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When to see a doctor
By Mayo Clinic staffMost often, dark under-eye circles aren't a medical problem, but if you want a more lasting solution than concealers and over-the-counter creams, see your dermatologist for advice. If discoloration and swelling appear under just one eye and seem to get worse over time, talk to your primary care doctor.
Depending on what's causing the circles under your eyes, your doctor may recommend prescription creams or a combination of treatments to erase or reduce discoloration. Laser therapy or chemical peels can be helpful in some cases. Hollows that cause shadows can be smoothed with injectable fillers, and surgery can eliminate puffy lids.
Self-care
Mild to moderate dark circles often respond well to simple and inexpensive treatments, such as:
- Cold. Try a cold compress, two chilled teaspoons or a bag of frozen peas wrapped in a soft cloth to temporarily reduce dilated and discolored under-eye blood vessels. Or, try a cooled, used teabag.
- Extra pillows. Elevate your head with two or more pillows to prevent puffiness that develops when fluid pools in your lower eyelids.
- Extra sleep. Although short nights don't usually cause under-eye circles, a lack of sleep makes you paler and more hollow-eyed, so shadows and circles you already have are more obvious.
- Dark glasses and sunscreen. Although a tan might hide dark circles in the short term, in the long run, the extra pigment it produces can make circles worse.
- Saline washes or sprays. Rinsing your sinuses with a saltwater solution (mix 1/4 teaspoon sea salt with 2 cups warm water) or over-the-counter saline spray can help relieve nasal congestion.
- Cosmetics. Hundreds of skin creams that claim to reduce or prevent under-eye circles crowd department store and drugstore shelves. The results of one well-publicized study showed that a cream containing vitamin K, vitamin C, vitamin E and retinol was moderately effective in treating under-eye circles.
- Camouflage. The right concealer can do just that — hide dark circles. If the circles under your eyes are bluish, use a peach-colored concealer, not one that's white or gray. And avoid scented products and those containing salicylic or glycolic acid, which can irritate delicate eye tissue, making redness and swelling worse.
- Mitsuishi T, et al. The effects of topical application of phytonadione, retinol and vitamins C and E on infraorbital dark circles and wrinkles of the lower eyelids. Cosmetic Dermatology. 2004;3(2):73-75.
- Freitag FM, et al. What causes dark circles under the eyes? Journal of Cosmetic Dermatology. 2007;6(3)211-215.
- Watanabe S. Condition known as "dark rings under the eyes" in the Japanese population is a kind of dermal melanocytosis which can be successfully treated by Q-switched ruby laser. Dermatologic Surgery. 2006;32(6):785-789.
- Gendler EC. Treatment of periorbital hyperpigmentation. Aesthetic Surgery Journal. 2005;25(6):618-624.
- Cymbalista NC, et al. Treatment of idiopathic cutaneous hyperchromia of the orbital region (ICHOR) with intense pulsed light. Dermatologic Surgery. 2006;32(6):773-784.
- Subrata M, et al. Periorbital melanosis is an extension of pigmentary line-F demarcation on face. Indian Journal of Dermatology, Venereology and Leprology. 2007;73(5):323-325.
- Correale CE, et al. Atopic dermatitis: A review of diagnosis and treatment. American Family Physician. 1999:60(4):1191-1209. http://www.aafp.org/afp/990915ap/1191.html. Accessed Oct. 19, 2008.
