What causes periorbital discoloration (dark circles under the eyes)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 5, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Dark Circles Under Eyes

  • Single Most Likely Diagnosis
    • Allergic rhinitis: This is often the most common cause of dark circles under the eyes due to increased blood flow and congestion in the nasal passages, leading to puffiness and discoloration.
  • Other Likely Diagnoses
    • Fatigue and sleep deprivation: Lack of sleep can cause paleness, which may make the dark circles more noticeable, and can also lead to puffiness due to fluid retention.
    • Dehydration: Inadequate fluid intake can lead to a decrease in skin elasticity, making the dark circles more pronounced.
    • Genetics: Some people may be more prone to dark circles due to their genetic makeup, which can affect skin pigmentation and thickness.
    • Aging: As we age, the skin loses its elasticity and becomes thinner, making the blood vessels under the eyes more visible and causing dark circles.
  • Do Not Miss Diagnoses
    • Thyroid disease: Both hypothyroidism and hyperthyroidism can cause changes in skin pigmentation, including dark circles under the eyes.
    • Anemia: Iron deficiency anemia can cause pale skin, making the dark circles more noticeable, and can also lead to fatigue, which exacerbates the condition.
    • Kidney disease: Chronic kidney disease can cause a buildup of toxins in the body, leading to changes in skin pigmentation, including dark circles.
    • Liver disease: Certain liver conditions, such as cirrhosis, can cause changes in skin pigmentation, including dark circles under the eyes.
  • Rare Diagnoses
    • Sjögren's syndrome: This autoimmune disorder can cause dry eyes and skin, leading to dark circles under the eyes.
    • Addison's disease: This rare endocrine disorder can cause changes in skin pigmentation, including dark circles under the eyes.
    • Ehlers-Danlos syndrome: This genetic disorder can cause skin hyperextensibility and fragility, leading to dark circles under the eyes.
    • Mastocytosis: This rare condition can cause an accumulation of mast cells in the skin, leading to changes in skin pigmentation, including dark circles under the eyes.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.