Dark Circles Under the Eyes: Causes and Treatment Options in Montreal
Hollow type
Shadow from lost volume. Tear trough filler is the most direct option.
Pigment type
Brown or grey tone. Brightening skincare, peels and daily SPF.
Thin skin type
Bluish tone, visible veins. PRP, skin boosters and gentle skincare.
Before anything
A medical assessment to find the real cause and rule out other factors.
Concealer can hide dark circles for a day, but it cannot change why they are there. If you have tried sleeping more, drinking more water and layering eye creams without a lasting difference, the cause is probably structural or pigment-related, and a more targeted approach is worth considering. This guide explains what actually causes dark circles, how to tell the types apart, how tear trough filler works, what the alternatives are, and what to expect at a consultation with Dr Peguy Télusma at GLIF Medical in Montréal.
What Are Dark Circles and Why Do They Appear?
“Dark circles” is an everyday term rather than a diagnosis. It describes darkness in the lower eyelid area, and the same appearance can have very different origins. Understanding which one applies to you is the single most important step, because the right treatment for one cause may do almost nothing for another.
Infographic 1 · The three main causes of dark circles
Hollow and shadow (tear trough)
The tear trough is the groove that runs from the inner corner of the eye diagonally toward the cheek. With age, and in some people from their twenties because of anatomy, volume in the cheek and under-eye area declines and the groove deepens. The hollow then catches light unevenly and creates a shadow that looks like a dark circle even when the skin colour has not changed. This is one of the most common types, and it is the one that tear trough filler is designed for.
Pigmentation
Some people produce extra melanin in the thin skin around the eyes. Sun exposure, inflammation from allergies or rubbing, and genetics all play a part. Pigmented circles look brown or greyish, do not fade when you tilt your head, and are treated with sun protection, brightening ingredients and, in some cases, peels or other skin treatments rather than filler.
Thin skin and visible vessels
Under-eye skin is among the thinnest on the body. When it loses thickness and collagen, the blood vessels and muscle beneath show through as a bluish or purplish tone. Skin-quality treatments aim to thicken and refresh the skin so that the tone looks less dark.
Everyday factors that make dark circles look worse
Lack of sleep, dehydration, allergies that cause rubbing and congestion, fluid retention linked to salt intake or hormonal changes, stress and sun exposure do not usually create dark circles on their own, but they make an existing tendency more visible. This is why lifestyle habits help but rarely solve a structural problem. Persistent, one-sided or worsening swelling and darkness can also point to a medical factor such as allergy, thyroid disease or anemia, so a physician’s review is worthwhile.
How Can You Tell Which Type of Dark Circle You Have?
Infographic 2 · A simple light test
Often filler
Skincare, peels, SPF
PRP, skin boosters
Because many people have more than one type, a self-check is only a starting point. During your consultation we examine the area in different lighting and positions, assess skin thickness and any bags or puffiness, and review your medical history before recommending anything.
What Is Tear Trough Filler and How Does It Work?
Tear trough filler is a minimally invasive treatment that uses a soft hyaluronic acid gel to restore volume in the groove beneath the eye. Hyaluronic acid is a molecule the skin already produces to hold water, and under-eye products use a gentle, low-density gel designed for thin skin. The gel is placed in very small amounts, either with a fine needle or a blunt-tip cannula, and sometimes the supporting cheek is treated as well to lift the area from below. When the hollow is filled, the shadow it created softens and the lower eyelid looks smoother and more rested.
Two features make hyaluronic acid popular for this delicate area. The result is visible immediately, which allows careful, gradual correction. And the filler is reversible: an enzyme called hyaluronidase can dissolve it if needed. For a broader overview of filler types and areas, see our guide to hyaluronic acid fillers.
Who Is a Good Candidate for Tear Trough Filler?
