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Much like waking up to a sudden redness, pimple, or blackhead, finding out that dark circles have formed under your eyes overnight can be a bit of a shock. After all, a sunken, purple, blue, or brown, bruise-like under-eye appearance may appear alarming at first glance for those whove never experienced it before. But board-certified dermatologist Courtney Rubin, MD, assures us that dark circles are actually "a common concern” among her patients and arent typically a medical problem.
There are a variety of factors that can contribute to dark under-eye circles, such as aging, genetics, or lack of sleep. And if youre looking to treat the condition, Rubin notes that understanding each dark circle contribution factor is critical to knowing how to reduce them. To learn more, we tapped Rubin, along with board-certified dermatologists Dendy Engleman, MD, and Alan Parks, MD, and board-certified cosmetic surgeons David Shafer, MD, and Reza Tigari, MD, to outline what dark circles actually are and whos at risk for getting them.
Ahead, the best dark circle treatments, as well as tips from the experts on how to prevent them in the first place
Meet the Expert
Dendy Engleman, MD, is a board-certified dermatologic surgeon at New York Citys Shafer Clinic.
Alan Parks, MD, is a board-certified dermatologist and founder of Park Perfection.
David Shafer, MD, is a cosmetic surgeon who leads Shafer Plastic Surgery in New York City.
Reza Tirgari, MD, is a cosmetic surgeon and founder of the San Diego–based boutique laser treatment clinic and medical spa Avalon Laser.
What Are Dark Circles Under Your Eyes?
"Dark under-eye circles, also known as periorbital hyperpigmentation, are visibly darkened areas appearing right under the eye caused by a variety of lifestyle factors, aging, genetics, and visibility of the blood vessels," according to Engleman. They can manifest in shades of brown, blue, black, or purple.
Dark circles under the eyes can affect people of all ages, skin tones, and skin types, according to Shafer. However, they are typically more common in older adults and those with a genetic predisposition to the condition.
What Causes Dark Circles Under Eyes?
There are numerous reasons that dark circles may pop up under your eyes. "For some individuals, dark under-eye circles can be more apparent depending on sleep, hydration, sodium intake, and lifestyle factors. For others, it can be genetic or worsen with age as we lose volume in the face," says Engleman. Here are the most common reasons they appear:
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Genetics
"[Some people] are born with under-eye circles and therefore fall into the hereditary category," says Engelman. "Theyre born with thinner, paler skin with more pigment under their eyes, and/or slower vascular movement."
"There can be dark blood vessels, which are visible through the skin," Shafer further explains. "Then theres the skin itself, which can be thicker and opaque or thinner and translucent. Lastly, theres the skins surface, which can be dark with increased pigmentation. Many of these factors can be genetic, a result of your bodys development, and environmental. However, in most cases, all the above."
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Youre Losing Volume
A major reason dark, sunken under-eyes become visible is due to a natural loss of volume in the facial area. “Underneath the eye is a special pillow of soft tissue called the SOOF (suborbicularis oculi fat),” explains Rubin. “Over time, this pillow of tissue shrinks and descends, leading to a decrease in the natural volume of the under eye and the creation of a shadow. This is one of the most common causes of dark circles.”
What’s more, she points out that as we age, the delicate skin covering that area of tissue is also prone to losing collagen and elastin, leading to thinner skin and even more obvious volume loss and shadows. Tigari adds that as volume diminishes under the eye and skin becomes thinner, the deeper capillary bed becomes more noticeable, which is why the under-eye area appears darker with age.
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Youre Not Getting Enough Sleep
Here’s another fairly well-known cause of dark under-eye circles. Tigari points out that sleep irregularities can lead to eyes appearing dark and/or baggy as a reflection of a hectic schedule.
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Youve Got Allergies or Sinus Congestion
Allergies have such a common impact on the appearance of under-eyes that Rubin says there’s actually a name for it: “allergic shiners.”
“Basically, the inflammation from allergic conjunctivitis (allergies affecting the eyes), along with frequent friction and rubbing of an itchy eye area, can lead to broken blood vessels and bruising,” she explains. “As the bruising heals, pigmented hemosiderin (a component of hemoglobin) is left behind, which causes dark marks under the eyes.” Even without rubbing, however, the periocular inflammation associated with allergic conjunctivitis is enough to cause post-inflammatory hyperpigmentation by itself, according to Rubin.
