The Best Treatment for Under-Eye Hollowness: Understanding PDGF and Your Options
16
Oct
2026
Under-eye hollowness can make your whole face appear tired, even when you are rested and healthy. That subtle, sunken look creates shadows, emphasizes dark circles, and changes the way light catches your upper cheeks.
For some people, these changes creep up gradually with age. For others, it’s just facial anatomy they’ve had since early adulthood, usually due to genetics.
As regenerative aesthetics continues to evolve, Platelet-Derived Growth Factor (PDGF) has attracted a lot of attention for its potential role in skin rejuvenation. It is increasingly discussed alongside popular treatments like Platelet-Rich Fibrin (PRF), microneedling, and injectable dermal fillers.
However, understanding what each treatment actually does is essential before you make a choice. Under-eye hollowness isn’t simply a skin-quality issue. It often involves changes deep in the underlying structure and volume of the face. That means a treatment designed primarily to support skin renewal may not be the right choice to fix the underlying depression.
So, can PDGF genuinely help with under-eye hollowness, and how does it stack up against other options?
What Causes Under-Eye Hollowness?
Under-eye hollowness—sometimes called a "tear trough" deformity—happens when the area between your lower eyelid and your upper cheek appears sunken or depressed. Several factors can contribute to this:
- Your Natural Facial Anatomy: Some people are simply born with deeper tear troughs due to the shape of their eye sockets, the position of the underlying tissues, or how their cheekbones and lower eyelids connect. In these cases, hollowness may be noticeable even in younger adults.
- Age-Related Volume Loss: As the face ages, fat compartments can shift or lose volume, and the supporting structures beneath the skin naturally become less prominent. The cheek can lose fullness, which makes that natural transition between the lower eyelid and cheek more noticeable.
- Changes in Skin Quality: Skin gradually becomes thinner and less elastic as collagen and elastin stores decrease over time. Thinner skin is more translucent, making the underlying anatomy more visible, which contributes to shadows and a tired appearance.
- Genetics and Lifestyle: Genetics play a massive role in your facial structure and how fat is distributed beneath your eyes. While sleep deprivation, dehydration, and allergies can influence how the area looks temporarily, they do not cause true, structural hollowness.
Understanding the root cause is vital because a hollow caused by volume loss is completely different from a dark circle caused by pigmentation, or a shadow created by a prominent fat pad. These concerns can look identical in photos but require very different clinical approaches.
What Is PDGF?
PDGF stands for Platelet-Derived Growth Factor. It is a vital signaling protein that helps direct the biological processes associated with tissue repair and cellular activity in your body.
In aesthetic medicine, PDGF has generated interest as a potential way to support skin rejuvenation, especially when used in conjunction with certain procedures. Unlike PRF, recombinant PDGF products are manufactured preparations, meaning they do not necessarily require a blood draw from you.
Research into applying PDGF topically following aesthetic procedures has shown very promising results. For instance, a 2025 randomized controlled clinical trial found improvements in several measures of facial skin quality when pure PDGF was used topically following microneedling, compared with standard post-procedure care.
However, it is important to distinguish this from injection. A topical growth-factor product, an injectable preparation, and a product approved for a specific medical indication are not interchangeable.
For example, Ariessence pure PDGF+ is explicitly marketed as a topical cosmetic product. Its manufacturer clearly states that injection is not an approved use. Its topical application after a procedure should not be confused with injecting PDGF beneath the eyes.
Can PDGF Injections Correct Under-Eye Hollowness?
This is where the distinction between skin rejuvenation and volume restoration becomes especially important.
PDGF is associated with cellular signaling and tissue repair. However, there is currently insufficient established clinical evidence to conclude that aesthetic PDGF injections can reliably correct under-eye hollowness caused by true, structural volume loss.
A hollow is a depression—a negative contour in the face. To correct it, treatment generally needs to address the underlying anatomy or provide structural support to lift that area. A growth-factor-based approach intended to improve skin quality (thickness, texture) serves a different purpose than a treatment designed to physically restore volume. Even if the skin quality in the area improves, the underlying depression will remain.
There are also critical product and regulatory considerations. The fact that certain PDGF-containing products have FDA approval for specific medical uses does not mean that injectable PDGF is FDA-approved for the cosmetic treatment of under-eye hollowness. The exact product, formulation, evidence base, and regulatory status must therefore be established before you consider this approach.
For anyone specifically interested in injectable PDGF beneath the eyes, a qualified medical professional must explain what product is being proposed, whether that use is authorized, what evidence supports it, and what risks are known or remain uncertain.
How Does PDGF Compare With Under-Eye Filler?
Hyaluronic Acid (HA) dermal fillers are specifically designed to provide volume and structural support. Certain HA products have FDA-approved indications for improving the appearance of depressed or hollow areas beneath the eyes in appropriately selected adults.
