Hollow or structural under-eye dark circles: what solutions exist?

The structural dark circles, or hollow dark circles, are identified by the appearance of a pronounced shadow beneath the eyes. The facial bone structure accentuates the hollow, making the orbital contours especially visible. Genetically determined, this type of hollow dark circle may also result from significant weight loss. Ageing can also contribute, as it tends to thin the facial fat pads. It is important to note that hollow dark circles are the most challenging to treat.

The injections of hyaluronic acid are currently the preferred method for eliminating structural dark circles.

This technique restores volume to the peri-orbital region, thereby filling the hollow. However, the results are temporary, lasting between 12 and 18 months. Several studies have demonstrated the benefit of hyaluronic acid injections in reducing the visibility of structural dark circles, including one conducted by SPADA on 32 women presenting this type of tear trough. After the hyaluronic acid injection, they were followed up for one year. Dermatological assessments demonstrated the achievement of a natural result that was maintained throughout the 365-day observation period, although this outcome was not quantified. The procedure was well tolerated; only one participant required a hyaluronidase injection to neutralise the hyaluronic acid due to overcorrection.

For a permanent correction of structural tear-trough hollows, it is necessary to opt for lipostructure, also known as lipofilling, a procedure involving the injection of fat cells harvested from other parts of the body into the eye-contour area.

The objective is to reconstitute the fatty pad of the under-eye hollow. Although highly effective, it is important to note that lipostructure is an invasive technique, performed under general anaesthesia and requiring hospitalisation, unlike hyaluronic acid injections which can be performed directly in a clinic. Nevertheless, when carried out by an experienced surgeon, this procedure carries relatively low risk. Only a slight asymmetry of the result may occasionally be observed, which can be corrected with a touch-up lipostructure.

Make-up will not plump up hollow under-eye circles, nor will a caffeine treatment. Instead, pay particular attention to hydrating this area with the eye-contour cream, which is highly concentrated in coenzyme Q10. Also known as ubiquinone, this coenzyme, naturally present in the body, helps stimulate cell regeneration and prevents collagen breakdown and loss of skin elasticity. The coenzyme Q10 will thus revitalise the eye area and help prevent the formation of early fine lines. This product also contains Barbary fig seed oil, an ingredient with tightening and firming effects that also offers antioxidant benefits.

• BERTHEUIL N. & al. Eyelid fat grafting: Indications, operative technique and complications; a systematic review. Journal of Cranio-Maxillofacial Surgery (2016).

• LIU C. & al. Autologous fine particles fat filling under direct vision in the repair of sunken upper eyelid after double eyelid surgery. Aesthetic Plastic Surgery (2022).

• SPADA J. Treating sunken upper eyelid with hyaluronic acid: Recommendations and results. Journal of Drugs in Dermatology (2022).

• YI K.-H. & al. Anatomical-based filler injection diagnosis to treatment techniques: Infraorbital groove and hollowness. Life (2025).