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Youre Dehydrated
“Remember, water makes up about 60 percent of the human body,” Rubin says. “If you are seriously dehydrated, your body’s tissues will begin to shrink, including your skin and the delicate tissue under the eyes.” So if you’re, say, in your 20s, you might want to reevaluate your water consumption before automatically jumping toward cosmetic treatments.
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Youre Straining Your Eyes
Straining your eyes doesn’t just hurt your vision—according to Parks, it can impact your under-eye appearance, too. “When you struggle to see something and strain your eyes, your blood vessels enlarge under your skin and show through as dark circles more prominently,” he explains. Parks suggests getting your eye prescription checked to avoid further straining and, as a result, darkening.
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Youve Got an Underlying Medical Condition
A less likely cause of dark circles is an underlying health condition. “There are conditions such as anemia, malabsorption syndromes, poor nutrition, hypothyroidism, and certain metabolic syndromes that can also lead to dark under-eye circles,” Tirgari says.
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You Have a Vitamin Deficiency
"Some vitamin and nutrient deficiencies can cause dark circles," Engleman says. Namely, vitamins B12, E, K, and D have been associated with the formation of dark under-eye circles. If you think a vitamin deficiency may cause your dark circles, speak with your primary care physician, who can confirm and administer treatments for vitamin deficiencies.
Are Dark Circles Permanent?
According to Shafer, dark under-eye circles are not permanent and can come and go naturally or be reduced with at-home and in-office treatments.
Can They Be Prevented?
"A combination of in-office treatments and over-the-counter skin care products can help best prevent and improve discoloration over time," Engleman says, "Getting proper sleep, hydration, and sticking to a skincare regimen can help combat the appearance too."
How to Treat Dark Circles
If youve decided to treat your existing under-eye circles, know that there are multiple concealers, creams, and in-office procedures that can all help, depending on the type of dark circles youre dealing with. Here are the best dark circle treatments:
Over-The-Counter Treatments
“There are always things you can try to help mask the appearance of dark circles, such as eye creams that include caffeine, retinol, algae, hyaluronic acid, and more," says Parks. "Caffeine is a vasoconstrictor, which, in turn, reduces redness, swelling, and extensive fluid from pooling around the eyes," adds Levine. "This will give a tightened appearance around the eyes."
Dermal Fillers
Volume loss caused by aging "can be corrected easily and quickly with specific dermal fillers that are made for this purpose,” Tigari says, noting that if that’s your goal, its important to see a practitioner with skill and experience with the procedure.
Make Lifestyle Changes
"Depending on what is causing [dark circles], you may be able to make lifestyle changes to combat this issue. For example, prioritizing sleep or protecting your skin from sun exposure can help reduce the appearance of dark under-eye circles," Shafer says.
Control Your Allergies
According to Shafer, "controlling your symptoms and irritants can help reduce" the effects of allergies on your dark under-eyes. You can try over-the-counter sinus medications, or as Engelman suggests, "speak to your physician about getting antihistamines like Zyrtec and Claritin." She also recommends "a daily sinus irrigation with a neti pot or similar product to clear the sinuses and improve the under-eye appearance" and notes that "lymphatic drainage massages that you can do yourself can reduce the puffiness" (think gua sha and facial rollers).
Apply Cold Compresses
Visible blood vessels seen through thin skin may contribute to dark circles under your eyes. Engleman suggests holding a cool compress to the area for five minutes to help shrink the blood vessels.
Increase Hydration
Our experts recommend making sure youre drinking enough water throughout the day. If you find that you do drink plenty of water, perhaps it’s other beverages you indulge in that could be to blame. Tigari notes that caffeine, alcohol, and other diuretics may lead to dehydration and require even more water for recovery—so you may want to scale back.
Laser Treatments
"In-office laser treatments can provide longer-lasting results for dark undereye circles," Engleman says. "I recommend CO2 fractional laser treatments, which can help reduce dark pigmentation underneath the eyes and improve volume loss or light-based devices like Broadband Light Therapy (BBL) or Pulsed Dye Laser, which can help reduce the appearance of hyperpigmentation and dark blood vessels under the eyes. "
Blepharoplasty Surgery
"If the patient has significant fat bags on the lower lids, I often perform blepharoplasty surgery to help reduce the bulging fat, which will lead to reduced shadowing under the eyes," Shafer says. "During the surgery, I also tighten the skin and can apply a chemical peel to help decrease skin pigmentation."
When to See a Doctor For Dark Under-Eye Circles
If youve tried just about everything and your dark circles persist or if youve noticed changes under just one eye that worsen over time, "its always a good idea to have a thorough exam and get labs with your primary physician," according to Tigari.