Dark circles under the eyes are one of the most common concerns people bring up, often with the same question: “Am I just tired, or is this something else?”
The truth is, dark circles under eyes usually have very little to do with how much sleep you’re getting. They’re influenced by anatomy, skin quality, and changes over time. For many patients, the goal isn’t to look wide awake every day. It’s to look less worn down than they feel.
“People keep asking if I’m tired”
Cosmetic concern, not a medical problem
Brighter, more rested appearance
What Are Dark Circles Under the Eyes?
Dark circles refer to discoloration or shadowing beneath the lower eyelids. They can appear brown, purple, blue, or gray, depending on what’s causing them.
What you might see:
In some cases, the skin under the eyes is thin enough that underlying blood vessels become more visible. In others, pigmentation, volume loss, or shadowing plays a larger role. Many people have been told they look tired or sick, and when they look in the mirror, the dark circles are often the first thing they notice.
Why Dark Circles Develop
Dark circles can develop for several reasons, and more than one factor is often involved.
Allergies: It’s common for allergies to cause under-eye and sinus swelling and congestion of the blood vessels in the lower lids. If you notice your dark circles are worse during allergy season, this may be a contributing factor.
Fatigue: You can get under-eye bags from lack of sleep. Fatigue increases the amount of swelling and hollowing seen around the eyes, making dark circles more pronounced.
Heredity: It’s very common for family members to have the same concerns with eye puffiness and dark circles. Genetics strongly influences skin thickness, pigmentation tendencies, and facial structure.
Sun exposure: The skin acts a little like a girdle to the fat and vessels of the lower eyelids. Sun exposure causes collagen loss under the eyes and destroys elastin in the skin, meaning you may experience puffy eyes and darker appearance after sun exposure.
Loss of facial volume: As we age, we lose collagen and elastin in our skin, as well as the fat that supports the cheek and the areas below the rim of the eye. This lack of structural support creates baggy lower eyelids and hollowing that casts shadows.
Visible veins: Some patients have very large facial veins that run from the lateral edges of the eye under the orbit, causing what’s called vascular dark circles and giving the skin a bluish color.
Thin or translucent skin: Some people naturally have thinner skin under the eyes, making blood vessels and underlying structures more visible.
How Dark Circles Can Affect Appearance
Dark circles can change how the entire face is perceived — often in ways that don’t match how you actually feel.
Patients often say they feel like they look:
These reactions are very common. Many patients are frustrated by being asked “Are you okay?” or “Did you get any sleep?” when they feel fine. Addressing dark circles is usually about improving brightness and balance, not dramatically changing the eye area.
What to Expect During a Consultation
A consultation at Lazaderm is focused on thoughtful evaluation and education.
During your visit, your provider will:
Understanding the cause is essential because different causes require different treatments. You’ll have time to ask questions and decide what feels right for you.
Setting Realistic Expectations
Treatments for dark circles can improve appearance, but results vary depending on the cause.
What to understand:
The goal is a brighter, more rested appearance that still looks natural.
The most effective treatment depends on what’s contributing most to the appearance of dark circles. A consultation allows your provider to evaluate skin quality, pigmentation, volume, vessels, and anatomy before recommending options. Often, a combination approach provides the best results.
Before pursuing in-office treatments, certain lifestyle factors are worth addressing.
Allergy medications: If you feel that you have puffiness in your lower eyelids, it’s usually worth a two-week trial of allergy medications. We recommend an over-the-counter oral medication such as Claritin, Allegra, or Zyrtec for swollen eyes. Another option is nasal sprays such as Flonase or Nasacort.
Sleep: If you’re burning the candle at both ends, try to get on a better sleep cycle. We recommend at least 7 hours of sleep at night. While lack of sleep alone rarely causes dark circles, fatigue makes them worse.
Sun protection: Wear a broad-brimmed hat, sunblock (EltaMD), and sunglasses — especially in the summer — to avoid puffy or swollen eyes from sun exposure and to prevent further collagen damage.
These simple steps can help reduce the appearance of dark circles and support the results of any professional treatments.
BBL can help address dark circles caused by pigmentation and small blood vessels.
How it works: BBL uses light energy to target both pigmented areas and small vessels in the lower lid area. The treated pigment and vessels gradually fade, resulting in a brighter, more even under-eye appearance.
Best for:
Considerations: The under-eye area is delicate, so treatment is performed carefully with appropriate settings. Multiple sessions may be needed for optimal results.
In some cases, MOXI may be considered for pigmentation-related dark circles.
How it works: MOXI delivers gentle fractionated laser energy that promotes cellular turnover and can help fade pigmentation over time.
Important considerations: The under-eye area is delicate and requires careful evaluation. MOXI is only appropriate when pigmentation (not hollowing or veins) is the primary cause of darkness. Your provider will determine if MOXI is suitable for your specific situation.
For dark circles caused by visible veins, vascular laser treatment can be highly effective.
How it works: The Cutera 1064nm laser targets and destroys the veins contributing to the bluish discoloration under the eyes. The treated veins are gradually absorbed by the body.
Best for:
Why 1064nm: This wavelength effectively targets deeper vessels while minimizing risk to the surrounding delicate skin.
Lasers can tighten the skin under the eyes, helping to address both puffiness and laxity.
Fractional lasers (Profractional, DeepFX, ActiveFX): These lasers create controlled micro-injuries that stimulate collagen production and skin tightening. They can benefit the lower lids but typically require multiple treatments for optimal results.
Ablative laser (Sciton Erbium): The Sciton Erbium laser gives the best results for under-eye skin tightening. The laser tightens the skin so it acts like a girdle, holding the fat and tissue in place and reducing the baggy appearance.
Best for:
When dark circles are caused by hollowing or shadowing, dermal fillers can restore support beneath the eyes.
How it works: Filler is placed along the orbital rim and tear trough to smooth the transition between the lower eyelid and cheek. This reduces shadows rather than directly treating color.
Important filler guidance: The only fillers that should be injected into the tear troughs are Restylane or Bellafill. These products have the appropriate consistency and properties for this delicate area.
Other fillers such as Juvederm Ultra Plus and Voluma are better suited for adding volume to the cheek area, which can indirectly improve the under-eye appearance by providing structural support.
Best for:
Skincare products can support hydration, brightness, and barrier health in the under-eye area.
What skincare can help with:
Products that may be recommended:
Limitations: Skincare alone typically cannot address significant hollowing, prominent veins, or deep pigmentation. It works best as a complement to professional treatments.
Some patients have significant puffiness and excess skin that may not fully respond to non-surgical treatments.
Signs that additional evaluation may help:
In these cases, your provider may discuss whether surgical evaluation with an oculoplastic surgeon or facial plastic surgeon would be appropriate. While Lazaderm focuses on non-surgical treatments, we believe in helping patients understand all their options.
If dark circles under your eyes are something you’ve been noticing or feeling bothered by, a consultation can help clarify your options. At Lazaderm, consultations focus on education, safety, and helping you feel confident in your decisions.
