The term ¡®dark circles¡¯ points to the darkness around the eyes and it is also called ¡®fatigue eyes¡¯ in the U.S and Europe because the dark circles under your eyes make you look tired and rundown. They can even make you look depressed or old which is why people with active lifestyles are bothered by this problem.
There are many causes of dark circles as listed below and oftentimes they are combined:

1. Red capillaries and dark blue veins underneath the skin are visible
2. Excess fat gathers under the lower lid and dark circles form under the bulge
3. The skin under the eyes is darker in color than skin elsewhere
(due to hyperpigmentation following atopic dermatitis, hereditary factors, unknown causes, etc.)
4. Dense pigments from fine lines under the lower lid
Dark circles must be treated according to causes and if there are multiple causes, need the treatments.
1. When red capillaries and dark blue veins underneath the skin are visible
Long pulse dye laser selectively removes blood vessels that have stretched unnecessarily. V-beam laser is typically used and V-star laser and Coolglide laser may be used on occasions.
Three or more treatments are needed to obtain the desired result at monthly intervals and partial swelling, erythema or bruising is possible following the laser treatment which will fade 2~7 days post-operatively. The procedure will not damage the skin surface, unless there are complications, you can wash your face and wear makeup right away after treatment.
2. Excess fat gathers under the lower lid and dark circles form under these puffy bags
Ultrapulse carbon dioxide laser is used to incise the conjunctiva and fat is taken from the lower eyelid. There is no need to close incisions with sutures and people cannot tell you¡¯ve had surgery unless you tell them. The average time for eyelid procedure is 20~30 minutes and there is no need to be hospitalized as local anesthesia is administered. Swelling and slight bruising can last up to 1~2 weeks. You should avoid alcohol and stay away from swimming in the week after the procedure. Light exercise is O.K.
3. When the skin under the lower lid has more pigmentation
If hyperpigmentation is the reason behind dark lower lids, whitening care is recommended. Vital iont and Ionzyme treatment (using Vitamin C) or Oxy-jet (oxygen) treatment is used once or twice weekly for over three months, but it may take longer for some cases for full results. Continuous application of whitening cream or Vitamin C products will improve results.
4. Dense pigments from fine lines under the lower lid
There are two techniques to eliminate fine lines under the lower lid: one is using laser and the other is wrinkle care.
For laser treatment, upgraded V-beam laser, Cool touch laser and Vantage laser are used 3~5 times every one or two months. You can go back to your regular activity right after these laser treatments.
For wrinkle care, Oxy-jet care and Skin master can be concentrated on the lower lid. A series of treatments are needed for 2~3 months at 1~2 week intervals. Anti-wrinkle products can be used in conjunction to improve results.
The lump of fat right below the eyeballs normally act as a cushion to support the eyeballs and the taut membrane surrounding this fatty tissue makes sure the fat does not jut out under the lower lid. Puffy bags below the eye are the result of the fasciae slacking and the fat pushing out under the weight of eyeballs. This lower eye lid atony is a cause of wrinkles and dark circles around the eyes and it can make people look sluggish and tired and even malicious and stubborn.
There is no clear explanation for fat accumulation below the eye, but heredity and aging play a part. In most cases, puffy bags become large and visible when you are tired and go away when you are in better shape and this process is reiterated until the skin loses its elasticity and fat remains under the eye.
In the past, surgical operations were performed to make an incision just below the lower lid lashes, remove the excess fat and to close incisions with fine sutures. However, incisions showed and there was a high rate of complications. State-of-the-art lasers have made treatment easy and they are used to incise the conjunctiva and remove fat below the eye without leaving any scars.
The conjunctiva inside the eyelid is locally anesthetized by gently pulling on the lower lashes, incision is made with the laser, and adequate amount of fat is removed. Laser eyelid surgery is a very quick procedure lasting only 20~30 minutes.
1. Since there are no incisions or sutures, there are no scars or complications such as ectropion.
2. The procedure is simple and has less bleeding which means a short healing period and going back to your social life immediately.
3. The amount of fat to be removed can be controlled during the surgery by looking at both eyes of the patient.

* When you have droopy and sagging lower lids, the existing method of incising the lower lid is better.

Washing your face and wearing makeup is possible from the day after the procedure and you can go back to regular activity. You should stay away from drinking alcohol, swimming, wearing contact lenses and excessive sports during the first week. You must be careful not to rub or bump your eyes. Occasionally, bruising can last for a couple of days.