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Periorbital anatomy · pigment · clinical evidence
PRP for dark circles under the eyes
Dark lower-eyelid areas may result from pigmentation, visible blood vessels, anatomical shadows, swelling or several coexisting factors. This article classifies clinical PRP studies by cause, measurement method and treatment setting.
- Pigmentation
- Blood vessels
- Tear trough
- Skin structure
- Evidence
- PRP preparation
4 groups of causesPigment, blood vessels, structure and swelling are considered separately.
19 studieswere included in an earlier systematic review with a total of 455 participants.
Mixed endpointsPatient satisfaction and objective measurements did not always produce the same findings.
No uniformityPRP preparation, injection technique and follow-up differed.
Dark circles are often perceived as a single cosmetic concern. Anatomically, however, very different changes may underlie a darker lower-eyelid area.
PRP has been clinically studied for periorbital skin for several years. Some studies report changes in skin colour, skin structure or subjective satisfaction. Others show only small or inconclusive differences in objective measurements.
What are dark circles?
The term describes an area beneath or around the eyes that appears darker. The literature also uses terms such as periorbital hyperpigmentation, infraorbital discolouration and “dark circles”.
This does not always represent actual pigment deposition. Blood vessels, shadows and anatomical depressions can also make the area appear darker.
Key conceptVisible colour results from the interaction of skin, blood vessels, volume, light and tissue shape.
One term, several causesStudy findings can only be transferred meaningfully when the investigated form of dark circles is comparable with the respective finding.
What can cause dark circles?
Brownish discolouration may be constitutional, genetic or post-inflammatory.
Thin skin can allow superficial blood vessels to appear bluish, violet or reddish.
Depressions, volume loss or changes in the midface can create shadows.
Fluid accumulation or inflammation changes how light and shadow appear.
Combinations of pigment, visible vessels, thin skin and structural shadows are common.
How are dark circles professionally assessed?
Observable features
Factors considered include colour, distribution, skin type, skin thickness, tear trough, shadow behaviour, visible vessels, swelling and skin laxity.
Colour toneVascular visibilityTear troughSkin thicknessSwellingWrinkle structure
Measurement methods
Standardised photography, clinical scales, dermoscopy, colour measurements and three-dimensional camera systems can produce different findings.
Read patient and device assessments separatelySatisfaction, photographic assessment and instrumental pigment measurement may represent the same change differently.
What is PRP?
Platelet-rich plasma as an autologous blood product
PRP is obtained from the patient’s own blood. Centrifugation separates the blood components and prepares a plasma fraction with an increased platelet concentration.
Platelets contain signalling proteins, cytokines and growth factors. Periorbital research examines possible effects on fibroblast activity, collagen formation, tissue remodelling and skin structure.
Biological basisExplains why PRP is investigated in studies.
Clinical endpointMust be assessed in controlled studies.
No uniform formulationPreparation and composition differ.
How was PRP applied in the lower-eyelid area?
Several small injection points in the lower-eyelid area or along the tear trough.
PRP after microneedling or laser treatment.
Comparisons with plasma gel, platelet-poor plasma or mesotherapy.
The number of applications in studies ranged from one to eight, with intervals of 14 to 56 days. This does not establish a uniform study protocol.
What did the 2014 pilot study show?
10 participants, one intradermal PRP application
After three months, a statistical change in skin-colour uniformity was reported. No statistically significant change was found in measured melanin content, skin hydration, wrinkle volume or wrinkle visibility.
small sampleno control groupone appointment
What do comparative studies show?
Comparison matrix: different autologous products and active ingredients
no uniform referenceComparisonPRP vs plasma gel
Setting
68 women, three applications in a split-face design.
Interpretation
Both sides changed; in this study, the results were more pronounced with plasma gel.
ComparisonPRP vs plasma gel
Setting
40 women, two sessions.
Interpretation
Initial changes in wrinkles were not demonstrated to the same extent later; an objective improvement in pigmentation was not confirmed.
ComparisonPRP vs tranexamic acid + vitamin C
Setting
18 participants, three applications at three-week intervals.
Interpretation
Both sides were assessed as changed; there was no statistically significant difference between the procedures.
What does the combination with microneedling show?
In a randomised and blinded study, some participants subjectively reported more even skin and altered texture. Independent dermatological assessments, however, showed no statistically significant differences.
Do not equate subjective and objective changePatient satisfaction and independent measurements should be evaluated separately.
What do systematic reviews show?
