Face – Dark Eye Circles

Dark Eye Circles

The presence of dark circles below the eyes is a common complaint, often accompanied by a high degree of frustration.

Often the discolouration is caused by a true increase in the amount of skin pigment (melanin). By far the most common underlying cause is genetic. Any irritant that causes chronic tissue swelling may also contribute (allergy, fluid retention, thyroid disease, kidney disease, eyelash infection, habitual rubbing, excessive sun exposure, metabolic imbalance, certain medications such as birth control pills, and so on).

Bleaching creams, solutions, and gels (hydroquinones) interfere with the formation of new melanin and may be helpful. Applied once or twice daily, they are available in a variety of brands and strengths. The simultaneous use of a retinoic acid and a sunscreen may be indicated. Since improvement will appear only gradually over several months, many patients give up on treatment before ever noting any result.


There is a solution, but it requires intense treatment and subsequent maintenance. We recommend an eyelid chemical peel combined with an intensive Vitamin K and A permeation treatment.

In some, the darkness is due to hollowness under the eye. In younger patients, the cause is predominantly genetic, and for the older patient, it is due to loss of fat. We call this the ‘tear trough deformity’, and the only solution is to fill out the hollowness with hyaluronic acid (HA) fillers. The result is instant and uplifting.

In some patients, darkness below the eyes may be the result of shadows cast by bulging fat in the lower eyelids. The convexity of the bags blocks overhead light and creates the appearance of discolouration. In such cases, filling the hollowness with a filler removes the darkness immediately.

In Summary:

  • Eye Bags may have underlying causes which could be hereditary or a lack of sleep.
  • Treatment depends if the bulge is due to fat or muscle.
  • Botox is indicated if it is a muscular bulge.
  • Surgery indicated if its due to fat.