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From dark circles to puffiness and lines, even the tiniest imperfections
 around the eye area can reveal a snapshot of our overall health. Explore the wealth of eye-enhancing treatments and procedures available to give you back the gaze you deserve.

A Closer Look

All of us have tiny blood vessels known as capillaries around the eyes, which are like a web under the skin, however, these capillaries are so fine that the red blood cells ‘queue’ up to pass through; in the process some of them ‘leak’ into the surrounding area.
And it is this breaking down of these red blood cells that leave behind the ubiquitous shades of black, grey and blue.

– Dr. Anwar Al Hammadi, Consultant Dermatologist at Mediclinic City Hospital


The skin around the eyes also involves lots of movement with frowning, smiling, tugging and so it is faster to wrinkle and sag than other areas of the face. One of the first areas on the face to lose fat is the eye area. “Fat pads start to move downwards leaving us with hollows under the eyes and drooping eyelids which makes us look older.
– Dr. Luiz Toledo, Professor of Post-Graduate Aesthetic Plastic Surgery, and Consultant Plastic Surgeon

Dark Under-Eye Area

Whilst the exact cause for so-called ‘raccoon eyes’ is not well understood, usually, the commonest cause is probably related to genetics and lifestyle, therefore, 
it is not rare to see more than one family member with this similar trait.

The Science Of Dark Circles

Often, dark circles under the eyes can be indicative of allergies and diminished liver and detoxification function. This can lead to blood stasis
and can become visible under the skin 
of the eyes. Puffy, saggy and/or baggy eyes can also signal deep and underlying inflammatory problems. Dark circles, are known 
in medicine as Idiopathic Cutaneous Hyperchromia at the Orbital Region (ICHOR). This is a skin hyperpigmentation characterised by bilateral darkening of the eyelid and orbital skin that contrasts with the adjoining facial skin. While many believe that lack of sleep or hours in front of digital screens may cause this, it is genetics that are crucial. Pigmentation problems often run in families, especially among Africans and Asians, due to extra melanin in the skin. Allergies and nasal/sinus congestion can lead to the appearance
of dark circles under the eyes. The darkness is more visible due to an increase in melanin deposits as well as an increase in haemoglobin in the tissue. The haemoglobin deposits are caused by blood stasis from lack of circulation in the local region and the entire process of ICHOR is mediated by inflammation.
– Dr. Nasim Ashraf, MD founder and CEO of DNA Health Corp USA (in the UAE)

Tip Of The Iceberg

ICHOR can be just the tip of the iceberg, as an expression of deeper underlying pathologies mediated by systemic and/or local inflammation and/or even hormonal imbalances. Kidney disease, liver disease, thyroid disease or
a state of chronic inflammation must be ruled out in individuals with ICHOR. In lieu of this, three genetic markers are helpful to know if one is more prone
 to ICHOR and include the inflammatory genes, the genes involved with platelet aggregation (sticky blood), and the detoxification genes.

A Femiclinic Patient Shares Her Journey Of Ageing Problems In The Intimate Areas

Inflammation And Our Eyes 

While inflammation is the culprit of many diseases, the eyes can also suffer. Diet is crucial in the appearance of our skin and integrity of the blood vessels in our body.

When we have too much inflammation and not enough antioxidant protection, our skin and vessels are the first to suffer the consequences. Therefore foods rich in antioxidants such
as fruits and vegetables can make a big difference. The top three super foods rich in vitamins and antioxidants are acai and blue berries, red or purple grapes and Omega 3 rich foods such as walnuts or salmon.
– Dr. Nasim Ashraf, MD founder and CEO of DNA Health Corp USA (in the UAE)


Puffiness and eye bags can sometimes be addressed by kidney support and a detox with diuretic foods such as asparagus, strawberries, cucumber and salads with plenty of herbs; with the most beneficial being estragon
 and rosemary. Soups are great to flush
 the urinary tract, like carrot, parsnip or asparagus soup with parsley. Great kidney supporting teas are mate tea, birch leaves, nettle, rosemary, horsetail and golden rod. Also be sure to stay hydrated with plenty of good quality drinking water, preferably from glass bottles rather than plastic.


