No one likes the look of dark circles under their eyes, which can make one look tired. Unfortunately, treatment of this common complaint can be difficult as several factors play a role in their appearance.

What causes dark circles under the eyes

  • Genetics. This is the most common cause of dark circles. In darker skinned individuals, too much pigment or too much skin can cause dark circles. In lighter skinned persons, thin skin can reveal blood vessels below, giving the skin a blue-purple hue.
  • Tear trough or bulging fat pad. There is a natural transition from where the eyelid meets the cheek, which is apparent in everyone. For some this gets hollowed out and forms a deep groove. For others, the skin just below the eyelid bulges outward, thus forming a deep groove below. This occurs due to natural aging and some are more prone due their genetics.
  • Aging. With age, the skin thins. Underlying blood vessels become apparent, the skin develops fine lines, and their is a change is texture and tone. As the skin loses its elasticity, it tends to bunch up, which makes it appear dark.
  • Seasonal Allergies. Hay fever and other allergens can result in the dilation of blood vessels under the eyes. This causes the skin to appear dark due to the increased blood flow. The released histamine can result in puffiness as well.
  • Not enough sleep. Although, most blame a lack of sleep to having dark circles, it is not common. If one does not get enough sleep puffiness can develop under the eyes.

How to treat dark circles under the eyes

While we cannot treat one’s genes, we can do things that reduce the appearance of dark circles.

Eye creams

Certain active ingredients in eye creams, such as retinol and peptides, increase collagan and elastin, reducing fine lines and “bunching” of the skin.  Retinol also reduces pigment, as do other ingredients such as vitamin C, kojic acid, and niacinamide. Topically applied caffeine constricts blood vessels, making dark circles appear lighter.

Dermal fillers

Restylane can be injected into the hollows or grooves under the eyes to reduce their appearance. This safe and effective procedure has results that last approximately six months or longer.

Chemical peels

Chemical peels have been used for centuries to tighten and lighten the skin. While still a good option, newer modalities have given other options, often with faster recovery, than chemical peels.


Microneedling is safe for all skin types, but by itself is minimally effective. When microneedling is combined with radiofrequency, significant improvement can be seen with minimal to no downtime. More than one treatment session is required for optimal results.

Fractional laser resurfacing

Laser skin resurfacing is extremely effective tool used to tighten the skin and stimulate collagen production by creating hundreds and hundreds of tiny round wounds that takes well over a week to heal. For those with fine lines and skin laxity, this is a great option for those who can have at least a week of downtime and several weeks of pinkness on the areas treated.

How do I get the best result

For most, there is not one treatment that will work to reduce the dark circles, but several. For skin laxity and fine lines, creams containing retinol can help, while chemical peeling, laser resurfacing, or surgery may be needed for moderate to severe laxity. For hyperpigmentation, actual increased pigment that is not due to laxity can be treated with creams containing retinol, Vitamin C, kojic acid, niaciniamide, and/or caffeine. Stronger prescription agents containing hydroquinone can be used for moderate cases. For severe cases, chemical peeling and/or laser resurfacing can be used. For puffiness caused by a visible fat pad, Restylane can be injected into the tear trough, or hollow under the eye, to reduce the appearance of the “bag” or surgery can be performed to remove the bag itself in some cases.

In short, for most creams and Restylane injections can very helpful at reducing the appearance of bags or darkness under the eyes.

Robert S. Bader, M.D., Dermatologist