Improving Dark Under-Eye Circles

By Ronald W Kristan, MD, FACS

Dark under-eye circles can make us look tired, even sad or angry. A circle, crescent or indent in the lower lid area is often the focus of unhappiness with how our eyes appear. There are many causes of dark circles under the eyes, and the cause will determine treatment options for improvement.

Commonly, dark under-eye circles come from aging. The aging process of the face and periorbital area has been well studied. The 3-D’s of aging include:

  1. Deflation
  2. Descent
  3. Deterioration

Hollowing or puffiness in the lower eyelid can cause shadows or transparency of the skin, allowing the dark veins underneath to show. This can happen as the fat in the lower lid shifts and the bone degrades. The other possible cause is actual discoloration of the skin not caused by shadow and fat shifting.

However, dark circles may not necessarily be related to age. Some other possible causes include:

  • Existing medical conditions, such as thyroid disease.
  • Seasonal allergies can cause dark circles under the eye from constant rubbing due to friction. This is often seen in other parts of the body as well.
  • Genetics may also play a role related to eczema and emotional issues. In addition, some people are just born with a hollow depression in the under-eye area.
  • Sometimes the lower lid skin stretches enough to allow light to reflect off the underlying blood vessels, creating a dark look called the Tyndall Effect.


Dark circles are commonly located in the lower lid area, called the “tear trough.” If the problem is a hollowing that is creating a shadow or transparency of the skin (which allows the underlying blood vessel to show through), fillers are used to increase the volume in the tear trough.

If the puffiness is causing a shadow from the fat elevation, surgery to remove the fat may be the most effective option.

In terms of treatments to tighten the skin and treat fine wrinkles and lines, ablative and non-ablative lasers are available, as are chemical peels. Radiofrequency technology has also been shown to stimulate the formation of new collagen and improve the skin’s elasticity.

There are many creams and ointments on the market that claim to erase dark circles under the eyes. I personally don’t endorse any particular brand. Sometimes the simplest approach is just makeup!

I do however have a simple approach to overall skin care. Keep your skin clean and moist and protect it with sunblock every day. Heavy alcohol consumption will age the skin, as will smoking. Stay well hydrated. Avoid excess sun exposure and get the proper amount of sleep. Maintain a healthy exercise routine.

And, if you are troubled by the appearance of your eyes, don’t hesitate to give us a call at Atlantic Eye. We are here to help!