Secrets to Controlling Dark Under Eye Circles: 5 Causes & Treatments

The skin around our eyes is the most thin and fragile on our face. Blood vessels, which sit directly under the skin, are more visible as blue or dark discoloration. Improper lymphatic drainage secondary to eczema, and allergies or other illnesses can cause swelling and puffiness to be exacerbated. Furthermore, the SOOF (sub-orbicularis oculi fat pad) can sag from aging, and/or be damaged by non-expert treatments.

What are the five main causes of dark under eye hollows?

1.  Allergies and Other Illnesses

Allergies and other illnesses (eczema, contact dermatitis, asthma, pigment disorders) can cause excessive puffiness and darkness around the eyes through a mechanism of histamine release followed by inflammation. When our head and neck lymphatics system becomes over-worked, it sometimes shows in our appearance. Common over the counter methods of treatment sometimes include the use of anti-histamines, nasal saline mists and cool compresses to help decrease superficial blood vessel inflammation. Discuss treatment options with your doctor on how to best control seasonal allergies and/or other illnesses (anemia, thyroid or liver dysfunction).

2. Sleep Hygiene

Sleep is our natural method of body rejuvenation. The optimal amount of sleep we require is different for each person at different stages in life. For example, children require more sleep than adults. Most adults require seven to eight hours of sleep nightly. While sleep deprivation is a common cause for under eye discoloration, excessive sleep can be detrimental to social well-being, mental motivation and appearance too. The amount of sleep is not the only important factor. Quality of sleep is as important as quantity of sleep. Broadly speaking, sleep hygiene is about how we sleep (comfortable bed and pillow), our environment (temperature and noise), and the conditions surrounding our sleep (screen time, alcohol and exercise before bed are not recommended). Providing ample time to wind down (de-stress) and relax both mentally and physically prior to bedtime ensures a successful night’s rest and our best appearance in the morning. My grandmother’s old adage of having a massage, a bath and a warm glass of milk before bed may have been correct (as long as we’re not lactose intolerant!).

3. Aging

As our face ages we lose volume, firmness, and skin integrity (collagen). All of these factors increase the appearance of tear trough (area under our eyes) hollows. The darkness seen under our eyes can sometimes also be a result of excessive shadowing. Having appropriate cheek volume to reflect the light away from under our eyes helps to give a more youthful appearance.

4. Side Effects

Occasionally, eye discoloration is due to trauma or iatrogenic (secondary to something we take or do) causes. Medications which cause vasodilation (enlarging them so they are more easily) of our blood vessels can also cause discoloration of our under eye skin. Excessive rubbing and scratching of our eyes can alter skin thickness and appearance around the eyes. Furthermore, improper dermal filler injection techniques can cause either the ‘Tyndall effect’ (blue-grey discoloration from superficial injections) or a lumpy/baggy look secondary to layering of fillers in an inappropriate manner. In some cases these can be corrected by a medical professional through the use of a reversal agent for the filler.

5. Genetics

Hereditary dark circles are not uncommon. Do dark circles seem to occur more prominently in your family members? If you are not pleased with your inheritance, it helps to know there are options for treatment.

1. Treat the Medical Cause

If under eye darkness is likely the symptom of a medical illness, please see your doctor for expert advice to achieve optimum health. Whether this is something simple like taking ferritin for your anemia, or more complex like controlling your asthma, good health shows in our appearance. Stay away from recreational drugs and alcohol, all of which affect our sleep and ultimately our mental and physical well being. Also, remember to practice good sleep hygiene and de-stress from your daily work.

2. Conservative Therapy

Expertly applied make up can conceal dark under eye circles and sometimes this is all that is needed. Cool cucumbers, soaked cool tea bags, and cool cloths/spoons placed for 10 minutes on our eyes as we rest in a supine position, all help to either stimulate or vasoconstrict (shrink) our blood vessels under the eyes. This temporarily decreases the amount of stagnant blood seen through the thin skin.

3. Topical Eye Ointments

There are an overwhelming number of eye ointments that claim to work on under eye circles. Some will make a temporary change in dark circles (Jeunesse); a few will help create a longer lasting result if used consistently (Diamonds, Rodan & Fields); but most will not make any difference. Finding the right topical ointment can be challenging but is worth the effort. Talk to someone you trust when it comes to skin care. Ingredients such as retinols, hyaluronic acids, vitamin K and vitamin C are key to eye region treatments. And remember – prevention is key when it comes to our eyes. Wear those sunglasses!

4. Fillers & Laser Resurfacing

Many men and women can benefit from adding volume to the midface and cheek. When these dermal fillers are used in expert hands, they can make a real difference in changing the appearance of dark hollows. Facial rejuvenation by restoring harmony and proportion, allows light to reflect off our cheek bones and midface, thus decreasing the look of darkness under our eyes. For select people, the under eye skin discoloration is due to changes in skin integrity, laxity and wrinkles; this requires laser resurfacing to bring about a more smooth rested appearance.

5. Plastic Surgery

Finally, there is a small subset of people who require a more invasive procedure to achieve the look they desire. In lower blepharoplasty the SOOF region is lifted to decrease under eye skin laxity and the appearance of dark circles.