Restylane Eyelight and JUVÉDERM Volbella XC are examples of products with FDA-approved indications specifically for infraorbital hollowing. This approval applies to those specific products and uses, not to all fillers or all under-eye injection techniques.
The difference in treatment goals is important:
- Under-eye filler may be considered when a visible depression is primarily caused by volume deficiency and your anatomy is suitable for treatment. It helps soften that transition between the lower eyelid and cheek.
- PDGF-based treatments are discussed in the context of regenerative signaling and skin quality. They should not be assumed to provide the same immediate, physical structural support as a volumizing filler.
Neither approach is right for every patient. Under-eye filler requires extreme care because the area is anatomically delicate. Potential complications can include persistent swelling, lumps, contour irregularities, and rarely, serious vascular complications. A thorough, in-person assessment is necessary before deciding if filler is appropriate at all.
What About PRF for Under-Eye Hollowness?
Platelet-Rich Fibrin, or PRF, is prepared entirely from your own blood. The blood is processed to create a platelet- and fibrin-rich preparation that can be used in selected regenerative treatments.
PRF has been studied extensively for under-eye rejuvenation, particularly for improving skin texture, fine lines, and crepiness. However, the evidence varies, and you should never confuse improvements in skin quality with reliable correction of a pronounced structural hollow.
PRF is not a direct substitute for a treatment designed to physically restore lost volume. Someone with substantial structural hollowness may need a very different approach than someone whose main concern is thin, crepey skin.
Furthermore, the fact that PRF and PDGF are both discussed in "regenerative aesthetics" does not mean they work identically. PRF is derived purely from your own blood, while recombinant PDGF preparations may contain a defined, manufactured growth factor. Their preparation, evidence, and appropriate uses differ significantly.
When Might Skin-Rejuvenation Treatments Help?
Not every under-eye concern is caused by volume loss alone. Many people have a combination of mild hollowness, fine lines, crepey skin, uneven pigmentation, and changes in elasticity.
In these cases, improving the skin quality may be a useful part of a broader treatment plan, even if it does not eliminate the structural hollow itself. Depending on your anatomy and skin condition, a provider may consider selected resurfacing treatments, topical skincare, or other approaches to improve the appearance of the surrounding skin.
The under-eye area requires special care, however. Treatments that are appropriate for the cheeks or other facial areas are not automatically safe for the lower eyelids. Device settings, treatment distance from the eye, eye protection, and provider experience are all non-negotiable considerations.
It is also vital to correctly identify whether dark circles are caused by pigment, visible blood vessels, shadows, or a combination of factors. Treating the wrong cause can produce disappointing results.
When Is Surgery a Better Option?
Under-eye bags and hollowness are often confused, but they are not the same concern.
Hollowness creates a depression. Under-eye "bags" usually result from prominent fat pads, changes in the supporting tissue, or fluid retention. It is possible to have one concern, or both at the same time.
When prominent fat pads or excess lower-eyelid skin are the main issue, a regenerative treatment or filler may not provide the desired correction. Lower blepharoplasty, a surgical procedure that addresses lower-eyelid fat and sometimes excess skin, may be a more appropriate and effective solution for selected patients. Surgery isn't necessary for every under-eye concern, but it is worth discussing when the primary issue is structural and non-surgical options are unlikely to address it adequately.
What Should You Expect From Treatment?
Your expectations should be based on the actual treatment goal.
If the goal is to improve skin texture, your provider should explain what degree of refinement is realistic and how long improvement may take. If the goal is to correct a hollow, the plan should address the underlying contour, rather than promising that better skin quality will automatically restore volume.
Results vary significantly according to your age, anatomy, skin condition, medical history, and the specific product or procedure used. Some treatments may require a series of sessions, while others may involve a single treatment followed by monitoring or maintenance.
It is equally critical to understand potential downtime and risks. The under-eye area is exceptionally delicate. Treatments should never be selected solely because they are described as "regenerative," "natural," or "minimally invasive."
Finding the Right Approach for Your Under-Eyes
There is no single treatment that works best for every type of under-eye hollowness.
- For a true, structural depression, an appropriately selected and specifically approved under-eye filler may be an option.
- For fine lines or crepey skin, a skin-quality-focused approach may be more relevant.
- For prominent fat pads or excess skin, a surgical evaluation may offer a more suitable solution.
PDGF is an area of growing interest in regenerative aesthetics, but injectable PDGF should not be presented as a proven or universally appropriate treatment for under-eye volume loss. Its role depends entirely on the exact formulation, intended use, available evidence, and regulatory status.
The most useful first step is identifying exactly what is creating the hollow appearance. Once the cause is understood, treatment can be selected according to your specific anatomy, skin condition, desired result, and acceptable level of risk.
The goal isn't simply to make the under-eye area look fuller. It is to choose an approach that addresses the actual concern while preserving natural facial proportions and protecting the delicate tissues around your eyes.