Dark Circles Under Eyes: Causes, Risk Factors, and Treatment

Dark circles under the eyes are a common dermatological concern, especially in women between the ages of 16-25.

Though dark circles are not usually signs of an underlying medical problem, because of their association with aging and fatigue, they can contribute to low self-esteem and an overall lower quality of life. 

According to data gathered in 2016, it’s estimated that the average woman in the United States spends $15,000 (USD) in her lifetime on cosmeceuticals and makeup.

A significant percentage of this is spent on under-eye concealers aimed at masking the appearance of dark circles and/or bags under the eyes. 

In this article, we’ll go over the causes and risk factors of dark circles under the eyes and which strategies may work to get rid of them.

We’ll also cover what you can do to prevent under-eye dark circles and when you may want to reach out to a healthcare provider.

Causes

There are many possible causes of dark circles under the eyes, a condition which has many names. 

Other terms used to refer to dark circles include: 

• Under-eye circles
• Periorbital hyperpigmentation
• Infraorbital dark circles
• Periocular hyperpigmentation
• Periorbital melanosis
• Infraorbital darkening
• Infraorbital discoloration
• Idiopathic cutaneous hyperchromia of the orbital region

There are four main types of dark circles:

1. Pigmented (brown color)
2. Vascular (blue, pink, or purple color)
3. Structural (skin color)
4. Mixed (a mix of more than one of the above types)

In most cases, the cause of dark circles is multifactorial, meaning there is more than one factor that contributes to their appearance.

Below are some of the most common causes and factors of dark circles under the eyes.

Genetics

A person’s ethnic origin and genetics are considered to have a significant impact on whether or not they will develop dark circles. 

In many cases, dark circles that run in families begin in early childhood and increase in pigmentation as people age. 

Postinflammatory hyperpigmentation

Postinflammatory hyperpigmentation is a common condition in which the skin develops more melatonin after inflammation or injury. 

Skin conditions that can cause postinflammatory hyperpigmentation include: 

• Atopic dermatitis
• Allergic contact dermatitis
• Psoriasis
• Lichen planus pigmentosus
• Erythema dyschromicum perstans

Though anyone can have postinflammatory hyperpigmentation, it’s found with greater frequency and severity in people with darker skin. 

Puffy eyes

Puffy eyes, also known as periorbital edema, are a result of fluid accumulation in the eye area and can also cause or worsen the appearance of dark circles.

Puffy eyes can happen due to infection, systemic illness, allergies, or other causes. 

Facial structure

The structure of your face can also impact your likelihood of developing dark circles. 

For example, tear-trough depression refers to a small depression (usually between 2-3 mm in size) of the lower eyelid.

This depression can be a result of inherited anatomical differences and/or aging and can cast a dark shadow or circle on the lower eyelids.

Other facial structure differences that can cause dark circles include:

• A thin layer of skin overlying the orbicularis oculi, or eyelid muscles
• Superficial location of vasculature

Other causes

There are other possible causes of dark circles.

Keep in mind that some of these causes may not have as much evidence linking them to dark circles as the causes listed above.

Other potential causes include:

• Lack of sleep or sleep disorders
• Excessive sun exposure
• Chronic illness
• Anemia
• Ocular hypotensive drugs
• Chemotherapy drugs
• Non-steroidal inflammatory drugs
• Ultraviolet radiation
• Lifestyle factors (certain factors like poor nutrition, stress, alcohol overuse, and smoking may contribute indirectly or directly to dark circles, but more evidence is needed to determine their level of impact on the condition)

How To Get Rid of Dark Circles

The first step in managing dark circles is to determine which factors may be contributing to your dark circles.

Working with a provider and/or dermatologist can help you to identify these possible factors.

Treatment options include concealment, minimally invasive procedures, and surgery. 

Below are some of the more common treatment options for getting rid of dark circles: 

• Concealment: Many cosmetic products, including concealers and foundations, are used to hide the appearance of dark circles. Keep in mind that most of these products will not work to adjust the natural pigmentation on your skin. However, products containing retinoids, hydroquinone, peptides, or caffeine may be especially helpful at decreasing discoloration of the skin.

• Non-invasive treatments: Several non-invasive dermatological treatments may help to lighten the skin under the eyes and stimulate collagen contraction. These include intense pulse light (IPL) therapy, radiofrequency (RF), Q-switched lasers, and pulsed dye lasers. 

• Invasive superficial treatments: You may speak to your provider or dermatologist about chemical peels, medical tattoos, ablative laser resurfacing, or hyaluronic acid gel soft tissue fillers. Keep in mind that some beauty spas may offer these treatments without medical licensing, but these services can be unsafe and not covered by insurance. When searching for dermatological procedures, be sure to seek treatment from a licensed professional. Some, if not most, of these procedures are considered cosmetic and not covered by insurance, even if the doctor that performs them is covered by your plan. 

• Invasive medical treatments: Fat transfer, surgery (such as blepharoplasty), and surgical implants are the most invasive options available for correcting dark circles. 

Prevention

Because there are many possible causes, dark circles cannot always be prevented. 

However, there are some things you can do to reduce the chances of getting dark circles:

• Sun protection: Protect your skin from sun exposure whenever possible by using hats, eyewear, sunscreen, and other protective measures. Avoiding prolonged sun exposure between the hours of 10am-5pm will also help to protect your skin.

• Prioritize skin health: Be sure to speak with your provider about any existing skin conditions and your treatment options.

• Get adequate sleep: Though sleeping well is easier said than done for many people, aiming to improve your sleep hygiene can reduce the risk of getting dark circles. This includes going to bed around the same time every night, limiting caffeine intake in the afternoon, and avoiding blue light from electronics for about 30 minutes to one hour before bedtime.

• Stress management: Stress may also exacerbate the appearance of dark circles. Incorporating a stress management technique into your routine may help limit the physical impacts of stress on the body.

Risk Factors

There are several factors that can increase your risk of developing dark circles, including:

• Ethnicity: Dark circles are more commonly found in people with Mediterranean ethnicities. 

• Genetics: If people in your family have dark circles, you are more likely to develop them as well. In fact, dark circles are most often seen in multiple members of the same family. 

• Age: Older individuals are more likely to have dark circles, as well as dark circles that are more pronounced in pigmentation.

• Certain medical conditions: Certain medical conditions can increase the likelihood of developing dark circles, including skin conditions associated with inflammation and sleep disorders that cause chronic fatigue. 

When To Seek Medical Attention

Dark circles are rarely a sign of a medical concern.

However, for some people, they can be the result of injury or a skin condition. If you’re concerned about your skin health, reach out to your provider to discuss your symptoms for proper diagnosis and treatment.

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.