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What causes dark under-eye circles?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Your co-worker isn't the only one who has thin skin. We all do—at least under our eyes. That's the thinnest anywhere on the body, and that allows dark, venous blood to show through. So if you are standing or sitting upright, blood pools there more.

In addition to being caused by lack of sleep, dark rings can be brought on by allergies or asthma. These conditions can cause more blood to pool in the tissues under the eye and can add puffiness to the area.

Watch as internal medicine specialist Dr. Keri Peterson explains what may be causing your dark under-eye circles.

There are tons of causes for under-eye circles. The bluish, purple rings aren’t just associated with getting older—people of all ages suffer from them due to a host of reasons ranging from heredity to allergies. But with thinning skin combined with lifestyle factors, such as chronic stress, drinking, smoking and sun exposure catching up with us, under-eye circles can take a turn for the worse.

Dr. Ellen S. Marmur, MD
Dermatologist (Skin Specialist)

There are six explanations for dark circles, and accurately diagnosing which one is your particular issue will be key to finding a remedy.

One is infraorbital hyperpigmentation, darkness concentrated on this area of skin, which is a genetic trait. To find out if that is your problem, gently pull the skin away from the hollow under the eye, making the area flat, which physically eliminates any shadow effect. If the darkness is still there, it is pigmented skin.

Or two, you may have thin skin (due to either heredity or decreased collagen from aging) resting on dark muscle and blood vessels, which creates that dark semicircle under the eyes.

Three, sometimes the circles are due to tiny blood vessels under the surface of the skin, another genetic feature.

Four, you may have deeply inset bone structure, which produces a shadow from your brow bone to darken the area under the eye.

Five, as we age the cheek and orbital bones dissolve, creating more of a shadow.

And six, bruises after plastic surgery such as rhinoplasty (nose job) or blepharoplasty (eyelid surgery) can leave a rust-colored stain under the eyes called hemosiderin.

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What if a leading dermatologist just happened to be your best friend and you could ask her anything? DR. ELLEN MARMUR, a world-renowned New York City dermatologist, answers all your questions with...
Dr. Salvatore J. Pacella, MD
Plastic Surgeon

Several conditions can cause dark under-eye circles, including thinning skin, dermatitis, allergies, pigmentation, or stress. Sometimes dark circles result simply from how the light shines on your lower eyelid. If your lower lid (sometimes called the tear trough) contains excess fatty tissue or a deep groove, ambient light can create unflattering shadows around the eyes.

Dr. Randolph P. Martin, MD
Cardiologist (Heart Specialist)

Dark circles can be caused by genetics, or if your parents or sibling has dark circles you may have increased risks. Watch my video to learn more about what causes dark circles and bags under the eyes.

Dr. Adam J. Scheiner, MD
Ophthalmologist (Eye Specialist)

As we age, we discover that one of the most noticeable changes to our appearance involves the eye area. Perhaps the most common complaint I receive as a specialist in cosmetic eyelid rejuvenation is that my patients have heard from others that they look sick or tired, even when they are feeling well and rested.

Typically, the origin of such unwanted comments is the non-verbal messages the lower eyelid region sends out as we age. This area can be affected by many different factors that contribute to dark circles under the eyes—the first is the convexity or concavity of the lower eyelid fat. If the lower eyelid fat protrudes into the lower lid region, it often catches overhead shadows.

Because most light is above us in our world (consider sunlight outside and room lights inside), this light is likely to cast a shadow over the protruding fat that becomes visible on the skin under this fat in the lower eyelid. The result of the shadowing is unattractive dark circles, sending a message of fatigue or illness.

A converse problem relating to lower eyelid fat is rare but can occur occasionally and involves the lack of fat in the lower eyelid region, causing a sunken-in appearance that similarly catches and displays shadows in the lower eyelid skin.

The second factor contributing to the appearance of dark circles under the eyes is dark pigment, which can deposit in the skin in the lower eyelid region. This is usually the result of sun exposure over a lifetime.

A third factor patients experience is the underlying vessels transmitting through the thin skin in the lower eyelid region.

Finally, the fourth factor, which can play a role in the appearance of dark circles under the eyes, is the presence of lower eyelid and cheek swelling, known as lower eyelid and cheek festoons.

While these four common causes of dark eye circles can result in less than optimal nonverbal messages, there are options available to treat them that can rejuvenate the appearance and clean-up facial messages to restore effective nonverbal communication.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.