If you’re searching for tear trough treatment, you’re usually trying to solve one problem: you look tired or drawn even when you feel fine. Tear troughs can create a hollow or shadow from the inner corner of the eye down towards the cheek, and they’re often mistaken for “dark circles”.
This article explains what tear troughs really are, why they happen, what treatments can help (and what can’t), and why this area needs careful assessment.
The short answer
Tear troughs are a normal anatomical feature that can become more visible with age due to changes in bone, fat, skin thickness, and supporting ligaments. There’s rarely one single cause, so treatment isn’t one-size-fits-all.
What are tear troughs?
A tear trough is the groove where your lower eyelid meets your upper cheek. The skin here is some of the thinnest on the face, which is why shadows and colour changes show easily.
They can appear as:
- A hollow or indentation
- A shadow that makes the under-eye look darker
- A sharp “line” between eyelid and cheek
They can also be present in younger people due to genetics, not just ageing.
Why do tear troughs develop?
Most people have a mix of these factors:
1) Loss of bone support
As the eye socket area changes with age, the structure under the lower eyelid can provide less support, making the area look more hollow.
2) Changes in fat pads
The fat that used to create a smooth contour under the eye can shift, reduce, or sit differently. This can exaggerate a hollow or create contrast between areas.
3) Thinning skin
Under-eye skin becomes more delicate and translucent over time. That can make shadows, veins, and pigmentation more noticeable.
4) Ligaments and structural tethering
Strong retaining ligaments can “hold” the skin in place, which can make hollows look deeper beside them.
Tear troughs vs dark circles: what’s the difference?
People often mix these up.
- Tear troughs = mainly shape (hollow/shadow)
- Dark circles = mainly colour (pigment, vessels, or thin skin)
You can have one without the other — and the treatment approach changes depending on which one you actually have.
Treatment options (and what each is best for)
- Skin-focused treatments
Best for: crepiness, fine lines, thin/translucent skin, overall texture
Limitations: won’t “fill” a hollow on its own
This option improves how the skin looks and behaves, which can reduce the tired appearance even without changing volume.
- Structural support and contouring
Best for: softening the transition between eyelid and cheek in carefully selected patients
Limitations: not suitable for everyone; must be conservative to avoid puffiness or irregular contour
In many cases, improving the mid-face support matters as much as the tear trough itself.
- Movement and facial dynamics
Best for: people whose under-eye area looks different when smiling, squinting, or speaking
Limitations: not a standalone “fix” — it’s part of planning
How your eyes and cheeks move can change what’s safe and what will look natural.
- Combination plans
Often the best results come from combining:
-
- skin support + structural support + an approach that respects movement
This usually looks more natural than trying to solve everything with one method.
- skin support + structural support + an approach that respects movement
Why expert assessment matters more here than almost anywhere
The under-eye area is delicate and higher-risk than many parts of the face. Treating the wrong person or using the wrong approach can lead to:
- Swelling that lingers
- Uneven contour
- Results that look puffy or unnatural
- In rare cases, serious complications
A proper consult should cover:
- Your anatomy and skin quality
- Whether you’re a good candidate at all
- Risks, limits, and realistic outcomes
- When “no treatment” is the safest option
A sensible, natural approach
Not everyone with tear troughs needs treatment. Sometimes the best first step is:
- skincare optimisation
- lifestyle and sleep review
- managing allergies/sinus issues (which can worsen under-eye appearance)
If treatment is appropriate, the aim should be subtle: to help you look more rested, not different.
Final thought
Tear troughs are common, and they’re complex. The best results usually come from getting the diagnosis right (hollow vs colour vs skin), then choosing a plan that matches your anatomy — not a trend.
If you want, I can turn this into:
- a shorter “quick read” blog version, or
- a FAQ-style post (good for TAYA and SEO without sounding salesy).