What causes dark under-eye circles?
Dark under-eye circles usually arise from one or more of four mechanisms: increased brown pigment in the skin, underlying vessels and muscle showing through thin under-eye skin, the shadow cast by a tear trough hollow or eye bag, and skin thinning with age. Heredity, lack of sleep, allergy and sun can make the look more pronounced.
Under-eye skin is noticeably thinner than skin elsewhere on the face and has little fat beneath it. Right under this thin skin lie the ring-shaped muscle that closes the eyelid and a dense network of small veins. The thinner and lighter the skin, the more easily the bluish or purplish tone of these structures shows. At the transition between the lower eyelid and the cheek there is a groove known as the tear trough; as fat and bone support change with age, this groove can deepen. Fat around the eye that becomes prominent can also form a bag with a shadow line just below it.
Various factors add to this structural base. Heredity can influence both the tendency to pigment and the depth of the tear trough, which is why in some people the darkness has been there since childhood or adolescence. Lack of sleep and fatigue can make the skin look paler and the vessel tone more visible. Allergic nasal congestion can cause fullness in the veins around the eyes, and frequent eye rubbing can increase pigment over time. Sun, smoking and collagen loss with age also contribute. Most of these factors make the look more pronounced but do not explain the darkness alone, so at the consultation they are assessed together.
What are the types of under-eye darkness, and how are they told apart?
Under-eye darkness is broadly divided into pigment-related, vessel and thin-skin related, structural shadow and mixed types. The colour tone, how the colour changes when the skin is gently stretched, and how the shadow varies with the angle of light offer clues; the definite distinction is made at an in-person examination.
In pigment-related darkness the colour is mostly brown or grey-brown and does not clearly disappear when the skin is gently stretched. This type is more common in people with darker skin and a family tendency. Pigmentation that develops after sun exposure, or after frequent rubbing because of eczema or allergic itching, can look similar. In vessel and thin-skin darkness the tone may be bluish, purplish or pinkish, and it is often described as more visible with tiredness, cold or during allergy periods. This type is easier to notice in fair, thin skin.
In structural shadow the skin itself may show no marked colour change; the dark look comes from the tear trough hollow or bag blocking light. The shadow therefore becomes more visible when light comes from above, for example under elevator or bathroom lighting, and lessens when light comes from the front or when the head is tilted back slightly. In most people these types coexist: a mild hollow, thin skin and some pigment can be present together. These mirror observations give an idea but do not replace a diagnosis. At the examination the colour and thickness of the skin, the presence of a hollow or bag, and any tendency to swelling are assessed together to work out how much each cause contributes.
What options exist for pigment-related under-eye darkness?
For pigment-related darkness the basis is sun protection, avoiding rubbing and irritation, and doctor-recommended skin-lightening care; in some people chemical peels or suitable lasers may be considered. Mesotherapy and filler do not directly target pigment and, on their own, generally do not give the expected effect in this type.
Pigment around the eyes can darken easily with sunlight. Applying broad-spectrum sunscreen gently to the eye area and wearing sunglasses are therefore the foundation of the approach. If there is allergic itching or eczema, treating it and not rubbing the eyes can reduce new pigment formation. Depending on the nature of the pigment, a doctor may suggest lightening ingredients suitable for the eye area; because the skin there is sensitive, using such products at random can cause irritation and, conversely, more darkening. The effect in most people appears gradually over weeks to months, and regular use and sun protection need to continue.
In some people mild chemical peels or laser and light treatments aimed at pigment may be considered; around the eyes these methods need experience and care, and in darker skin the risk of post-inflammatory darkening is discussed separately. Some mesotherapy products containing lightening components exist on the market, but information on their effect on under-eye pigmentation is limited; this option can only be discussed individually, once expectations are clear. Under-eye mesotherapy, light filler or salmon DNA treatments do not directly lighten pigment. If thin skin or a hollow is present along with pigment, these methods may be part of a plan aimed at the other causes.
What can be done for vessel and thin-skin darkness?
For vessel and thin-skin darkness the aim is to support the quality and density of the under-eye skin so that the underlying vessel tone is less visible. Under-eye mesotherapy and polynucleotide (salmon DNA) products can be considered for this; the effect is gradual and limited, and it does not remove vessels.
In under-eye mesotherapy, low-density hyaluronic acid or amino acid products are usually placed superficially in small amounts into thin skin. Polynucleotide products, known as salmon DNA, are a different ingredient class and have variants developed for the eye area. In both approaches the goal is skin that looks more hydrated, elastic and dense, which in some people may help the bluish tone draw less attention. Several sessions a few weeks apart are generally needed, and results vary from person to person. The details, session plans and limits of these methods are covered on our under-eye mesotherapy and under-eye salmon DNA pages.
In prominent, thick-looking vessels, some laser or light treatments may be assessed separately; that decision depends on the vessel and on safety around the eye. Where darkness is linked to allergic nasal congestion, treating the allergy can noticeably change the look. Regular sleep, not rubbing the eyes and staying away from smoking are supportive steps. A cold compress can temporarily reduce morning puffiness but does not change vessel tone. Under-eye filler does not target vessel tone; in very thin skin, superficially placed filler can create a bluish reflection, so it is assessed carefully in this type and is often not the first option considered.
Which methods come up for the shadow of a tear trough hollow or bag?
For the shadow cast by a tear trough hollow, hyaluronic acid under-eye light filler and, where needed, cheek support may be considered in suitable people. With a marked fat bag or frequently recurring puffiness, filler may not be suitable; an assessment by the relevant specialty for eyelid surgery is then recommended.
