Dark circles: It’s not just about lack of sleep

Before you grab tea bags, cold spoons or cucumber slices, you may want to think about the deeper reason you are experiencing dark under eye circles, also known as periorbital hyperpigmentation.

Lack of sleep is often the first to blame. That’s because poor sleep can cause dilated blood vessels and fluid retention, resulting in visible discoloration and puffiness. It can also cause the skin around your eyes to become thinner and more pale, accentuating underlying blood vessels.

Additionally, your cortisol levels rise when you don’t sleep well, which can break down collagen. This decrease in collagen can reduce skin elasticity and exacerbate the appearance of dark circles.

Certain health conditions can also cause dark under eye circles:

• Allergies, eczema and chronic sinus issues. These conditions can lead to inflammation and blood vessel dilation around the eyes.
• Iron-deficiency anemia. This condition may cause paleness and increased visibility of underlying blood vessels.
• Thyroid disorders. These disorders can contribute to puffiness and skin changes.
• Chronic liver or kidney conditions. These conditions can intensify discoloration.

How can you get rid of dark under eye circles?

Identifying and managing contributing health conditions is the first step, but treatments that address hyperpigmentation and skin thinning can also be helpful.

This typically includes topical treatments, such as vitamin C, retinoids and other brightening agents, that even out your skin tone and support collagen production. However, these treatments sometimes cause irritation, so it’s important to start slowly and patch test before full application.

For a more aggressive treatment, a combination of laser therapies can address vascular issues while also promoting collagen production to reduce the appearance of deep wrinkles. Platelet-rich plasma (PRP) injections can also stimulate collagen and improve skin tone and elasticity.

When dark circles result from structural changes, such as age-related volume loss or fat displacement, topical products offer limited improvement. Instead, in-office procedures, like dermal fillers, can effectively restore volume and reduce shadowing.

If you have significant skin laxity (sagging) or prominent lower eyelid “bags” due to fat prolapse, surgical intervention may be necessary, such as lower eyelid blepharoplasty. This procedure should be performed by a board-certified plastic or oculoplastic surgeon with experience in eyelid surgery.

Ultimately, a personalized, cause-specific approach to treatment is key to achieving meaningful and lasting results.

Katelyn DeRosa is a dermatology physician assistant at Advocate Health Care.

Are you trying to find a dermatology provider? Find one in Illinois or Wisconsin.