Even pregnancy, thyroid imbalance and food allergies could lead to hormonal causes contributing to puffiness and dark circles under the eyes. Low testosterone and low oestrogen levels can give the unwanted appearance of dark shadows, and since our skin is particularly sensitive to oestrogen levels, a deficiency of this hormone can lead to thinning skin – and the already delicate skin under the eyes is the most susceptible. Unfortunately, as the skin becomes thinner, the veins beneath become more visible. This occurs in the peri-menopausal period.

The Treatments


Patients in their twenties or thirties might improve their inherited traits that can make them look older or tired. If only the upper eyelids are affected there is no need to operate on the lower eyelids, and vice versa. If excess skin is the problem, it might not be necessary to remove fat. Usually, however, with a patient in their forties of fifties, there is the need to correct the drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle, and sometimes a forehead lift is recommended if the upper eyelid condition is accompanied by sagging of the eyebrows.
– Dr. Luiz Toledo, Professor of Post-Graduate Aesthetic Plastic Surgery, and Consultant Plastic Surgeon

In the upper eyelid, the incision is hidden within
 the natural fold, and extends to the outside corner of the eye. Excess skin and fat are removed while the incision is performed with a laser and there is no bleeding. The lower eyelid fat pockets are removed through an incision placed inside the lower eyelid, and there is no need for stitches. If there is a need to remove excess skin and muscle, then another incision is hidden just below the lower lashes, easily camouflaged by the natural creases, then subsequently laser may be used to tighten the lower eyelid skin.

Hematoma, infection and reactions to anaesthesia, temporary blurred or double vision.

Bruising and swelling may take several weeks to disappear, but usually
 with makeup or dark glasses, the aspect is almost normal. Most return back to work about 7 to 10 days post-op. Results are often permanent.

Brow Lifting Using the ThreadLift

This procedure, comments Dr. Ahli, is performed under local anaesthesia, is designed to elevate, reposition, and lift lax skin of the brow, face and neck without surgery, but has now become less invasive and risky with less downtime.

The ThreadLift works by having tiny threads inserted painlessly under the skin. These fine threads are similar to those that would be used to support the deep structures
 of your face if you were to receive a real surgical face lift, and using local anaesthetic, the threads are passed into the droopy brows element with a special guide needle. The threads are then able to grab on to the soft-tissue and muscle of the desired area.

The ThreadLift is done without general anaesthesia, a knife, scars or significant recovery downtime. Most patients experience minimal bruising or swelling for between one to seven days.

The ThreadLift shows immediate effects. Patients can achieve 30 to 70 percent of what an invasive face lift may achieve and well over 90 percent of ThreadLift patients report very satisfying lift results. The ThreadLift lasts three to five years and may be repeated.

Non-Surgical: Tear Trough Filling Using Fillers or Fat Injection

For hollows under the eyes, Dr. Toledo explains that dermal fillers and/or fat transfers can do wonders and help restore a more natural and rested look. For fat transfer, the procedure begins with local anaesthetic injected into the belly and after 10 minutes, a liposuction cannula is used to harvest a small amount of fat which takes another 10 to 15 minutes. While the fat is being prepared, the face is anesthetised, then this ‘good’ fat is injected to the eye region just over the bony shelve under the eyes to add volume. This is a very safe and well-tolerated procedure, however some of the transferred fat does get reabsorbed.

Collagen Induction Therapy 

collagen induction

Margaret Lorimer, Founder and Managing Director of Lesprit Medical Clinic explains that Collagen Induction Therapy commonly known as derma-rolling is a cosmetic treatment, which encourages the production of collagen resulting in improved skin texture, softer lines and wrinkles unveiling firmer skin. There are different types of derma-rollers available for different kinds of indications.

After prepping the eye area, a small handheld rolling device covered with lots of tiny, closely spaced needles is used to cover the eye contour area in a rolling and stamping motion increasing the absorption of topically applied skincare. The treatment has two major benefits; one is that collagen production is stimulated, and secondly, at the same time, a clear channel is provided for topical skincare to be absorbed more effectively through the top layer of skin.