Often a good candidate
- A visible hollow or groove under the eyes
- Shadow that improves when light hits from above
- Mild to moderate volume loss
- Realistic expectations and good general health
May need another approach
- Mostly pigmented or vascular dark circles
- Prominent under-eye bags or fat pads
- Very loose or crepey skin
- Pregnancy, breastfeeding or active infection
Filler can sometimes make bags look more noticeable, because adding volume beside a bulge can emphasise it. In those cases, a different plan, or in more significant cases a surgical opinion, is the honest recommendation. A good provider will tell you when filler is not the right choice.
What to Expect: Procedure, Recovery and Results
Your visit begins with an assessment and discussion of goals. After cleansing and numbing cream, the injections take roughly 20 to 30 minutes. Mild pressure or stinging is common. Cold compresses help with swelling, and you can usually return to normal activity the same day.
Infographic 3 · Typical treatment timeline
Results vary with your anatomy, the product and the amount used. Many people see a lasting improvement for around 9 to 18 months, after which the filler gradually fades. Because the body can retain a little extra water around filler in the first days, the final result is judged after a couple of weeks, and a small adjustment can be made at review if it is needed.
Aftercare tips
For the first day or two, avoid strenuous exercise, saunas, heavy alcohol and pressing or massaging the area unless instructed. Sleep with your head slightly elevated if swelling bothers you, use cold compresses gently, and apply sunscreen daily. Call the clinic if you notice anything unusual.
Risks and Safety of Under-Eye Filler
The under-eye area has thin skin, fine blood vessels and little fat, so technique and anatomical knowledge matter more here than almost anywhere else on the face. Honest information about risks is part of choosing well.
Choose a physician who knows the facial anatomy in depth, uses approved products, explains these risks before treatment and keeps hyaluronidase available. You can verify any Québec physician’s licence on the registry of the Collège des médecins du Québec.
Other Treatments for Dark Circles: PRP, Skin Boosters and Skincare
Filler is not the answer to every dark circle. For pigmented or thin-skinned types, other options often make more sense, and they can be combined with filler when a hollow is also present.
PRP (platelet-rich plasma)
Uses concentrates from your own blood to support skin quality, thickness and tone. Read about PRP and the vampire facial.
Skin boosters
Injected hydration that improves skin texture and glow. See our skin boosters guide.
Targeted skincare
Caffeine to reduce puffiness, vitamin C to brighten, licorice extract to ease pigment, and gentle acids to refine texture.
Daily sun protection
SPF 30 or higher around the eyes helps prevent pigmentation from deepening.
Comparing your options
A combined plan is common. For example, a patient with a hollow and thin skin might have a small amount of filler to restore volume and a series of skin-quality treatments to improve tone. Your physician will sequence treatments so each one supports the others.
Lifestyle Habits That Support Better Results
Good habits do not replace treatment, but they help results look better and last longer. Aim for consistent sleep, manage allergies so you rub your eyes less, stay hydrated, limit excess salt that can promote puffiness, protect the area from sun every day, and avoid smoking, which thins skin and slows renewal. A gentle eye-area routine with brightening and hydrating ingredients is a sensible foundation whichever treatment you choose.
How Much Does Tear Trough Filler Cost in Montreal?
Pricing depends on how much product your anatomy needs, whether the cheek is treated as well, and the experience of the injector. Filler is usually priced per syringe or part-syringe, so a small, careful correction often costs less than a large one. Be cautious of unusually low prices, vague product names or treatment offered without an assessment. After your consultation at GLIF Medical you receive a clear plan and quote, so you can decide without pressure.
Common Myths About Dark Circles and Under-Eye Filler
Myth: dark circles mean you are tired
Often they are simply anatomy or pigment. Sleep helps, but it cannot fill a hollow.
Myth: filler fixes every dark circle
It treats shadows from hollows. Pigment and vessels need other approaches.
Myth: only older people need it
Many people have hereditary hollows in their twenties and thirties.
Myth: filler always looks puffy
Puffiness comes from too much product or poor placement, not from the treatment itself.
