Dark Circles Under Eyes

Medically Reviewed By William C. Lloyd III, MD, FACS
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What are dark circles under the eyes?

Dark circles under the eyes are the appearance of darker than normal skin between the lower eyelid and the top of the cheek. Sometimes, the upper eyelid also shows a darkening. Dark circles can affect infants, children, adolescents and adults, and men and women alike. Other names for them include shadows or dark rings under the eyes. Medical terms for it include periorbital hyperpigmentation, periocular hyperpigmentation, and periorbital melanosis.

People often assume dark circles under the eyes are due to a lack of sleep. Poor quality sleep and insomnia can certainly cause this condition. However, a variety of other conditions can lead to dark circles under the eyes. Some of these causes relate to lifestyle, such as drinking too much coffee or crying. Other causes are genetic, such as having thin skin on the lower eyelids, which makes the underlying blue-colored veins more visible. Prominent skin darkening under the eyes can be a common normal feature in certain ethnic groups.

Having dark circles under the eyes is not the same as bruising from trauma. Dark circles are usually not a symptom of a medical condition. Neuroblastoma, a rare disease mostly affecting children under 5, can cause dark circles to appear beneath each eye. However, it is far more common to have dark circles from allergies, anemia, nutritional deficiencies, and other chronic illnesses.

Depending on the cause, dark circles under the eyes can arise suddenly and disappear quickly, such as after a mild allergic reaction or swelling in the area. Dark circles under the eyes that develop over time may be a sign of chronic dehydration or anemia.

Seek prompt medical care if you develop unexplained dark circles or discoloration under the eye or a dark circle appears under only one eye.

What other symptoms might occur with dark circles under the eyes?

Dark circles under the eyes and other types of discoloration under the eyes may occur with other symptoms depending on the underlying condition including:

What causes dark circles under the eyes?

Dark circles under the eyes can be due to a variety of conditions, including inflammation, allergies, and lifestyle factors. Dark circles under the eyes and other types of discoloration are often caused by relatively minor conditions, such as fatigue. They usually do not result from more serious conditions. If your symptoms are persistent or cause you concern, contact your doctor or healthcare provider.

Diseases, disorders and conditions that cause dark circles under the eyes

Some medical conditions can cause dark circles and discoloration under the eyes including:

Lifestyle and general causes of dark circles under the eyes

Lifestyle habits, genetics, and everyday causes can also result in dark circles under the eyes or discoloration including:

  • Aging, which causes already delicate skin under the eye to become thinner

  • Alcohol, caffeine or sodium consumption

  • Certain medications, such as birth control pills

  • Crying

  • Fatigue

  • Inherited (genetic) factors

  • Insomnia or poor-quality sleep

  • Shadows due to swollen lower eyelids or deep-set eyes

  • Smoking

  • Stress

  • Sun exposure

When should you see a doctor for dark circles under the eyes?

In most cases, having dark circles under the eyes is not serious. They are usually not a sign of a medical condition. However, they can be bothersome and cause self-consciousness.

Make an appointment with your primary care doctor if you have other symptoms, such as swelling or skin changes in other areas of your face. You should also see your doctor if dark circles accompany fatigue, weakness, or sleep problems.

Otherwise, a dermatologist may be able to help. See a dermatologist for solutions for how to get rid of dark circles under your eyes that are not likely related to sleep or other conditions.

How do doctors diagnose the cause of dark circles under the eyes?

To diagnose the underlying cause of dark circles, your doctor will take a thorough medical history, perform an exam, and possibly order testing. Questions your doctor may ask about your medical history include:

  • How long have you had dark circles?

  • Are the dark circles always present or do they come and go?

  • Do other people in your family have similar discolorations?

  • What, if anything, seems to improve or worsen the discoloration?

  • Are you experiencing any other symptoms, such as fatigue or allergies?

  • How much sleep do you get each night? Do you sleep soundly or is your sleep interrupted?

  • Do you smoke?

  • How much alcohol and caffeine do you consume on a daily basis?

  • What medications do you take?

During the exam, your doctor may look for signs of underlying problems, such as thyroid disease or anemia. A dermatologist will want to find out if pigment or blood vessels are playing a role in the dark circles. They can use a handheld tool—a dermatoscope—to closely examine your skin. They may also use a Wood’s lamp—another handheld device. It illuminates the skin with ultraviolet light and can detect problems with skin pigmentation.

In some cases, your doctor may order testing to rule out medical conditions. This may include blood tests to check your blood cell count, blood chemistry, nutritional status, and certain hormone levels.

It is not always possible to diagnose an underlying cause or condition for dark circles under the eyes. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

How do you treat dark circles under the eyes?

If your doctor diagnoses an underlying medical condition, treating it may help resolve the dark circles. This may involve treating anemia, eczema, or other medical causes of dark circles.

Dark circles under eyes creams and other treatments

Dermatologists have several dark circles under eyes treatment options that may improve their look. Depending on the underlying issue, this may involve products to reduce the pigment or plump or fill thin skin. Options may include:

  • Chemical peels, such as glycolic acid

  • Injectable fillers, such as hyaluronic acid, and other injectable therapies, such as platelet-rich plasma and carboxytherapy (subcutaneous carbon dioxide)

  • Laser therapy, with or without bleaching agents

  • Prescription creams. Dark circles under eye cream may work by bleaching the skin or by increasing skin cell turnover. Examples include hydroquinone and tretinoin.

  • Procedures, such as autologous fat transplantation to fill lower eyelid skin or eyelid surgery to reduce shadows from excess skin

Dark circles under eyes home remedies

There are several things you can do at home to reduce the look of dark circles under the eyes. This includes:

  • Applying cold compresses to your eyes to reduce swelling and constrict blood vessels

  • Applying phenylephrine HCl (Preparation H or generic) under the eyes to constrict blood vessels. It may irritate the eyes, so use it infrequently. Apply a tiny amount and pat it gently on the skin with your fingertips. 

  • Getting adequate sleep every night

  • Sleeping with extra pillows to elevate your head and reduce puffiness in your lower eyelids

  • Using concealer to blend discoloration

  • Wearing a daily sunscreen for the face

What are the potential complications of dark circles under the eyes?

Complications associated with dark circles under the eyes vary depending on the underlying cause. It is important to contact your healthcare provider when you have unexplained dark circles under the eyes, particularly when they are accompanied by other symptoms or occur after a head or facial injury. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can help reduce any potential complications including:

  • Anaphylaxis (life-threatening allergic reaction) due to severe allergies

  • Daytime sleepiness and impaired ability to carry on daily activities due to insomnia

  • Neurological complications, such as coma and permanent brain damage, due to serious head trauma

  • Spread of periorbital/orbital infection resulting in meningitis, brain abscess and possibly loss of vision and brain damage
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Aug 20
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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