It has been almost a year since the hot search on the Internet, and it is still hard to find the No. 1 clinic for dark circles.
Hu Liang, deputy chief physician of plastic surgery with 13 years of medical experience, is the only doctor in this “Dark Circle Clinic”. Clinic hours are fixed on Monday afternoons, and only 20 sources are open online each week.
During this period of time, there were not many patients who finally received medical aesthetic treatment at the “Dark Circles Clinic”. “70% of patients with dark circles do not need excessive medical intervention”, but for Hu Liang, the need for medical intervention does not mean that doctors have no responsibility for diagnosis and treatment. Facing anxious patients, Hu Liang can always do comfort.
Can’t get a number in two months
Only 20 accounts are opened online every week, which seems to be a kind of “hunger marketing”.
Hu Liang also thought about opening more account sources. At the beginning of the establishment of the specialized disease clinic, the number of open appointments has doubled. However, Hu Liang found that not only did the patients have to wait too long, but he also did not have enough energy to deal with the patients’ demands. His ideal consultation time should be controlled within 5 to 10 minutes. In order to ensure the quality of medical visits, he limited the number of sources to 20.
Actually, if a patient goes to the hospital to register offline, Hu Liang will not limit the number of “dark circles outpatient clinics” due to the difficulty of seeing a doctor in another place. This “hidden rule” Hu Liang only mentioned to patients who need follow-up, so that patients can receive stable treatment during the course of treatment.
In contrast to the shortage of outpatient number sources for specialized diseases, there is a strong demand for dark circles under the eyes. According to the “2022 China Injectable Medical Beauty Industry Analysis Report” by New Oxygen Data Yan Research Institute, the proportion of hyaluronic acid desalinating dark circles under the eyes has been stable at about 1/5 of the hyaluronic acid project for a long time. Gutters and dark circles hyaluronic acid products are also one of the fastest-rising items overall .
Hu Liang’s plastic surgery department often comes into contact with patients who need cosmetic surgery. Originally, dark circles were not the main complaint of the patient, but compared with the appearance before and after the operation, dark circles became an additional requirement. “Even if I have medical aesthetic needs, patients don’t know which department to go to. Our hospital has a dermatology department, and patients often ask me if I can go there for treatment.” Facing these patients who don’t know which department to go to for treatment, Hu Liang took a step forward and added a special outpatient clinic for dark circles in his expert clinic.
Image source: Visual China
Being the first person to eat crabs at the demand outlet, Hu Liang’s dark circle clinic naturally “fired”. Hu Liang received nearly 100 messages on the afternoon of the opening day just from the publicity of the hospital media and local media. After that, the dark circle clinic was also searched on Weibo.
“In the afternoon, a colleague came to me and said that he heard that his dark circles under the eyes were ‘rescue’ in the special disease clinic. In fact, he stayed up a lot late, so I only gave him some beauty improvement suggestions. It also depends on whether you can reduce staying up late.” Hu Liang mentioned that even the doctor couldn’t help but be moved.
When the discussion on the Internet fades, the huge gap between supply and demand still puts the dark circle clinic in a difficult situation. A patient from Hefei has been making an appointment for a dark circle clinic online since July, and he always encountered a situation where the number was sold out as soon as the number opened. It took more than two months to get Dr. Hu Liang’s number.
Considering the treatment course of patients who seek medical treatment in other places, Hu Liang voluntarily requested to add a night outpatient clinic three months ago and extend the working hours to 8 pm.
70% of patients do not need excessive intervention for dark circles
Hu Liang’s clinic has no shortage of patients with “panda eyes”, but he found that about 70% of the patients’ dark circles do not need to be treated with drugs or medical and cosmetic interventions. The difference in the necessity of treatment comes from the different understandings of dark circles between doctors and patients.
Dark circles are not a disease, the scientific name is periorbital hyperpigmentation (POH). Despite the lack of consensus, a number of diagnosis and treatment studies have shown that dark circles can be divided into pigmented, vascular, and structural, and patients can also suffer from multiple types of the above .
Classification of dark circles Source: Reference 
“Young people who stay up late for a few days, drink alcohol, and even make-up problems may cause vascular dark circles. At this time, the blood vessels around the orbit are constricted and the skin is in a state of hypoxia, which will indeed cause dizziness around the eyes Darkening. This situation can be improved in a short period of time through changes in living habits or skin care products.” Analysis by Sun Caihong, chief doctor of the Department of Dermatology at Jiangsu Second Hospital of Traditional Chinese Medicine, “but there are also some patients who suffer from trichiasis or atopy. Eye discomfort due to dermatitis, neurodermatitis caused by frequent rubbing of the eyes, or post-inflammatory pigmentation secondary to repeated periocular skin neurodermatitis and eyelid allergic dermatitis. This pigment metabolism has a process. Some patients It is a little older, the skin is aging and sagging, or the tear trough is sunken. The treatment of this shadow type is more complicated and involves micro-plastic surgery.”
