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wasperformed FacialSurgery.com
Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.


What causes the dark circles under my eyes?

Dark circles under the eyes have several possible causes.

In many people, the skin of the lower eyelids is very thin, and the dark that you see is the venous blood in the veins underneath that thin skin.  No good treatment is available for that condition, because we don't know how to coax the veins to carry less blood.

Sometimes the dark circles are actually excess pigment in the skin of the lower eyelids, as if the skin had a huge freckle that covered much of the lower eyelid skin.  You can tell if that's what is going on by stretching the lower eyelid skin down and to the side, and carefully comparing the color of the skin to the color of the adjacent cheek skin.  When pigment is the problem, it can often be treated with topical bleaching creams (not hugely effective) or with a skin peel, which tends to pull excess pigment out of the skin.

The dark circles can just be shadow.  With time, the lower eyelids usually develop little bulges, which represent the fat that cushions the eyeball pushing forward.  The fat bulge makes it look as though there were a little groove underneath the bulge of fat, and that semi-circular groove looks like a dark circle.  Fat bulges can be treated with lower eyelid surgery, also called a lower eyelid blepharoplasty.

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