What Dark Circles Say About Your Health

ByJanis Updated

Dark circles under the eyes are a common cosmetic concern that can make a person appear tired, stressed, or older than they are. While many cases are harmless and temporary, in some instances, dark under-eye circles may point to an underlying medical issue. Understanding the causes and identifying when they may be related to illness helps you decide whether lifestyle changes, medical treatment, or both are necessary.

What Are Dark Circles Under the Eyes?

Dark circles refer to the visible darkening of the skin below the lower eyelids. The discoloration may appear bluish, purplish, brown, or black, depending on your skin tone and the underlying cause. In many people, they are caused by thinning skin that reveals blood vessels beneath or by excess melanin, the pigment responsible for skin color.

Are They a Medical Concern?

Dark circles are usually not a medical emergency. However, they may indicate underlying health conditions in some individuals. They are not an illness themselves, but rather a symptom that may reflect physical, dermatological, or systemic issues.

Common Causes of Dark Circles

Dark circles may be caused by a combination of genetic, lifestyle, and environmental factors. In some cases, they signal medical problems that require attention.

1. Genetics

  • Some people inherit thinner skin under the eyes or a tendency to accumulate pigmentation.
  • Family history of dark circles makes it more likely that they will appear early and persist over time.

2. Sleep Deprivation and Fatigue

  • Lack of rest dilates blood vessels and increases blood flow, which can darken the under-eye area.
  • Poor sleep may also cause puffiness, casting shadows that deepen the appearance of circles.

3. Aging

  • With age, collagen production declines, and the skin becomes thinner.
  • The fat pad under the eyes shrinks, leading to hollowness and visible veins.

4. Dehydration

  • When the body lacks fluids, the skin appears dull and sunken, particularly under the eyes.

5. Allergies and Nasal Congestion

  • Allergic reactions trigger histamine release, causing swelling, itchiness, and blood vessel dilation.
  • Nasal congestion can slow blood flow, resulting in pooled blood beneath the eyes (sometimes called “allergic shiners”).

6. Iron Deficiency Anemia

  • Low iron levels reduce oxygen delivery to tissues, which can lead to paler skin and more visible veins.
  • This makes the area under the eyes look darker in contrast.

7. Skin Conditions

  • Eczema, contact dermatitis, or allergic reactions can inflame and irritate the skin, increasing pigmentation and darkness.

8. Hyperpigmentation

  • Sun exposure increases melanin production.
  • Not using sunscreen on the under-eye area allows pigment to accumulate, especially in darker skin tones.

9. Alcohol Use and Smoking

  • Both contribute to poor circulation, dehydration, and premature aging of the skin.

Symptoms That Suggest an Underlying Illness

Although dark circles are often cosmetic, you should consider medical evaluation if you notice:

  • Persistent fatigue or weakness
  • Pale skin and brittle nails (signs of anemia)
  • Chronic nasal congestion or post-nasal drip
  • Skin rashes or frequent itching
  • Weight loss without trying
  • Changes in appetite or sleep patterns
  • Newly developing circles without an obvious cause

How Are Dark Circles Diagnosed?

A healthcare provider or dermatologist may:

  • Review your medical history and symptoms.
  • Ask about allergies, sleep habits, diet, and medications.
  • Conduct a physical exam of the skin and facial structure.
  • Order blood tests if anemia, allergies, or other conditions are suspected.

Treating Underlying Medical Causes

If allergies are the issue:

  • Use antihistamines (oral or topical).
  • Avoid known allergens and use air purifiers.

If anemia is diagnosed:

  • Iron supplements and dietary changes may help.
  • Addressing the underlying cause of low iron is essential.

If eczema or skin irritation is present:

  • Corticosteroid creams or moisturizers can reduce inflammation.
  • Avoid harsh products and fragrances around the eyes.

When to See a Doctor or Dermatologist

Consult a medical professional if:

  • Dark circles appear suddenly or worsen over time.
  • They don’t respond to lifestyle changes or over-the-counter treatments.
  • There’s associated swelling, irritation, or bleeding.
  • You suspect an underlying health problem, such as anemia or chronic allergies.

A dermatologist may suggest advanced treatments such as:

  • Topical Creams: Retinoids, vitamin C, hydroquinone, and kojic acid can improve pigmentation.
  • Chemical Peels: Light peels exfoliate and improve texture and tone.
  • Laser Therapy: It targets pigmentation and promotes collagen production.
  • Injectable Fillers: Hyaluronic acid fillers restore lost volume.
  • Blepharoplasty: Surgical removal of excess fat and skin under the eyes provides long-term improvement.

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.