Number of sessions
A course of three treatments is recommended, with a session every two weeks, followed by a maintenance session every two to three months for rejuvenation.

The final results are an overall improvement of fine lines and wrinkles, improve the texture of the skin, increasing the absorption of topically applied skincare for dark circles and skin rejuvenation.

Pixel Eyelift 

The Pixel Eyelift is a superb technique using the latest fractional laser resurfacing technology enabled by a fractional ablative laser, which is safe and effective with minimal downtime or side effects.

A numbing cream for anesthetic purposes is applied to the eyelids. By targeting small areas from a small roller-like device that is passed over the eye area, the laser beam is broken
into microscopic columns of laser light. When the beams strike, they leave normal surrounding skin areas intact so the outcome is quick healing, and these columns of laser light remove old, damaged collagen and elastic fibres so that new fresh tissue can grow into these channels. Ideal for dark areas and wrinkles, loose upper and lower eyelid skin, this non-invasive procedure helps with drooping eyebrows too.

Number of sessions
Depending on the degree of damage to the skin and the results required, a treatment programme is recommended according to the client’s needs; most require three to five treatments, spaced three to six weeks apart.

Immediately post treatment, 
the eye area is somewhat red and
 puffy, which may last for several days. Then an improvement in skin tone 
and texture is seen once the redness fades – even after one treatment – as the laser kick-starts collagen production. A progressive improvement in the texture and smoothness of the skin emerges over several months.

Plasma Rich Platelet (PRP Treatment) 


PRP therapy uses ‘platelet-rich plasma’ – your own platelets and plasma taken from a small sample of your blood – to stimulate collagen and improve the skin’s texture and elasticity.

When PRP is placed back into the skin by injection or micro-needling, it initiates a localised stem cell response and increases the blood circulation. This is great for thin crepey skin, especially around the eyes and the treatment can be done every three months to minimise the lines, dark circle as well as tightening toning skin.
– Dr. Hossein Yavari, Specialist Dermatologist at CosmeSurge, Dubai and Abu Dhabi

Nutritional Deficiencies 

Deficiencies in iron and vitamin C are the most common causes of dark circles as vitamin C is an antioxidant that protects skin cells from damage, supports collagen production and keeps them in good health; it also helps the body absorb iron from food. Therefore, low iron levels results in poor oxygenation in the body tissues due to low supply of oxygenated blood. A vitamin K deficiency not only impairs the formation of blood clots but also causes you to become more susceptible
to bruising when capillaries break. It also strengthens the walls of your capillaries, preventing them from leaking blood. Another common nutrient culprit is over excessive intake of sodium found in most fast foods; extra-large intakes of salt contribute to the retention of fluids near the eye area and cause a dark tint.

On a lighter note, check out what celebs do to get rid
of their puffy eyes

Excessive Redness 

red eyes

Capillaries distend when the area is lacking in nutrition; they expand to try to take in more nutrients whether they are present
 or not. This can be linked to an overworked cardiovascular system due to excessive consumption of unhealthy foods and sugary drinks or alcohol.

Yellowed Eyes

yellow eyes

A yellowish tone in the eye area is directly related to an over-functioning liver and gallbladder. Excessive dairy consumption can be the culprit of this discoloration.

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Lisa is an Anglo-Italian writer, editor and New Media entrepreneur who founded the global business network and publishing company, (GVPedia.com) in 2004. Previously she worked as a development writer for the Bay of Bengal Project, a UN Food & Agriculture Organisation (FAO) project based in Chennai, India. After moving to the Middle East in 2001, Lisa was editor of several consumer magazines in the region such as Aquarius, Jumeirah Beach Magazine and Property World Middle East. She was the editor-in-chief of NewYou, the region’s premier monthly publication dedicated to Integrative Health, Medical Aesthetics, Holistic Healing and optimal longevity and is now heading wellnessworld.blog. a portal dedicated to similar topics. Lisa has spent over 20 years living in emerging economies and has published over 30 books within the ‘Best of...’ annual series of publications across five continents.