Why do dark circles appear under the eyes?
Dark circles can come from changes in skin colour, visible blood vessels or shadows. Several factors often occur together:
- Pigmentation: inherited skin colour, sun exposure or irritation can contribute to darker under-eye skin.
- Visible vessels: thin skin can make underlying vessels more noticeable.
- Shadows: a tear-trough hollow, changes in facial volume or under-eye bags can create shadows. A hollow is a contour change, rather than pigmentation.
- Puffiness and irritation: allergies, eczema and repeated eye rubbing may contribute to swelling or darkening.
Genetics and ageing can affect several of these features. Poor sleep may make the area look more tired, but better sleep will not necessarily remove inherited pigmentation or a structural hollow. Fine lines and crow’s feet are separate concerns, although they can occur alongside dark circles.
How is the cause assessed?
A clinician checks the skin, eyelid contour and swelling, and asks when the change started, whether it affects one or both eyes, and whether there is itching or irritation. Previous under-eye treatments also matter. Colour alone, or a photograph, cannot reliably identify the cause or show which procedure is suitable.
Dark circles alone do not establish a vitamin deficiency or a circulation problem. Tests are considered when the history and examination suggest a medical reason, rather than routinely for every cosmetic concern.
What can you try at home?
- Protect against sunlight: use shade, UV-protective sunglasses and a broad-spectrum SPF 30 or higher sunscreen suitable for the surrounding skin. Follow the label and keep it out of the eyes.
- Keep skincare gentle: avoid rubbing and stop products that sting or irritate. A moisturiser can help dry skin, but an eye cream cannot fill a tear-trough hollow.
- Keep a regular sleep routine: this may help a tired appearance, without addressing every cause of dark circles.
- Get advice for persistent itching or swelling: treating an allergy or skin condition may be more useful than a cosmetic procedure.
Ask a clinician before using strong lightening products, retinoids or acids near the eyes. Do not use home chemical peels in this delicate area.
Which treatments may help?
The useful option depends on the cause. Improvement is possible for some people, but no single treatment reliably removes every type of dark circle, and results are not necessarily permanent.
Pigmentation or visible vessels
A dermatologist may consider targeted skincare or selected laser treatments after assessing the skin. Evidence for dark-circle treatments is limited and results vary. There is no fixed number of sessions that suits everyone. Skin tone, eye protection and the exact device matter; burns, irritation and unwanted pigment changes are possible.
Radiofrequency microneedling is a different technology from laser treatment. Neither the device name nor a promise of “no downtime” is enough to establish that treatment near the eyes is appropriate.
Hollows and shadowing
Hyaluronic acid (HA) filler may improve a hollow in carefully selected patients. It changes contour; it does not remove melanin or treat an allergy. People with significant bags or swelling may need a different approach.
Filler can cause bruising, swelling, lumps or persistent puffiness. Rarely, a blocked blood vessel can cause skin injury or vision loss. Assessment by an appropriately trained doctor is essential, even when the concern appears mild.
Puffiness, loose skin or wrinkles
These need their own assessment. Irritation or allergy should be addressed first when present. Persistent bags, excess skin or a drooping eyelid may need specialist evaluation; a skin-tightening procedure is not a universal substitute for that assessment. Treating crow’s feet does not necessarily improve under-eye darkness.
When should you seek medical advice?
Arrange an assessment if the change is new, mainly on one side, worsening, or accompanied by persistent itching or swelling. Long-standing dark circles without other symptoms are usually a cosmetic concern.
Seek urgent medical care for eye pain, a sudden eyelid droop, changes in vision, or a red, hot, painful swollen eyelid. After filler, unusual pain, pale or dusky skin, or any vision change needs immediate medical attention.
Planning an assessment and costs in Thailand
The cost depends on the cause and the treatment, if any, recommended after assessment. Ask for a current written quote explaining the proposed treatment, expected number of visits, follow-up and what is included. A package quantity or price does not establish what is appropriate for your eyes.
Choose a licensed clinic and a doctor experienced in assessing the eye area. Before a procedure, ask about the exact product or device, its intended use in Thailand, realistic improvement, risks and aftercare. An overseas approval does not establish Thai regulatory status or suitability for every treatment area.
The earlier article advertised a free consultation; confirm whether that offer still applies and what it includes.
To discuss your concern and arrange an assessment, contact Smooth Clinic. If you need an English-language consultation, confirm language support when booking.
References
- Mahesh et al. Clinical and Dermoscopic Evaluation of Periorbital Melanosis (2022).
- Michelle et al. Treatments of Periorbital Hyperpigmentation: A Systematic Review (2021).
- Fabi et al. Randomized controlled study of HA filler for infraorbital hollowing (2021).
- U.S. FDA: Dermal Fillers, Risks and Patient Information.
- U.S. FDA: Potential Risks with Certain Uses of RF Microneedling (2025).
- American Academy of Dermatology: Practice Safe Sun.
- NHS: Eyelid Problems.