Vascular dark circles won't respond to pigment treatment. Learn how to self-diagnose & treat right.
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Author
Wi Young-jin · Chief director
Seoul National University College of Medicine · Seoul National University Hospital Specialist
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3 Self-Check Methods to Confirm
Whether Blood Vessels Are Causing Your Dark Circles

The day-to-night temperature gap has gotten quite large these days.
During seasonal transitions, skin blood vessels repeatedly constrict and dilate,
and more people find the area under their eyes looking darker
and duller.
There is something I hear very often in the clinic.
"Doctor, I've been using brightening cream
and even got laser treatments — so why won't it go away?"
A significant number of these people actually
had a vascular issue, not pigmentation.
In other words, they started treatment without first checking the cause.
Today, I'll talk about how to distinguish vascular dark circles on your own
and the real treatment methods that fit them.
💡 Key summary of today's post
Q. How can I tell if it's a vascular issue?
A. If you gently pull the skin sideways
and the color looks purple or bluish,
there is a very high chance it is the vascular type.
You're seeing blood vessels showing through.
Q. Why do brightening lasers or creams
not work?
A. Treatments that target melanin pigment
do not act on blood vessels deep in the skin.
Q. For vascular dark circles,
what kind of laser is used?
A. Lasers that selectively target blood vessels —
V-laser types — are effective.
Dark circles:
the cause comes first

The causes of dark circles
are broadly divided into four types.
Pigment type: melanin pigmentation (brown tone)
Vascular type: thin under-eye skin lets blood vessels show through (blue-purple tone)
Structural type: deep tear troughs or volume loss create shadows
Mixed type: a combination of the three causes above
The vascular type, in particular,
tends to appear in people with thin skin.
When you're tired or when temperature changes are significant, blood vessels dilate,
making the color appear darker.
This is exactly
why it doesn't improve no matter how many pigment laser sessions you get.
3 Ways to Check
if Your Dark Circles Are Vascular

In the clinic,
this is the self-check method I recommend first.
1. Stretch test (pulling the skin)
Gently pull the under-eye skin to the side.
If the color spreads, it's pigment type;
if the color stays the same
or becomes more distinct, it's vascular type.
2. Check response to temperature change
After a warm shower,
if the under-eye area looks darker, it is vascular type.
That's because heat dilates blood vessels.
Conversely, it may temporarily lighten with a cold compress.
3. Check the color tone
Under natural light, if it looks brown, it's pigment type;
if it's in the blue-purple or reddish-purple range,
it is likely vascular type.
👨⚕️ Dr. Wi Young-jin's practical note:
To people who have received pigment lasers
multiple times elsewhere,
there is something I always say.
"If the cause is vascular,
a melanin-only laser is meaningless."
However, under-eye concerns often involve both
vascular issues and structural (tear trough)
problems at the same time.
In such cases, combining vascular treatment with volume restoration
is necessary to see proper improvement.
Why V-laser Is Used
for Vascular Dark Circles

The key to treating vascular dark circles
is 'selective targeting.'
V-laser
uses a specific wavelength that reacts
only to hemoglobin in the blood.
Laser energy
is absorbed by blood vessels and generates heat,
coagulating and constricting dilated vessels
to reduce how much they show through the skin.
Points to note:
Repeated sessions spaced 2–3 treatments apart are safer than a single session.
Temporary bruising (purpura) may occur after treatment.
If you have important events coming up, it's better to adjust the treatment timing.
These people should take caution
People with darker skin tones
Because melanin absorption is higher, fine-tuned adjustment is essential.
People taking blood thinners
If you take aspirin or similar medications, bruising may be more severe.
People with deep tear troughs
Laser alone has limits, so fillers or other methods should be combined.
To be honest, the under-eye area is very sensitive, so
rather than aiming to "remove it completely,"
the right approach is
"to improve it as naturally as possible."
Frequently Asked Questions (FAQ)
Q1. Does it improve with just one laser session?
A. In my experience,
cases that wrap up in one session are rare.
It is much more effective
to proceed while monitoring progress over about 2–3 sessions.
Q2. Will it interfere with work life?
A. Bruising may last about 1–2 weeks after treatment.
I recommend getting it done when your schedule is flexible.
Q3. Are brightening creams completely useless?
A. If it is a mixed type
with accompanying pigmentation, they can help,
but for purely vascular type,
cream alone has clear limitations.
If you have any questions, feel free
to contact us via WhatsApp or phone.
This was Dr. Wi Young-jin.

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