19 studies with 455 participants
The pooled data showed higher patient satisfaction. Study design, controls, preparation and assessment methods differed substantially.
approximately 95% womenshort follow-up
14 studies compared
PRP showed stronger indications of pigment changes, while PRF was more often studied for skin structure and fine lines. Superiority was not demonstrated.
26 studies on PRP and PRF
Changes in hyperpigmentation were rated as moderate, while objective findings for wrinkles and skin structure were mixed.
Different protocols limit the strength of conclusions
Composition, concentration, leukocyte content, activation, injection volume, lighting and measurement methods were not uniform.
How can the evidence be interpreted?
Research does not provide a uniform result for every form of dark circles. The most frequently reported findings are changes in subjective satisfaction, partly more even-looking skin colour and inconsistent objective measurements.
Pigment typeVascular componentTear troughSkin thicknessPRP concentrationLeukocyte contentActivationInjection depthNumber of sessionsPhotographic documentationFollow-up
Pigmentation, vascular visibility, a structural tear trough and swelling are not identical study targets.
What safety data are available?
Predominantly temporary local reactions were documented: pain or burning, swelling, redness, small bruises, tenderness and unevenness at injection sites.
Systematic reviews also point to small study groups and limited follow-up periods.
The periorbital region has complex anatomy; application technique and professional qualification are independent safety factors.
What other procedures are being investigated?
Depending on the cause, the literature describes topical agents, chemical peels, laser and light procedures, microneedling, volume-restoring procedures, autologous fat transfer, surgery and combinations.
Cause-specific researchProcedures for a structural tear trough are studied in different research settings from procedures for primary hyperpigmentation or vascular visibility.
Technical context of PRP preparation
The tube system, anticoagulant, separation gel, relative centrifugal force, rotor radius, run time and further processing influence the plasma fraction obtained.
Technical module: two components of a PRP workflow
The information describes technical characteristics and does not imply suitability, efficacy or approval for a specific application in the lower-eyelid area.
Vi PRP-PRO
Sterile PRP tube made of borosilicate glass with 0.8 ml sodium citrate and thixotropic separation gel. The vacuum is designed for approximately 9 ml of blood.
- Material
- Borosilicate glass
- Additives
- 0.8 ml sodium citrate · separation gel
- Reference value
- 1,200 × g · 7 minutes
- Plasma yield
- approximately 4–4.5 ml as a reference value
Hettich EBA 200 MD
Compact medical-device centrifuge with an integrated eight-place fixed-angle rotor.
- Rotor
- 8-place · fixed angle
- Capacity
- maximum 8 × 10 ml
- Maximum
- 6,000 rpm · 3,461 × g
Frequently asked questions about PRP and dark circles
Can PRP change every form of dark circles?
Pigment-related, vascular, structural and mixed forms are not identical. Findings cannot automatically be transferred between different causes.
How many PRP sessions were studied?
Depending on the study, one to eight applications were described. Two or three appointments at intervals of two to four weeks were common.
When were changes assessed?
Many studies assessed results a few weeks to three months after the final application. Long-term data are less common.
Are the results permanent?
Durability cannot currently be assessed uniformly. In individual studies, initial changes were no longer demonstrable to the same extent at later assessments.
Is PRP the same as PRF or plasma gel?
No. PRP, PRF and other autologous plasma products differ in their preparation, composition and investigated use.
Summary of the evidence
Dark circles may result from pigmentation, visible blood vessels, anatomical shadows, swelling, skin changes or several coexisting factors.
PRP has been studied in small clinical trials both alone and together with microneedling, laser or other plasma products. Some studies reported changes in skin colour, skin structure or patient satisfaction. Objective measurements and independent assessments, however, did not produce the same findings in every study.
Preparation, application, suitable patient groups and the duration of possible changes remain inconsistently defined.
Sources and further reading
- Periorbital hyperpigmentation: causes and classification
- Periorbital hyperpigmentation: a comprehensive review
- Pilot study of PRP in infraorbital skin
- PRP compared with platelet-poor plasma gel
- Split-face comparison of PRP and plasma gel
- PRP compared with tranexamic acid and vitamin C
- PRP combined with microneedling
- Systematic review and meta-analysis of PRP for periorbital rejuvenation
- Systematic review comparing PRP and PRF
- Systematic review of PRP and PRF in periorbital aesthetics
Medical notice: This article presents published study findings, professional assessments and technical relationships for informational purposes. It contains no recommendation for or against a specific treatment and does not replace a medical examination, diagnosis or individual treatment decision. Product references relate exclusively to technical aspects of PRP preparation.