Dark Circles Under Eyes: Causes and Treatments by Type
Dark circles come from pigment, visible blood vessels, hollowing or skin laxity. How to identify your type and which topicals, fillers, lasers, peels or surgery fit.
Dark circles under the eyes have several causes, and the best treatment depends on which one you have. The short answer: pigment-type circles respond to topicals and peels, hollowing responds to filler, visible blood vessels respond somewhat to lasers, and bags or loose skin usually need surgery. Many people have a mix.
The main causes
A systematic review of 39 studies grouped dark circles (periorbital hyperpigmentation) into pigmentary, structural, vascular and mixed causes (Michelle et al., Dermatol Surg, 2021):
| Type | Looks like |
|---|---|
| Pigmentary | Brown discoloration |
| Vascular | Blue or purple tint |
| Structural (hollowing) | Shadow from a tear trough |
| Laxity and bags | Puffiness and loose skin; bags are often from fat pushing forward against a weak septum (Coban et al., Aesthetic Plast Surg, 2023) |
A dermatologist can help tell these apart, since many people have more than one.
Treatments by type
The 2021 review concluded (Michelle et al., Dermatol Surg, 2021):
- Volume loss: soft tissue fillers and fat grafting are most effective.
- Excess skin laxity: blepharoplasty (eyelid surgery) works best.
- Pigment: topical creams and chemical peels help.
- Vascular and pigment types: lasers are mildly to moderately helpful.
- Other options studied: carboxytherapy, platelet-rich plasma and normobaric oxygen.
It also noted that high-quality evidence is scarce.
A 2026 multispecialty review of 50 studies added that microneedling and polynucleotides target texture and fine lines, botulinum toxin can help a thickened under-eye muscle, and surgery is preferred for herniated fat and poor lower lid support (Beer et al., Dermatol Surg, 2026).
Microneedling and PRP under the eyes
The AAD says combining microneedling with platelet-rich plasma (PRP) can boost collagen production, and that results appear gradually over months, often after several sessions (AAD: microneedling). Choose an experienced provider for this delicate area.
At-home care
- Sunscreen around the eyes daily to stop pigment from worsening (AAD: sunscreen FAQs).
- A gentle retinoid eye product at night for thin, crepey skin, introduced slowly.
- Niacinamide, which improved hyperpigmented spots over 12 weeks in a facial trial (Bissett et al., Int J Cosmet Sci, 2004).
- Treat allergies and avoid rubbing your eyes.
- Concealer: a peach or orange corrector can offset blue or purple tones.
When to see a doctor
If dark circles appear suddenly, affect one eye only, come with swelling, or don't fit any of the patterns above, see a doctor to rule out other causes.
What doesn't work well
Cold spoons and cucumber slices give temporary de-puffing at most. Eye creams can't fix hollowing or fat bags.
Frequently asked questions
Is filler safe under the eyes? It can work well for hollowing in experienced hands; vascular risks exist with any filler (FDA: dermal fillers).
Can lack of sleep cause dark circles? It can make them look worse temporarily.
This article is for educational purposes only and is not medical advice. Talk to a board-certified dermatologist about your situation.
Sources
- Michelle L et al. Treatments of periorbital hyperpigmentation: a systematic review. Dermatol Surg. 2021. PubMed
- Beer J et al. What's new with under eye treatment: a multispecialty systematic review. Dermatol Surg. 2026. PubMed
- Coban I et al. Anatomical basis for the lower eyelid rejuvenation. Aesthetic Plast Surg. 2023. PubMed
- Bissett DL et al. Topical niacinamide reduces yellowing, wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin. Int J Cosmet Sci. 2004. PubMed
- American Academy of Dermatology. Microneedling; Sunscreen FAQs
- U.S. Food and Drug Administration. Dermal fillers
