Dark Circles Under the Eyes: Causes & Treatment Guide

Dark Circles Under the Eyes FAQs

What causes dark circles under the eyes?

Dark circles under the eyes usually have one or more of five causes: pigmentation (excess melanin, often genetic or sun-related), visible blood vessels showing through thin under-eye skin, shadowing cast by under-eye hollows or eye bags, vascular congestion linked to allergies, fatigue or nasal congestion, and lifestyle factors such as poor sleep and dehydration. Most people have a combination, which is why identifying the dominant cause matters before any treatment.

Can the NHS treat dark circles under the eyes?

The NHS does not usually treat dark circles as a cosmetic concern. However, a GP may investigate if dark circles appear suddenly, are linked to other symptoms, or could reflect a medical cause such as iron-deficiency anaemia, thyroid problems, allergies or eczema. If we suspect a medical contributor during consultation, we recommend GP review before any aesthetic treatment.

How do I know which type of dark circles I have?

A simple mirror check helps. Gently stretch the under-eye skin: if the darkness fades, it is more likely pigment or visible vessels; if a shadow or groove remains, hollowing is contributing. Tilting your head back under good light can reveal whether the darkness is a true colour or a shadow. A doctor-led assessment confirms the dominant cause, because treatments differ completely between pigment, vascular and structural dark circles.

Are dark circles the same as under-eye hollows?

No, although they often coexist. Under-eye hollows are a structural depression in the tear trough that casts a shadow. Dark circles can be caused by that shadow, but they can also come from pigment, visible blood vessels or thin skin with no hollowing at all. This is covered in detail in our under-eye hollows treatment guide.

Do dark circles mean I am unhealthy or not sleeping enough?

Not necessarily. Poor sleep and dehydration can make dark circles look worse temporarily, but most persistent dark circles are driven by genetics, skin thickness, pigmentation or facial structure rather than tiredness. If dark circles are new, worsening or accompanied by fatigue, breathlessness or other symptoms, it is worth asking your GP to check for causes such as anaemia.

What treatments help dark circles under the eyes?

Treatment depends on the cause. Pigment-related dark circles may respond to targeted skincare, selected laser or IPL; vessel-related darkness through thin skin may improve with polynucleotides or skin boosters that thicken and hydrate the skin; shadowing from hollowing may be softened with carefully placed tear trough filler. No single treatment suits every type, and the under-eye area is high-risk, so a doctor-led assessment is essential.

Can dark circles be cured permanently?

Dark circles can be significantly improved but rarely cured permanently, because the underlying causes — genetics, skin quality and facial structure — continue to change over time. Treatment aims to reduce their appearance, with maintenance depending on the cause and the approach used. Outcomes vary by individual.

Why do under-eye creams not get rid of my dark circles?

Most over-the-counter eye creams hydrate the skin and may temporarily reduce puffiness, but they cannot correct pigment in the deeper skin, thicken thin skin enough to hide vessels, or restore lost volume. They can be a helpful supportive measure, but they will not address structural or vascular causes, which is why results are often disappointing when the cause is not skin-surface dryness.