What causes eye dark circles?

From the Guidelines

Dark circles under the eyes are primarily caused by a combination of genetics, aging, fatigue, allergies, and lifestyle habits, with exacerbating conditions such as smoke, allergens, and low humidity also playing a role 1. When considering the causes of dark circles, it's essential to look at the various factors that contribute to their appearance.

• Genetics play a significant role, as some people naturally have thinner skin under their eyes or more prominent blood vessels, making dark circles more visible.
• Aging is another factor, as we lose fat and collagen, causing the skin to become thinner and more translucent, which makes blood vessels underneath more apparent.
• Lack of sleep, stress, and fatigue can cause fluid buildup and make the area appear puffy and darker.
• Allergies trigger the release of histamines, causing blood vessels to dilate and become more visible.
• Dehydration, excessive sun exposure, smoking, and alcohol consumption can also contribute to dark circles. It's worth noting that some studies, such as the one on blepharitis preferred practice pattern 1, highlight the importance of exacerbating conditions like smoke, allergens, and low humidity in worsening dark circles. To reduce their appearance, it's recommended to ensure adequate sleep (7-9 hours nightly), stay hydrated, use cold compresses, apply sunscreen daily, treat allergies with antihistamines if needed, and consider using eye creams containing ingredients like vitamin C, retinol, or hyaluronic acid. For persistent dark circles, dermatological treatments like chemical peels or laser therapy might be beneficial, but it's crucial to consult with a healthcare professional to determine the best course of treatment.

From the Research

Causes of Eye Dark Circles

• Dermal melanin deposition, which can lead to pigmentation under the eyes 2
• Postinflammatory hyperpigmentation secondary to atopic or allergic contact dermatitis, resulting in dark circles 2
• Periorbital edema, or swelling around the eyes, can also contribute to the appearance of dark circles 2
• Superficial location of vasculature, which can cause a bluish or purplish discoloration under the eyes 2
• Shadowing due to skin laxity, where loose skin creates a shadow effect, making the area appear darker 2

Classification of Dark Circles

• Pigmented (brown) type, accounting for 5% of cases 3
• Vascular (blue to purple) type, accounting for 14% of cases 3
• Structural type, accounting for 3% of cases 3
• Mixed type, a combination of pigmented and vascular types, accounting for 78% of cases 3

Factors Contributing to Dark Circles

• Periorbital puffiness, which can be caused by a higher "pre-septal thickness" 3
• Infraorbital palpebral bags, which can be caused by protruded retroseptal fat pads 3
• Microvasculature congestion and permeability, melanin accumulation, and hemoglobin degradation-related pigmentation, which can be improved with topical treatments 4

Treatment Options

• Topical treatments, such as a multicorrective topical eye cream, can improve the appearance of infraorbital dark circles and under-eye puffiness 4
• Classification of dark circles according to their causes can help select suitable instruments and detailed evaluation items for treatment 5
• Treatment options should be chosen according to the cause of the dark circles, as multiple factors can contribute to their appearance 6