Priorities
Under-eye hollows
Shadows, hollows, and dark circles under the eyes, with treatment based on what's causing them.
Under-eye hollows cast a shadow that can make you look tired even when you’re well rested. The skin in this area is thin, so concealer often creases into fine lines rather than covering the darkness.
“Dark circles” are really three different problems sharing a name: a hollow, a pigment, or a bag. Each needs a different treatment, and one of them isn’t something we treat, so identifying the cause comes first.
What we'd want you to know
Pigment, hollows, and puffiness each need their own approach
If the skin is thin and crepey and the shadow is a shallow groove, we’d start with PRP injections under the eyes: three sessions, four to six weeks apart, placed with a cannula by our nurse practitioners. It uses your own blood rather than filler, and we’ll review results at three months. We can also discuss PRF at your consult.
If the darkness is more about texture and dullness than a groove, microneedling with PRP under the eyes with our medical esthetician works on the surface. There’s no heat involved, so it’s the safer route for darker skin.
Finding the cause of under-eye shadows
In window light, we’ll do three quick tests. First, we’ll press your cheek up: if the shadow lifts, it’s a hollow. Next, we’ll stretch the skin sideways: if the color stays, it’s pigment. Then you’ll look up while we watch your lower lid: if a pouch moves, it’s fat.
For a hollow with thin skin, we suggest PRP or PRF injections. The evidence is still early. A 2025 review of 96 papers found only a few studies compared PRP with PRF, all favoring PRF, in small samples, and its senior author founded a PRF company, per Periodontology 2000. That’s why we plan it as a series, followed by maintenance every 6 to 12 months. Individual results vary.
For pigment and texture, we’ll suggest microneedling with PRP plus daily sunscreen. A deep hollow with good skin may be a candidate for filler. Galderma reports 93 percent of Restylane Eyelight patients with improved hollows at 18 months, per Restylane. It’s the slowest and most careful injection we do on the face.
A bag is orbital fat. A systematic review of under-eye treatments concluded surgery is the answer when laxity is the cause, per Dermatologic Surgery. In that case, we’ll recommend seeing a surgeon.
Your questions, answered
What does the under-eye area look like the next day?
Expect puffiness on day 1, and possibly a bruise on days 1 to 3 that fades to yellow by day 7. Sunglasses help cover it. If you have something important coming up, book your session at least a week before.
PRP or PRF, which one do you use?
The Lincoln Park booking menu lists PRP under eyes and microneedling with PRP under the eyes. PRF is spun slower without anticoagulant, sets into a gel, and releases more slowly, and you can ask about it at your consult. Our PRF vs PRP guide covers which one suits crepey skin and which suits dark circles.
How far before a wedding should under-eye PRP be done?
Plan your last session 6 to 8 weeks before the wedding, which means starting the series about four months ahead. If filler under the eyes is part of your plan, give it 4 to 6 weeks.
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In the 14-study review that compared them, PRF had the better evidence for crepey skin, fine lines, and texture, and PRP had the stronger signal for…
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