What causes under-eye aging, and how do you treat it?
“Under-eye aging is anatomical: the fat pads that cushion the eye lose support and can bulge or shift, the bone of the socket recedes, the mid-cheek drifts downward, and the already-thin skin gets thinner — together they create the hollow, the shadow and the crepiness. Because the cause is layered, so is the fix. Often the biggest improvement comes from restoring mid-cheek support rather than filling the hollow directly, paired with regenerative EZ Gel or PRF, Density skin tightening, and resurfacing lasers like Erbium or CO2 to firm and smooth the skin — plus a great eye cream and daily sunscreen, and I love Hydrinity and Pavise for that. Not everyone is a candidate for tear-trough filler, though: if you have under-eye bags, festoons or eyes that puff and hold fluid, HA filler can make it worse, so I assess carefully before ever recommending it.”
— Deborah Lenchus, MSN, APRN
Medically reviewed by Deborah Lenchus, MSN, APRN · Last reviewed July 2026.
Tired-looking under-eyes — hollows, dark circles, fine lines, and crepey texture — are one of the most common concerns we treat. The right approach depends on whether the issue is volume, skin quality, or pigment.
Best under-eye treatments
- EZ PRF (your own platelets) — a natural option that improves under-eye quality and dark circles.
- Under-eye filler / facial balancing — restores hollows when appropriate.
- RF microneedling — smooths crepey under-eye skin.
Deborah’s Clinical Perspective
The under-eye ages for anatomical reasons, and understanding them is what keeps treatment safe and natural. The small fat pads that cushion the eye lose their support and can bulge or slide, the bone of the socket quietly recedes, the mid-cheek drifts downward, and the skin here — the thinnest on the face — becomes thinner still, letting vessels and muscle show through as a shadow. Because of that layered anatomy, filling the hollow directly is often not the answer; frequently the most natural improvement comes from restoring mid-cheek support, which lifts and softens the lid-cheek junction from below. From there I build skin quality with regenerative EZ Gel or PRF, Density skin tightening, and resurfacing lasers like Erbium or CO2 for crepey texture, and I insist on a good eye cream and daily sunscreen — I love Hydrinity and Pavise — because thin, sun-exposed skin is half the problem. I am also candid about who should not have tear-trough filler: if you have true under-eye bags from herniated fat, festoons, or eyes that puff and hold fluid, HA filler is hydrophilic and tends to make the puffiness worse, and salt or allergies can make it fluctuate. In those cases I steer toward skin-tightening, resurfacing and regenerative options instead, and I would rather tell you honestly that filler is not right for you than create a heavier, overfilled eye. A few practical notes I share often: not every dark circle is a hollow — hereditary or pigment-related shadows, which are common in deeper skin tones, respond to brightening medical-grade skincare and gentle peels rather than filler, so identifying the true cause comes first. For anyone anxious about filler or who is not a candidate, EZ Gel and PRF are a beautiful natural alternative, using your own blood to improve skin quality with no synthetic product at all. And because under-eye puffiness often fluctuates, I always ask about sleep, salt and allergies before treating, since calming those triggers first leads to a smoother, more predictable result.
Why LuXe
Every treatment is performed personally by nurse practitioner Deborah Lenchus, MSN, APRN — never a technician — at our Davie studio serving Weston, Cooper City, Plantation, Pembroke Pines, Southwest Ranches, and Fort Lauderdale.
FAQ
What causes dark under-eye circles?
A mix of hollowing, thin skin showing underlying vessels, and pigment — treatment depends on the cause.
Is under-eye filler safe?
In experienced hands and the right candidate, yes. It is a delicate area best treated conservatively.
Book a consultation in Davie & Weston.