What causes dark circles under the eyes?

A fellow caregiver asked...

What causes dark circles under the eyes?

Expert Answer

Jessica J. Krant, MD, MPH, is a board-certified dermatologist specializing in medical, cosmetic, and surgical dermatology, including Mohs micrographic skin cancer surgery. In addition to her work in private practice, Krant is assistant clinical professor of dermatology at SUNY Downstate Medical Center.

The reason for dark circles under the eyes is more complex than it seems on the surface. There can also be more than one cause, and it can differ between people. The tissue of the lower eyelid is complex: it contains skin (including dermis beneath the surface), fat, many blood vessels, tissue fluid, and nerves.

One common cause of dark circles is unidentified allergies. If an allergy is unidentified but causes a low-level irritation of the eye, especially if it causes itching that leads to rubbing of the eye, it can cause dark circles. Another is aging, with the natural thinning of skin that comes along with it. This allows the vessels beneath the surface to show through more, which can lead to a shadow. A third cause is inflammation which can cause the tiny vessels to be a little bit leaky, and leak red blood cells into the tissue, which can appear purplish to brown when they reach the surface. Finally, genetics and family history is a big cause of natural dark circles under the eye which are very difficult to reverse.

Gentle eye treatment, sunscreen, sunglasses, and various creams are used to try to eliminate dark circles and bags under the eyes, but no single treatment is proven to do the trick for all.