The patient’s judgment of the severity of dark circles depends on daily feedback. Hu Liang mentioned a British guy with a fair complexion. Since there are less tear troughs formed in the periorbital subcutaneous tissue, there will be dark circles under the eyes visually. EnglishThe original intention of the country boy insisting on bringing a translator to the dark circle clinic is because he is always ridiculed by people around him for “excessive indulgence”.
Over time, when the patient knocked on the outpatient clinic, Hu Liang had some judgments: this one was probably the object of his pursuit, and the other was supposed to be socializing at work… being “impressed by others” “The patients who were pushed by them came to the dark circle clinic to find the truth.
The diagnosis itself is important enough, even if there is no medical intervention in the end.
“Shadow dark circles need to be improved through medical and aesthetic methods such as hyaluronic acid filling, but this may be a normal skin aging process, and risks and demands need to be fully communicated after diagnosis.” Sun Caihong explained. In this sense, the symptoms of dark circles under the eyes are an irreversible phenomenon. Those who come to the outpatient clinic are not so much seeking medical treatment as seeking beauty.
Another rare situation is when the dark circles under the eyes are talked about by the patient overshadowing other existing conditions. “If dark circles are a medical need, ptosis is a disease. I once had a patient who thought dark circles were serious, but my diagnosis was that her eyes were asymmetrical, and there was a possibility of muscle weakness. It is a suggestion to treat ptosis.” Hu Liang mentioned.
Image source: Visual China
From home to work, 90% of the time is spent talking
When the patient came to the clinic but was told that there was no need for excessive intervention, how to give treatment advice became a difficult problem that Hu Liang had to face. Faced with anxious patients, Hu Liang can always do comfort.
During the five- to ten-minute outpatient clinic, Hu Liang spent 90% of his time talking. He often prepares a mirror and asks the patient to point out what they feel dissatisfied with, and then talk about the patient’s family and occupation on this topic, to fully understand the state of mind, and then give advice.
He had little experience at first. As more and more patients are admitted, he will say encouraging words to patients at the beginning, “Actually, when you entered the door, you didn’t notice your dark circles.” Doctor’s certificate. Once a policeman came to the outpatient clinic. He was very happy after hearing that the doctor said that he had no dark circles under his eyes. He took out his mobile phone and asked the doctor to say, “Your dark circles are not that serious.”
Patients who leave worrying about treatment options also need reassurance. A patient talked about family history, and Hu Liang talked about the patient’s emotional state from the family. In the end, Hu Liang gave a surgical suggestion for tear trough filling, and told that this can only be improved, and it will last from half a year to a year. Hearing the patient retreating here, Hu Liang could only comfort him that there was no need to worry about his appearance, and insisted on receiving treatment at the moment. When you get older or get married and feel more serious, you can still come to the outpatient clinic.
Hu Liang said frankly that the hotly searched dark circle clinic has no barriers in terms of treatment technology, and it is not special, and the clinic is also in the stage of accumulating experience. He had also heard about the idea of a private clinic planning to open while it was hot, but there was no sound afterward.
In the dark circle clinic, doctors in the industry have different opinions. On the one hand, the problem of dark circles is understood as pigmentation in the medical field, but from a medical aesthetic point of view, this is what patients need. On the other hand, dark circles are not a disease. Specialized disease clinics should better serve the follow-up of chronic diseases, and use specialized disease clinics to meet the needs of patients. Instead, it creates anxiety that dark circles are diseases.
Hu Liang did not consider this issue. He wants to let patients in need of dark circle treatment know there is a solution, but he also worries about sending the wrong message about dark circles. Now, Hu Liang still hopes to continue to open the special outpatient clinic for dark circles. “The absence of the special outpatient clinic does not mean that anxious patients do not exist. In the face of these patients, comfort is also of value.”
Thanks: This article has been professionally reviewed by Sun Caihong, chief physician of the Department of Dermatology, Jiangsu Second Hospital of Traditional Chinese Medicine
Image source: Visual China
 New Oxygen Data Yan Research Institute, “2022 China Injectable Medical Beauty Industry Analysis Report”
 Ma Gang, Xu Tianhua, Zhao Xun, Song Weimin, Jiang Li, Cao Dongsheng, Liu Geng & Fu Jun, Lin Xiaoxi. (2016). Progress in the diagnosis and treatment of dark circles. China Laser Medicine Magazine, 25(6), 6.
Sarkar, R., Ranjan, R., Garg, S., Garg, V. K., Sonthalia, S., & Bansal, S. (2016). Periodic hyperpigmentation: a comprehensive review. The Journal of clinical and aesthetic dermatology, 9(1), 49.
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