How to Get Rid of those Dark Circles Under Your Eyes

Dark under-eye circles are a very common concern in our office, from both women AND men. They can cause a tired, angry appearance, and this can have a real impact on self-esteem, and even on interpersonal and business relationships. The good news is that we can usually identify the cause(s) of under-eye darkness, and then use a diagnosis-specific plan to treat that cause.

There are two basic causes of under-eye darkness: pigmentation and shadowing. You can tell the two apart by shining a light directly at the under-eye region. If the dark coloration remains present even in direct light, it is caused by pigmentation. If not, the darkness is caused by shadowing (direct light eliminates the shadow cast by surrounding structures, like bags under the eyes, but we’ll get into that below). In many cases, a combination of pigmentation and shadowing causes the dark circles.

Darkness caused by pigmentation may be present for several reasons:

When an underlying cause can be identified, it should always be treated. For example, allergy sufferers can be treated with antihistamines or other agents, and this may improve the issue. In some cases, laser therapy to address pigmentation may be helpful, although I rarely find this to be necessary. Platelet rich plasma injections have shown promise in early anecdotal experience, but data for this is still forthcoming.

My patients find K-OX EYES by ISDINCEUTICS very helpful in treating pigment-based dark circles. However, it is critical to remember that pigmentation alone is rarely the entire story, and attempts to treat dark circles under the eyes by only addressing the pigment may result in frustration, as shadowing often plays a significant part in causing the problem.

Light and shadow play a tremendously important role in facial aesthetics (think about the skyrocketing popularity of contouring which is designed to simulate this real-world phenomenon). If you consider your lower eyelid and the top of your cheek (an area we refer to as the “lid-cheek-junction”), you will notice that this is a very complicated surface. Light can hit it the “right way” or the “wrong way” – the wrong way being the way that casts shadows making you look like you have dark circles under your eyes. This can happen primarily for one of two reasons (or a combination of both). First, if the fat under your eye begins to bulge and appear like a small bag, this will cast a shadow on the cheek below and created an aged, tired appearance. Second, loosening, deflation, and descent of the soft tissues under the lower eyelid can create a “valley” in the region that is prone to shadowing. Fat bulges can be treated with a lower blepharoplasty (more on that here:, which is a procedure designed to remove the excess fat. The deflation and descent of the soft tissues can be treated with minimally or noninvasive techniques like fillers or fat grafting, designed to correct lid-cheek-junction volume distribution.

The name of the game with dark under-eye circles is that they can be a complicated, but very treatable problem. The key is to have a thorough evaluation to ensure that your treatment plan is customized for your specific issue. No two under-eye circles are exactly alike!

I hope this was helpful, and I invite you to join the conversation in our Facebook group at!

Office of Darren M. Smith, MD

You Might Also Enjoy...

Using Facial Structure to Maximize Beauty

Darren M. Smith, MD, a board certified plastic surgeon on NYC's Upper East Side, draws on his unique subspecialty training (aesthetic surgery AND craniofacial surgery) to discuss the role facial structure plays in achieving optimal beauty results.

I love my kid(s), but not my C-section scar

Ideally, a C-section scar is thin, low, and barely noticeable. Frequently, however, this does not turn out to be the case. Here, New York City plastic surgeon Darren M. Smith, MD reviews common issues with C-section scars and how they can be addressed.