darkened areas. Lastly, prescription-based topical retinoids and/or skin brightening creams are very effective.

The main thing is not to get caught up in purchasing unnecessary, over-the-counter products or creams – these cannot compare to the prescriptive medications that your dermatologist can provide.

Under-eye puffiness and dark circles are quite a common problem especially associated with lack of sleep and dehydration. There are steps which can help this problem starting with a cooling eye mask which soothes puffiness.

Applying chilled cucumber slices can be quite calming to swollen, puffy eyes. The cool temperature and astringent effect can help to constrict the skin blood vessels and capillaries lessening puffiness and dark circles caused by dilated blood vessels.

Teas:

• Black tea bags (with caffeine) contain tannins which can be helpful for puffy eyes while the caffeine constricts dilated capillaries diminishing the dark circles.
• Green tea is also quite helpful as it contains anti-inflammatory polyphenols.
• Chamomile tea is another excellent soothing compress for puffy eyes since it contains bisabol.

Tea bags are preferable to cotton pads soaked in tea since they are far more concentrated in tannins. They should be freshly steeped for five minutes and then added to ice water for five to ten minutes to cool them down.

Raw potato slices are used by many and can provide relief to puffy eyes. Since potatoes oxidize and turn brown very quickly after being sliced and exposed to air, keep the potato slices in water right away and refrigerate them overnight.

The most common questions my patients are concerned about are their tired look, and sometimes that tired look to the patients is their upper eyelids and sometimes it can be in the lower eyelids. They often seek eyelid surgery (blepharoplasty) to reduce the under-eye puffiness and skin hooding of their eyes.

During the blepharoplasty consultation we talk about removal of primarily excess skin on the upper lids and primarily fat or bags under the lower lids. That's the blepharoplasty goal: to clean up and freshen up both the upper and lower lids.

Leaving the house without a lightweight eye cream or gel, should just never happen. By dotting a little under the eye, mid-afternoon, wonders may occur to the tired and sad looking eye.

One day, a co-worker stopped in her tracks to ask me if I had just taken a nap. Some products use ingredients that have light-reflecting elements to brighten up the eye zone.