To find out what is causing dark circles under the eyes, the first thing that is required is a diagnosis and identification of their type. Often there is a combination of factors.
Depending on the type of dark circles, there are different causes:
- Pigmented dark circles under the eyes
Cause: excess melanin (hyperpigmentation). They may be genetic, post-inflammatory, or due to accumulated sun damage.
Characteristics: brown colour, which does not change with light or gesture.
Treatment:
- Topical depigmenters (kojic acid, tranexamic acid, retinoids)
- Mild peelings specific for the periocular area
- Depigmenting lasers or pulsed light (with caution)
- Strict sun protection
- Vascular dark circles under the eyes
Cause: congestion or dilation of superficial blood vessels, often due to thin skin or genetic predisposition.
Characteristics: purplish or bluish tone, more visible when cold or tired.
Treatment:
- Creams with caffeine or vasoconstrictor actives
- Collagen stimulation with polynucleotides or growth factors
- Vascular lasers (such as Nd:YAG laser or PDL)
- Improving skin quality to thicken the skin
- Structural dark circles under the eyes (due to sagging or loss of volume)
Cause: loss of subcutaneous fat or lowering of the cheekbone, which generates a marked furrow between the lower eyelid and the cheekbone (nasojugal furrow).
Characteristics: shadow that is cast on the eyebrows and worsens with ageing.
Treatment:
- Hyaluronic acid filler specific for under-eye circles (low cross-linking, precise technique)
- Collagen stimulators such as polynucleotides or diluted calcium hydroxyapatite
- Volume replenishment in the middle third of the face if needed
So… How do I know what type of dark circles I have?
Most patients have more than one type of combined dark circles: pigmentation + vascularisation, sagging + thin skin, etc.
Therefore, the first step is a comprehensive medical assessment, where we analyse anatomy, colour, volume, texture and bone structure to define a tailor-made treatment plan.
Conclusion: there are different causes of dark circles under the eyes… that is why a medical diagnosis is so important.
At Clínica de Felipe we offer multiple treatments depending on the type of under-eye circles. We are waiting for you to have an assessment together and choose the most suitable treatment for your particular case.
