Shereene IdrissBoard Certified Derm, Founder and Chief Nerd

Botox and eye creams don’t treat under-eye hollowing. Here’s what actually does…

31 Mar 2026 · 2 min

Watch on YouTube

1:30

In this educational video, Shereene Idriss explains that under‑eye hollows are a structural issue caused by mid‑face volume loss and bone resorption, not a problem that can be fixed with Botox or topical eye creams. She emphasizes the importance of diagnosing the underlying cause before treatment. Idriss outlines three effective interventions: (1) hyaluronic‑acid fillers placed strategically along the outer face to create a lift and improve the tear‑trough area, (2) platelet‑rich fibrin (PRF) derived from the patient’s own blood to strengthen under‑eye tissue, and (3) stem‑cell‑enriched fat transfers to regenerate tissue and restore mid‑face volume for a natural, rested look. She underscores that many patients receive ineffective treatments because the real issue isn’t identified, and she ends with a call to subscribe for more content.

Chapters

What do I do to get rid of it? I've done the, um, Clear Brilliant. I've done Botox. I've never done fill. I use great eye cream. I always— I hear this every week, and I need to say this clearly and with love: Botox and under-eye creams are not a treatment for under-eye hollows. Under-eye hollowing happens when you're losing volume in your midface over time, in addition to the fact that your bone structure is literally hollowing out and your under-eyes are sinking in. And that groove that you're seeing, that's your tear trough, and it's structural. Botox, which relaxes the muscle, is never going to address that structure. And no eye cream, no matter how good, is ever going to rebuild volume or bone density. For true under-eye hollowing, these are your options. Hyaluronic acid fillers can help, but I did not just inject her under eyes. In fact, I injected along the outer aspect of her face to give the illusion of a lift while making her under eyes look better. 2, PRF. I've used this for my under eyes where we derive it from our own blood to help to strengthen our tissue under our eyes. And 3, if you do not want to have surgery that's changing your under eye, stem cell enriched fat transfers are a great option to regenerate your tissue under your eyes while revolumizing your midface where you've lost that volume to give you an overall naturally rested appearance. This is 5 months after. The real issue here is not that you've tried Botox or eye cream, is that nobody has helped you identify your actual problem. And that is true for most under-eye concerns. Diagnose first, treat second. Subscribe if you want more of this.