If eye creams and sleep haven't done the trick to fix your dark circles, there may be a deeper issue going on. Dark circles are caused by a variety of issues, and there are treatments that your dermatologist can offer that go beyond what's available on the drugstore shelf. If you have persistent dark circles and are ready to explore new treatments, here are a few you should know.

Dark Circle Treatment: Replace Volume

"For dark circles, I recommend a multi-modality treatment," says Dr. David Shafer, MD, FACS, a NYC-based plastic surgeon. "From the inside, you want to replace the volume that you lose with aging," Dr. Shafer explains. If you notice a hollow-looking "trough" underneath your eyes, you've probably had some volume loss, and that's what's causing a dark, sunken appearance.

The solution? "We can use fillers for that," Dr. Shafer says. A hyaluronic acid filler, such as Juvéderm or Restylane, will be able to fill in the area so that it becomes even with the surrounding areas of skin again.

Dark Circle Treatment: Plump-Up Skin

Another issue that creates the look of dark circles is thinning under-eye skin. "When the skin becomes thin, then you can start to see the blood vessels and other skin elements under there that are darker purple," Dr. Shafer says. This is often a normal part of aging, but some people may experience this sooner in life, or find that the blue tones are more pronounced.

If so, "Fillers injected superficially can help cover that up," says Dr. Shafer. If you go the injectable route, don't be scared of treating the eye area — those needles won't go near your actual eye! That being said, "It's very important that you have an experienced injector," Dr. Shafer cautions. "You want to have somebody who's board-certified and using an FDA-approved filler."

Dark Circle Treatment: Skin-Refining Lasers

If your dark circles aren't caused by hollow under-eye areas or thin skin, you may simply need to correct the tone and texture of your skin. "Laser and chemical peels can help with that," Dr. Shafer says. "If the darkness is from vasculature, then the VBeam Perfecta laser is very good. If the darkness is from pigmentation on the skin, then the Pico Way laser is very good."

Find an experienced MD who specializes in laser treatments, and make sure she or he does a consultation to fully explain which laser will be used and why.

Whether or not you choose to try any of the above treatments, concealer is always an option. Dab it onto any dark under-eye areas with your ring finger, then lightly tap into skin to blend in the edges.

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