Dark circles can be caused by hollowness under the eyes that produce a shadow. This area, called a tear trough, can be corrected with an injectable filler, like Restylane, implemented by an experienced injector. Puffy fat pockets in the lower lid also cause under eye circles. Lower lid surgery (blepharoplasty) can remedy this cause.
A patient may also have hyperpigmentation of the actual skin under the eye causing it to appear darker. A prescription lightening agent can improve this hyperpigmentation. Another cause of dark under eye circles is thin, translucent skin that shows the blood vessels beneath. There are not many remedies for translucent skin, but hopefully I helped with my other suggestions!
Written by Dr. Halaas