Why do I see a lot of this in my practice, and typically, it's more common in people of Mediterranean descent, Greek people, Spanish, Latin and that type of thing. For one reason or another, they're just genetically predetermined to form dark bags. What's causing it? Well, it can be just excess pigments or it's blood vessels in the eyelids. The eyelid skin is so thin that you're seeing what is immediately below the skin.
It can also be related to allergies and nasal congestion. So, simple things you can do, you can put ice on the eyes, you can restrict salt, you can get an ointment, which is a fade cream, hydroquinone ointment may help. But then otherwise, we may have to do more invasive procedures. A light peel, typically, I like to use, TCA peel for that, or a light laser treatment with a specific type of laser.
Actually, bags on the eyes can accentuate darkness, so actually doing lower eyelid surgery can help that. I have a picture to show you of a case, that actually, it was a combination of some staining, but with bags as well. So in this particular case, I removed the bags around the eyes, and then did a light peel on top of that and got a nice result. But it is a tough and frustrating problem.
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