Why the Under-Eye Area Changes as We Age (And Why It’s So Delicate)

The eyes are often the first place we notice signs of ageing. From dark circles and hollowness to fine lines and crepey skin, changes under the eyes can make us look tired, even when we feel rested.

But why is this area so prone to ageing and what makes it so delicate?

I take an anatomy-first approach to understanding facial ageing. And the under-eye area or tear trough is one of the most complex and sensitive areas I treat, and requires careful, personalised attention.

Not a one-size-fits-all solution.

In this blog you will find what’s really happening beneath the surface, and how advanced, cosmetic treatments like PRF and PDO mono threads can help support and refresh this area naturally.

Why is the tear trough Area Is So Delicate?

The skin under your eyes is the thinnest on the body. Which means it's more vulnerable to changes in hydration, collagen loss, and circulation.

But there’s more to it than just thin skin.

Beneath the surface, the tear trough area contains:

• Minimal subcutaneous fat (for natural cushioning)

• A network of lymphatic vessels, which impacts fluid retention

• The orbicularis oculi muscle, constantly in motion with blinking and facial expression

• Tear trough ligaments, which can become more prominent with age

This delicate combination of structures means even small anatomical changes can lead to noticeable visual differences like hollowness, shadows, puffiness or fine lines.

How the Tear Trough Ages Over Time

As we move through our 30s, 40s and beyond, the following changes tend to occur:

• Volume loss in the mid-face and tear trough fat pads

• Bone resorption in the the bone surrounding the eye socket

• Reduced collagen and elastin production

• Thinner skin and decreased blood flow, contributing to a darker appearance

• Weakened ligaments, leading to more visible hollowing or under-eye bags

Even lifestyle factors like sleep, sun exposure, stress and nutrition can amplify these signs.

The result? A tired, sunken, or shadowed look that many clients feel doesn’t match how they feel inside.

PRF for Tear Troughs

PRF (Platelet-Rich Fibrin) is an injectable treatment derived from your own blood, rich in platelets, growth factors, and fibrin matrix. It’s a gentle, natural approach that supports tissue health in areas like the under-eyes, where skin is fragile and volume loss is common.

What makes PRF special?
PRF releases growth factors more slowly than PRP, allowing for a more sustained support process. It works well in delicate zones and may assist with improving skin quality and overall under-eye appearance.

PDO Mono Threads for TeAR tROUGHS

While PRF works biologically to support the area, PDO mono threads can be used to target crepey, thinning skin that develops under and around the eyes.

PDO mono threads are fine, dissolvable threads placed just under the skin. They don’t “lift”, but instead stimulate collagen production over time, helping improve firmness and skin quality in areas prone to sagging or laxity.

Benefits of PDO mono threads (when used appropriately):

• Improves skin texture under the eye

• Supports collagen production

• Helps soften fine lines and crepiness

• Complements other treatments like PRF or skin needling

Not every under-eye concern is the same. What looks like dark circles may be shadowing from mid-face volume loss. Puffiness might be fluid retention, not fat. And crepey skin requires a different approach than hollowing.

That’s why I offer private, in-depth consultations to assess your anatomy, skin health, and goals before recommending any treatment.