Section : Conference Notes

Dark Circles (Infra-Orbital) Around the Eyes: a Combination Treatment

Combination of Micro Needling and Trichloracetic acid 10% Peels in the Management of Infraorbital dark circles

Markantoni V et al.

AAD 2015 Annual Meeting, San Francisco CA – United States

  • The pigmented skin of dark circles appears gives and impression of tiredness
  • Dark circles are very frequent and although proposed mechanisms are proposed (CLICK HERE to read more)
  • Because of this, it might be a good idea to exclude other etiologies (CLICK HERE to read more)
  • That being said, once the diagnosis is made treatment options are often multiple and unsatisfactory. They include whitening creams, topical retinoids, chemical peels, lasers, fat transplants, fillers and blepharoplasty (surgery)
  • The following study from Greece suggests micro needling the skin followed by a five minute application of trichloracetic acid topical application:
    • they performed the study in 13 female patients aged between 13 and 62, phototypes II to IV
    • 4 session treatments spaced by 2 weeks
    • the procedure was NOT painful
    • Results:
      • all patients improved.
      • Doctors evaluated the improvement as “fair”, “good” or “excellent” in 94% of patients
      • Patients rated the response as “fair”, “good” or “excellent” in 95.2% of cases
    • Adverse events included: mild discomfort, transient erythema and edema (described as common but no figures shown)
    • No recurrence was observed 4 months after the last treatment


  • The photos on the poster are not published here as the patients would be identifiable.
  • However there are two patients and based on this the response according to us is “fair-to-moderate”, but closer to “fair.”
  • Conclusion: Although all patients appear to have improved it might have been useful to break down the results as visually not many patients would have more than a “fair” to “moderate”  response.


Dr Christophe HSU – dermatologist. Geneva, Switzerland