The undereye area is often one of the first places patients notice signs of fatigue or aging. Because the skin beneath the eyes is thinner and more delicate than the rest of the face, even small changes in hydration, sleep, or sun exposure can have a noticeable impact.

Dr. Karen Horton, a San Francisco Board-Certified Plastic Surgeon, was recently interviewed in an educational article published by the American Society of Plastic Surgeons (ASPS) discussing best practices for maintaining the undereye area. Her insights highlight how thoughtful treatment planning and consistent daily habits can help maintain a refreshed appearance over time.

Why the Undereye Area Changes Over Time

The lower eyelid region is uniquely sensitive to both internal and external factors. As skin thins and collagen decreases, underlying structures such as muscle and blood vessels can become more visible. This contributes to common concerns such as dark circles, hollowing, and a tired appearance.

Dr. Horton explains that what many patients perceive as “dark circles” is often a combination of anatomy and lighting. As the skin becomes thinner and hydration decreases, the underlying muscle can show through more prominently.

Lifestyle factors can further influence these changes, including:

• Dehydration
• Lack of sleep
• Sun exposure
• Smoking
• Stress and fatigue

The Importance of a Personalized Approach

Maintaining the undereye area begins with understanding that no single treatment works for everyone. Factors such as age, skin quality, pigmentation, and volume loss all play a role in determining the most appropriate approach.

For some patients, nonsurgical treatments may help improve texture or volume. For others, surgical options may eventually be more appropriate. The key is careful evaluation by a qualified provider and a plan that evolves over time. See before & after results after blepharoplasty here.

Daily Habits That Support Undereye Health

While treatments can improve the appearance of the undereye area, daily habits are essential for maintaining results.

Simple, consistent practices can make a meaningful difference, including:

• Staying well hydrated
• Getting adequate sleep
• Using daily sun protection
• Avoiding smoking
• Maintaining a consistent skincare routine

Even small changes can help support the skin barrier and reduce the appearance of fatigue.

Skincare and At-Home Maintenance

Targeted skincare can also play a role in maintaining the undereye area. Products that help reflect light or improve hydration may temporarily soften the appearance of dark circles and uneven tone.

Dr. Horton also emphasizes the value of daily sun protection, noting that even light coverage with mineral-based products can help protect the skin and maintain a more even appearance over time.

Being Thoughtful About Trends

With new treatments and devices frequently promoted on social media, it’s important for patients to approach trends with caution. Not every product or technology is appropriate—or proven.

Dr. Horton advises patients to be mindful of treatments that promise dramatic results without established safety data. A thoughtful, evidence-based approach is always the safest path forward.

A Long-Term Approach to Undereye Care

Maintaining a refreshed undereye appearance is not about a single treatment or product. It is the result of a combination of good habits, appropriate skincare, and carefully selected treatments when needed.

Working with a Board-Certified Plastic Surgeon and an experienced aesthetic team helps ensure that care is tailored, safe, and aligned with long-term goals.

Considering Undereye Treatment?

If you are noticing changes in your undereye area or are interested in exploring treatment options, a personalized consultation can help determine what approach is appropriate for your anatomy and goals. Contact Dr. Karen Horton’s San Francisco office to schedule a consultation