If you’ve had dark under-eye circles since childhood, you’ve probably tried a lot of different things to get rid of them. Heavens knows I have. My eyes have dark circles underneath them, thanks to genetics and my skin tone. Though there are foods that claim to lighten them, none have worked for me. I’ve used niacinamide which reduced them by a small fraction. Algenist’s Triple Algae Eye Renewal Balm lightened them close to 50%, which was far better than I thought possible for an over-the-counter product. But like every other cosmetic solution I’ve tried, it didn’t alleviate my need to use a cover-up under my eyes. I also tried the Lyma laser to lighten them, but fifteen minutes of daily usage every day for 90 days proved beyond my patience level, and I gave up after one month.
Wearing makeup has been part of my daily routine, but I’ve grown to love going bare-faced and only wear makeup about once a week. When I apply eye makeup these days (which I used to do every day), it feels uncomfortable and foreign. But no matter how accepting I’ve become of my unmade face, I can’t get past my dark under-eye circles. So I decided to finally go big, which for me meant going to a professional.
When I called my local cosmetic dermatologist, I said I wasn’t sure what service I wanted for under-eye circle lightening but was open to laser, prescription cream, or fillers. Those were the three solutions I’d read about, and I wasn’t sure which I was a better match for. When they suggested "PRP," I replied with a tentative "OK" without knowing what it was. Once at the appointment, the practitioner confirmed that would be the best fit for me and explained what it was. When they told me it was safer than fillers, more effective than lasers, and less expensive than either, my response was an enthusiastic "Yes!"
What Is PRP?
Platelet-rich plasma, which is rich in the growth factors needed for healing, has been used as an injectable in recent years for injury recovery in parts of the body such as tendons, ligaments, and joints. "The cytokines and growth factors forming PRP play a crucial role in the healing process," a 2018 study notes.
It’s become a concept many in the aesthetics and beauty industries are familiar with for its usage as a "vampire facial," where PRP is injected all over your face and results in overall plumping and wrinkle reduction.
Why Does It Work?
The premise behind PRP is that the platelets in your blood have regenerative and healing properties. The plasma incites your body to produce more collagen and has anti-inflammatory properties. As far as under-eye circles go, the idea is that the platelet-rich plasma will induce your under-eye area to create more collagen and blood vessels and thicken the skin there. In turn, you not only have new skin with a healthier structure but there will also be more flesh in between your blood vessels under your eyes and the skin of your face. Both of those things reduce the appearance of under-eye circles, which has been repeatedly proven in studies. According to a 2021 review on PRP treatment of under-eye circles, "the past decade has seen the adoption of this novel therapy around the world."
Because PRP is composed of your blood and not something foreign, the risk factor for injecting it into your face may be significantly less than with fillers, which were previously the standard option for under-eye circles.
In a worst-case scenario, fillers gone wrong in your eye area can cause blindness. Filler-related blindness is not frequent, but it’s happened hundreds of times at least. While this is possible with PRP, as it is with any injections near the eye, it seems to be even less likely than with fillers. And, while fillers can create distance between your blood vessels and your skin, they don’t actually lighten anything; that means that when they dissolve, you’re likely left right back where you started. After four sessions of PRP, the results are claimed to last up to two years. If you get it done once annually, that is purported to be sufficient to keep the effects indefinitely.
What Happens During a PRP Injections Appointment
To get your plasma for under-eye injections, first, you have a single vial of blood drawn. Then, that blood is taken into a different area and spun in a centrifuge. The centrifuge concentrates the platelets, and the resulting liquid is a golden color. The plasma color surprised me, as I anticipated that it would still look like blood, but the color we know as "blood red" is removed once the red blood cells are spun out. The plasma is then injected in about half a dozen different spots under each eye, which the practitioner massages gently into your skin as they go.
To perform PRP for the first time for my under-eye circles, an assistant took my blood and numbed me up with a topical cream, which was left to sit on for about thirty minutes. Then the practitioner performed the injections. Though I wouldn’t call it downright painful thanks to the numbing cream, I also wouldn’t call it a fun experience. Luckily it was over quickly, and I went on my way. There was a tiny bruise under one eye from one of the injections, but it was barely noticeable. There were also numerous needle marks, which appeared as little red dots that flaked off after a few days.
I quickly discovered that while it takes up to a month for PRP to work, and three to four appointments are needed to get the full effect, you may see immediate results that are downright astonishing. As someone with structural hollows around their eyes, the PRP treatment made me look the best I ever have. That effect made me understand immediately why people get fillers there. Following my first appointment, the circles under my eyes were completely eradicated ...temporarily.
After a few days, when my body had absorbed the PRP, the lightening effect became much more subtle. The circles were a touch lighter than prior, but not a lot. However, I continued to see improvement throughout the month (as the practitioner told me would happen). At no point in the month did the circles under my eyes return to anywhere near as intense as they had been prior.
I recently went back for my second appointment, where the same process was repeated. Even though an entire vial of blood is more than what’s needed for the injections, they don’t store it in between. While it’s a shame to have to get new blood taken each time when there is leftover plasma from the time prior, it’s reasonable that a derm doesn’t function as a blood bank. The needles in my face the second time felt less jarring than the first, presumably because I was prepared for the sensations from the previous experience.
Though I’m not yet at a place where I feel comfortable going without cover-up under my eyes (which is my ultimate goal), I only use a third of the quantity I did before my first injection. For the month after the first appointment, I still felt self-conscious if I left the house without cover-up, but the results were sufficient enough that I did so anyway several times.
Now, with the second appointment visibly furthering the process along, I imagine I’ll save under-eye cover-up for the occasions when I bother wearing makeup like eyeliner and mascara or lipstick for fun’s sake rather than in a fix-it capacity. I’m perfectly content to go back a couple more times for treatment and to stop by annually to prevent my eyes from looking like they did before my first appointment.
PRP is a less expensive alternative to more dangerous practices. It functions to lighten the dark under-eye circles quickly, and because it’s made of your blood, it couldn’t be safer. It also costs a fraction of what you’d pay for the alternatives, and it may last longer. I wish it had been around when I was younger, but it’s definitely making me a lot happier with my 40-something face.
Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E, et al. Platelet rich plasma: new insights for cutaneous wound healing management. J Funct Biomater. 2018;9(1):10. doi:10.3390/jfb9010010
Elnehrawy NY, Ibrahim ZA, Eltoukhy AM, Nagy HM. Assessment of the efficacy and safety of single platelet-rich plasma injection on different types and grades of facial wrinkles. J Cosmet Dermatol. 2017;16(1):103-111. doi:10.1111/jocd.12258
Evans AG, Ivanic MG, Botros MA, et al. Rejuvenating the periorbital area using platelet-rich plasma: a systematic review and meta-analysis. Arch Dermatol Res. 2021;313(9):711-727. doi:10.1007/s00403-020-02173-z
Chatrath V, Banerjee PS, Goodman GJ, Rahman E. Soft-tissue filler-associated blindness: a systematic review of case reports and case series. Plast Reconstr Surg Glob Open. 2019;7(4):e2173. doi:10.1097/GOX.0000000000002173