- According to a study published in the NCBI, dark circles affect women more than men. Dark circles are prominent in 47.50% of individuals between the ages of 16-25.
- One of the most common causes of dark circles is genetics.
- Untreated dark circles can be permanent.
- A thorough medical diagnosis followed by therapy can treat dark circles.
What Are Dark Circles?
Dark circles refer to the darkening or discolouration of the skin under or around the eyes. The affected skin appears to look blue, black, or dark brown. This appearance of pigmented skin is also known as Periorbital Hyperpigmentation (POH), Periorbital Melanosis, Infraorbital Darkening, Infraorbital Discoloration or Periorbital dark circles.
What Are The Causes?
Dark circles are the result of a combination of factors, broadly divided into two groups. The common ones are:
1. Internal or Endogenous Factors
- Heredity (or Constitutional POH) – Genes determine the amount of melanin produced and its distribution across the body which directly influences hyper-pigmentation around the eyes.
- Nutritional deficiency – Iron and Vitamin-K deficiencies can cause discolouration under the eyes.
- Peri-Orbital Edema – This is when fluid accumulates under the eye, making it look “puffy”. Allergies, salt and water retention, high blood pressure, medical disorders (e.g. liver, thyroid, kidney) and sinus infections are some of the reasons for Peri-Orbital Edema or puffiness, resulting in post-inflammatory hyperpigmentation.
- Prominent vasculature – Due to the reduced thickness of the overlying skin, the underlying vasculature becomes more prominent, particularly around veins making the area around the eyes appear darker.
- Ageing – As we age, collagen in our skin begins to degrade and hyperpigmentation, sagging skin, fine lines, and wrinkles begin to appear. The skin under the eyes becomes thin, and the blood vessels become more prominent, making the area under the eye appear darker.
- Tear trough depression – It is an age-related change which occurs due to the loss of fat content, the thinning of overlying skin, and the descent of the cheek area which results in a hollowing effect under the eye which casts shadows giving the appearance of dark circles.
- Acanthosis Nigricans – This is a condition where the thickening of the skin gives a velvet-pigmented appearance around the eyes. It is related to an insulin hormone imbalance and other metabolic disorders.
- Other causes include post-inflammatory hyperpigmentation, dermal melanocytosis, and pigmentary demarcation lines.
2. External or Exogenous Factors
- Fatigue and stress – A poor sleep cycle, environmental, and psychological stress can strain the muscles around the eyes, often causing POH. Dark circles under the eyes are not necessarily a sign of tiredness, but the two do appear correlated.
- Sunlight – When the skin comes into contact with sunlight, it leads to an increase in the production of melanin, leading to POH.
- Medication – Hormonal medication and ocular hypotensive eyedrops (like the type used to treat glaucoma) can cause dark circles to form.
- Alcohol/Smoking – Excessive smoking and alcohol consumption can aggravate periorbital hyperpigmentation. Smoking, specifically, can affect the microcirculation of the skin and can cause dark circles.
How Is POH Diagnosed?
Diagnosis for POH takes a multi-causal approach. A detailed medical and hereditary history along with lifestyle, dietary habits, and environmental stressors, are all taken into consideration and is followed by a thorough cutaneous examination. Only then is the diagnosis established and treatment prescribed.
Who Is At Risk?
According to a study published in the Indian Journal of Dermatology, the “…commonest form of POH was constitutional (51.50%) followed by post inflammatory (22.50%). Faulty habits were observed viz. lack of adequate sleep (40%), frequent cosmetic use (36.50%), frequent eye rubbing (32.50%), and lack of correction for errors of refraction like myopia in 12% patients. The strong association of POH with stress (71%), atopic (33%) and family history (63%) was noted.”
Is treatment necessary?
Dark circles can make a person appear tired and much older than they are. Any treatment administered at the onset of the issue yields better results than later. It is best to seek a consultation to ensure that there is no underlying dormant issue.
How Do I Prevent Dark Circles From Appearing Under Eyes?
- Adequate sleep rests the facial muscles, which helps rejuvenate the whole body. The sleep cycle helps the body repair itself during the sleep cycle.
- Drinking adequate amount of water keeps the skin hydrated. It is a natural moisturizer and cleanser through perspiration.
- Diet plays a significant role in maintaining healthy skin and hair. It is advisable to avoid or limit processed food products.
- The regular use of sunscreen and moisturizer protects the skin around the eyes.
- Avoid rubbing your eyes frequently.
Are home remedies helpful?
There is no dearth of information about home remedies to cure dark circles. These remedies have no conclusive scientific evidence towards their efficiency in treating skin concerns. It is recommended to refrain from practising home remedies as the reactions to various ingredients may be unpredictable and could aggravate the situation.
- Topical medication containing retinoids and skin lightening agents like kojic acid, vitamin C, etc.
- Dark circle peels
- Brightening peels
- Q-switched YAG lasers for deep pigmentation
- Microneedling Radiofrequency for fine lines under the eye
- Botox for fine lines on the outer corners of the eye
- Fillers for tear troughs
Multiple factors cause dark circles. A thorough medical treatment plan, along with lifestyle changes, should be implemented. It is always advisable to seek and pursue treatments prescribed by a certified dermatologist.