More permanent solutions than over the counter creams are certainly more invasive and costly and have several potential unwanted effects which you need to be aware of. The initial step is to make an appointment with a professional dermatologist, who will confirm that you've exhausted all other options and advise you on what to do next. Before you commit to a surgical procedure, take time to educate yourself. Understanding what to expect, and being aware that best results aren't guaranteed, is a vital part of the procedure.

If your circles are due to visible veins below the skin surface, laser treatment might get great results. The light from  laser removes the top layer of skin, eliminating old, unhealthy cells in the process. With time, this skin will thicken and the darkness will diminish.

Often, dark under eye circles are caused by dark pigmentation. This might be down to natural skin tone, or due to a lot of exposure to the sun. These dark patches called hyperpigmentation and your treatments might be something as simple as changing a medication you might be taking that is affecting your skin, or the use of bleaching creams or a topical retinoid (produced by vit a). Additionally, there are other, more invasive options. Always seek expert suggestions and find out the possible risks as well as the possible benefits.

Fat grafting is a surgical procedure for dark circles under eyes which has been growing in popularity recently. Fat is taken from other parts of the body and injected under the skin under eyes. By thickening skin, those dark shadows are less visible. Again, this shouldn't be an impulse decision. Be realistic in your expectations. Accept that no surgical procedure will completely remove all dark shadows under your eyes. Your doctor may prescribe a topical treatment and suggest some other ways in which you can improve the overall condition and look of your skin.

As with every surgical procedures, do lots of research prior to choosing your surgeon. Try to go for someone who has lots of experience in performing treatments for under eye darkness and who has glowing recommendations and an impeccable reputation. Choosing the least expensive option is not going to produce the greatest results; it's worth paying a bit more for a far better quality of service. Your initial consultation with a doctor is the perfect time to ask all the questions you have about the process. Only when your mind is at ease and you're totally sure that you are in good hands should you consider proceeding. Safety must always be your most important consideration.