In people with a pronounced tear trough, relatively thick skin and no fat bag, placing a small amount of hyaluronic acid of suitable consistency with a cannula or needle can soften the shadow. This is commonly known as light filler, and its details are covered on our under-eye light filler page. In some people the main problem is loss of support in the mid-face; in that case supporting the cheek first, rather than filling under the eye directly, can give a more balanced result. Because filler does not change under-eye skin quality, if thin skin is also present, skin-quality treatments such as mesotherapy or polynucleotides can appear in the same plan at different times.
An under-eye bag usually forms when fat around the eye becomes prominent. The bag and the shadow just beneath it cannot be reduced with injections; in that situation filler can sometimes make the bag look more prominent. Puffiness that is worse in the morning and eases through the day may point to a tendency to oedema, and hyaluronic acid products can increase that swelling. For this reason, in people with a bag or a tendency to oedema, referral to a specialist in this area for options such as eyelid surgery can be made. At the examination the contribution of the bag and of the hollow to the shadow is assessed separately; not injecting on the basis of unrealistic expectations is part of safe planning.
Who may not be suitable, and when is medical assessment needed first?
Under-eye injections may be postponed or not recommended in people with an active infection or eczema around the eyes, during pregnancy or breastfeeding, with a known allergy to the product, or with a marked bag or tendency to oedema. Darkness that started recently, is one-sided, or comes with swelling and itching needs medical assessment first.
Assessing suitability for under-eye injections covers eye-specific information as well as general health history. Thyroid disease, allergic eye problems, dry eye, previous eyelid surgery, or products of unknown content used around the eyes can affect the plan. Blood thinners and some supplements increase the likelihood of bruising; you should not stop prescribed medication without asking your doctor. Elective injections are usually postponed during pregnancy and breastfeeding. It also matters that expectations match what the method can offer; expecting the darkness to disappear completely is often unrealistic when the cause is mixed. The decision on suitability rests with the doctor.
Under-eye darkness is mostly a harmless, long-standing appearance, but some situations need medical assessment first. If the darkness appeared over a short time or is increasing quickly, if the change is marked in only one eye, or if it comes with eyelid swelling, redness, itching or pain, changes in vision, or general symptoms such as fatigue, pallor and palpitations, the relevant doctor should be consulted before any aesthetic treatment is planned. Anaemia, allergic disease, thyroid problems or skin conditions can play a role in this picture. At the consultation these possibilities are asked about first, and referral to the relevant specialty is made if needed.
Frequently asked questions
Does lack of sleep really make dark circles worse?
Yes, lack of sleep and fatigue can make under-eye darkness look more pronounced in most people. The skin can look paler, and fluid retention and vessel tone around the eyes can increase. However, if there are structural causes such as inherited pigment or a tear trough hollow, the darkness continues despite regular sleep. Sleep is therefore a supportive step, not a solution on its own.
Dark circles run in my family; can they be hereditary?
Yes, dark circles can have a hereditary side. The tendency to pigment, the thinness of under-eye skin and the depth of the tear trough can look similar within a family, which is why in some people the darkness has been there since childhood or adolescence. In hereditary darkness the aim is to identify the cause and soften the appearance; because genetics cannot be changed, expectations are set accordingly.
Do eye creams get rid of dark circles?
Eye creams can offer only a limited contribution, depending on the cause. Moisturising ingredients may make thin skin look fuller and smoother, and lightening ingredients recommended by a doctor may help pigment-related darkness fade gradually over weeks. Products containing caffeine may temporarily reduce puffiness in some people. No cream changes the shadow cast by a tear trough hollow or a bag.
Does iron deficiency cause dark circles?
Iron deficiency and anaemia can make the skin look paler and make under-eye darkness more noticeable, but not everyone with dark circles is iron deficient. If symptoms such as fatigue, tiring easily, pallor or hair loss are also present, it is appropriate to see your doctor for a blood test. You should not take iron supplements on your own without testing.
Can allergy cause dark circles?
Yes, allergic nose and eye problems can make dark circles more pronounced. Nasal congestion can cause fullness in the vessels around the eyes and create a bluish-purple shadow, and frequent eye rubbing because of itching can increase pigment over time. Treating the allergy and avoiding rubbing can affect the look in this type; aesthetic treatments are usually planned outside an allergy flare.
How can I make dark circles less noticeable with make-up?
A colour corrector matched to the tone of the darkness helps most people. Peach or orange-toned correctors are often used for bluish or purplish tones, and a lightly warm concealer close to your skin tone for brown pigment. With shadow from a hollow, thick matte concealers can settle into lines and emphasise the shadow; thin layers on moisturised skin give a more natural look.
Do dark circles get worse with age?
In most people, yes. With age the under-eye skin thins, collagen decreases and the underlying vessel tone becomes easier to see; changes in fat and bone support around the eye and cheek can also deepen the tear trough. Years of sun exposure can increase pigment. For this reason, at older ages the darkness is usually of mixed cause and the plan may involve more than one step.
Which doctor should I see for dark circles?
The first step is an in-person examination to work out the cause of the darkness. Injectable skin-quality and filler treatments are assessed in aesthetic medicine; with marked pigment or a skin condition, dermatology, with an eyelid bag the surgical specialties who treat this area, and with general symptoms such as fatigue or allergy the relevant doctors may become involved. Depending on the cause, more than one specialty can work together.
Sources (3)
- Dermatol Surg (Michelle L, et al.): Treatments of Periorbital Hyperpigmentation: A Systematic Review (2021)
- Turk J Ophthalmol (Nalcı Baytaroğlu H, Hoşal MB): Complications of Periorbital Cosmetic Hyaluronic Acid Filler Injections: A Major Review (2025)
- Aesthetic Plast Surg (Liu X, et al.): The Efficacy and Safety of Hyaluronic Acid Injection in Tear Trough Deformity: A Systematic Review and Meta-analysis (2024)
This content is for general information and does not replace a personal medical assessment.