How to Choose a Provider for Under-Eye Treatment
Look for a licensed physician with specific training in facial anatomy and aesthetic injectables, a clinic that begins with an assessment rather than a sales pitch, and a willingness to say no when filler is not appropriate. Ask which products are used, how complications are managed and what follow-up is included. Real before-and-after photos with consent, clear information on risks and transparent pricing are all signs of a trustworthy practice.
Meet the Physician: Dr Peguy Télusma
Founder and Medical Director, GLIF Medical
- Québec-licensed family physician (CMQ permit 02565)
- Certified aesthetic medicine physician with experience in regenerative medicine and non-surgical aesthetic procedures
- Continuing medical education through Harvard Medical School, including laser and aesthetic skin therapy
- Languages: French, English, Spanish and Haitian Creole
At GLIF Medical, Dr Télusma takes a physician-led, evidence-based approach: a personalized medical evaluation first, a clear explanation of the cause of your concern, and a treatment plan that prioritises natural-looking results.
Dark Circles and Tear Trough Filler: Frequently Asked Questions
What is the best treatment for dark circles under the eyes?
It depends on the cause. Hollow, shadow-type circles usually respond best to tear trough filler. Pigmented circles respond better to brightening skincare, sun protection and peels, while thin, crepey skin may benefit from PRP or skin boosters. An in-person assessment identifies which type you have.
Does tear trough filler get rid of dark circles?
It can soften dark circles that are caused by a hollow, because filling the groove removes the shadow. It does not remove pigment or visible blood vessels, so results depend on your type of dark circle.
How long does tear trough filler last?
Results commonly last about 9 to 18 months, depending on the product, your metabolism and how the area is treated. Some patients choose a light touch-up before the filler has fully faded.
Is under-eye filler safe?
When performed by a trained physician using approved hyaluronic acid products, it is generally considered safe, but the under-eye area is delicate. Risks include swelling, bruising, lumps and, rarely, serious vascular complications, which is why anatomy knowledge and technique matter.
Can tear trough filler be dissolved?
Yes. Hyaluronic acid filler can be dissolved with an enzyme called hyaluronidase if the result is uneven, too visible or not what you wanted.
Does it hurt, and what is the downtime?
Most patients report mild discomfort, and numbing cream is commonly used. Swelling is usual for a few days, bruising is possible, and most people return to normal activities quickly.
Can tear trough filler cause puffiness or a bluish tint?
Overfilling can create puffiness, and product placed too superficially in very thin skin can give a bluish look known as the Tyndall effect. Careful patient selection, conservative amounts and correct depth reduce these risks.
Are dark circles a sign of a health problem?
Usually not, but persistent or one-sided swelling and darkness, or dark circles with other symptoms, should be reviewed. Allergies, thyroid problems and anemia are examples of medical factors worth ruling out with a physician.
How much does tear trough filler cost in Montreal?
The cost depends on the amount of product needed, the areas treated and the injector’s expertise. After your assessment, you receive a clear plan and quote. Avoid choosing a provider on price alone.
How do I book a consultation at GLIF Medical?
Call (514) 665-0558 or use the booking options on glifmedical.ca. Dr Peguy Télusma sees patients at the Verdun (Île-des-Sœurs) clinic in Montréal.
Book a personalized evaluation with Dr Peguy Télusma at GLIF Medical in Verdun, Montréal.
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GLIF Medical Content & SEO Team
Updated October 20, 2026 · Medical review: Dr Peguy Télusma, MD, CCFP
Our team prepares patient education guides on injectables, skin health and medical aesthetics for patients in Montréal. This article is for information only and does not replace an individual medical assessment. Results vary.
Sources & references: Treatments of Infra-Orbital Dark Circles by Various Etiologies (PubMed Central, PMC7992473). · Tear Trough Deformity, EyeWiki, American Academy of Ophthalmology. · Nonsurgical correction of the tear trough deformity with hyaluronic acid (PubMed 20124855). · Collège des médecins du Québec physician registry.