Written by Albina Suarez-Ojedis / Medically reviewed by Heidi Young, PAC

"You look so tired lately. Is everything ok?" My co-worker looked really concerned. I assured her that I was ok. Sure, I wouldn't mind catching up on sleep, but who gets enough sleep nowadays? During lunch, I called R+H and booked a tear-trough filler. Now my co-worker asks me how I manage to look so refreshed!


Periorbital (under eye or tear trough) dark circles are one of the most common concerns we hear from our patients. Not only do periorbital dark circles make you look tired, but they also make you look older than your real biological age, and that is something very few women find acceptable.

Here are some of the most common causes of periorbital dark circles:

  • Aging

In our early 20s our collagen production significantly drops, and the thin and delicate skin under the eyes becomes even thinner and more translucent. In addition to collagen loss, as we age, our skin also loses elastin, and this contributes to the loss of elasticity or crepey-ness of under-eye skin. Lastly, as we age, our facial fat pads thin and separate, and the combination of these factors contributes to undereye volume loss and shadows.

  • Sun overexposure

Overexposure to sun may stimulate increased melanin production in under eye areas compared to the rest of the face due to the under-eye skin being more sensitive, leading to hyperpigmentation, or brown spots (sun spots), that contribute to under-eye dark shadowing and dark circles.

  • Allergies

When allergies flare, our bodies produce histamine, which may turn our eyes red and itchy. Inflammation and rubbing of an itchy eye may cause broken blood vessels and create bruising. As the bruising heals, pigmented hemosiderin is left behind, causing discoloration.

  • Genetics

Published in the Brazilian medical journal, Anais Brasileiros de Dermatologia in 2015, a study found that one of the main contributing factors of dark circles in the Brazilian population was genetic hyperpigmentation.

Some other causes for developing periorbital dark circles may be:

  • Fatigue
  • Dehydration
  • Anemia/Iron Deficiency
  • Underlying illness or health condition
  • Dermatitis
  • Eczema
  • Smoking
  • Alcohol Consumption

How can dark circles be treated?

Here are 5 treatments for dark circles:

  • Chemical peels

Chemical peels can be very effective in reducing dark circles. They work by removing the epidermis where melanocytes (cells that produce melanin/pigment) are localized.

  • IPL

IPL works by breaking down melanin/pigment into tiny particles which are then flashed out by the lymphatic system.

  • RF Microneedling

Dark circles caused by the loss of volume and thinning skin may be reduced by Morpheus8 treatment, which stimulates skin’s own collagen and elastin production, improving skin laxity, thinness, and reducing the loss of volume.

  • Dermal fillers

Dermal fillers treat under-eye hollowness by restoring the lost volume in the under eye areas.

  • Exosome/Autologous Growth Factor injections

Exosomes and Autologous Growth Factors have regenerative and healing properties. When injected in under eye areas, they trigger the skin to build collagen which thickens the delicate under eye skin, improving the appearance of dark circles.

Periorbital dark circles are usually caused by many different contributing conditions and factors. Cosmetic treatment of under eye dark circles depends on correct identification of the cause and may be varied or combined. This is why it is very important to be treated by a trained medical professional to ensure you get the best treatment for the cause of your dark circles, and thus the best outcome.


R+H Aesthetic Medicine serves Northern California residents in the Greater Sacramento Area, Roseville, and South Lake Tahoe.


Photo Credit: "Dark Circles, Unkempt Hair, and barely a smile" by JenWaller is licensed under CC BY-NC-SA 2.0.

Published: Jun 01, 2022

Written by Albina Suarez-Ojedis / Medically reviewed by Heidi Young, PAC

"You look so tired lately. Is everything ok?" My co-worker looked really concerned. I assured her that I was ok. Sure, I wouldn't mind catching up on sleep, but who gets enough sleep nowadays? During lunch, I called R+H and booked a tear-trough filler. Now my co-worker asks me how I manage to look so refreshed!


Periorbital (under eye or tear trough) dark circles are one of the most common concerns we hear from our patients. Not only do periorbital dark circles make you look tired, but they also make you look older than your real biological age, and that is something very few women find acceptable.

Here are some of the most common causes of periorbital dark circles:

  • Aging

In our early 20s our collagen production significantly drops, and the thin and delicate skin under the eyes becomes even thinner and more translucent. In addition to collagen loss, as we age, our skin also loses elastin, and this contributes to the loss of elasticity or crepey-ness of under-eye skin. Lastly, as we age, our facial fat pads thin and separate, and the combination of these factors contributes to undereye volume loss and shadows.

  • Sun overexposure

Overexposure to sun may stimulate increased melanin production in under eye areas compared to the rest of the face due to the under-eye skin being more sensitive, leading to hyperpigmentation, or brown spots (sun spots), that contribute to under-eye dark shadowing and dark circles.

  • Allergies

When allergies flare, our bodies produce histamine, which may turn our eyes red and itchy. Inflammation and rubbing of an itchy eye may cause broken blood vessels and create bruising. As the bruising heals, pigmented hemosiderin is left behind, causing discoloration.

  • Genetics

Published in the Brazilian medical journal, Anais Brasileiros de Dermatologia in 2015, a study found that one of the main contributing factors of dark circles in the Brazilian population was genetic hyperpigmentation.

Some other causes for developing periorbital dark circles may be:

  • Fatigue
  • Dehydration
  • Anemia/Iron Deficiency
  • Underlying illness or health condition
  • Dermatitis
  • Eczema
  • Smoking
  • Alcohol Consumption

How can dark circles be treated?

Here are 5 treatments for dark circles:

  • Chemical peels

Chemical peels can be very effective in reducing dark circles. They work by removing the epidermis where melanocytes (cells that produce melanin/pigment) are localized.

  • IPL

IPL works by breaking down melanin/pigment into tiny particles which are then flashed out by the lymphatic system.

  • RF Microneedling

Dark circles caused by the loss of volume and thinning skin may be reduced by Morpheus8 treatment, which stimulates skin’s own collagen and elastin production, improving skin laxity, thinness, and reducing the loss of volume.

  • Dermal fillers

Dermal fillers treat under-eye hollowness by restoring the lost volume in the under eye areas.

  • Exosome/Autologous Growth Factor injections

Exosomes and Autologous Growth Factors have regenerative and healing properties. When injected in under eye areas, they trigger the skin to build collagen which thickens the delicate under eye skin, improving the appearance of dark circles.

Periorbital dark circles are usually caused by many different contributing conditions and factors. Cosmetic treatment of under eye dark circles depends on correct identification of the cause and may be varied or combined. This is why it is very important to be treated by a trained medical professional to ensure you get the best treatment for the cause of your dark circles, and thus the best outcome.


R+H Aesthetic Medicine serves Northern California residents in the Greater Sacramento Area, Roseville, and South Lake Tahoe.


Photo Credit: "Dark Circles, Unkempt Hair, and barely a smile" by JenWaller is licensed under CC BY-NC-SA 2.0.

Call or text us today to schedule an appointment. We can help you look and feel your best!

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P:(916) 209-0545 T:Text Us E:[email protected] 580 N Sunrise Ave Ste 150
Roseville, CA 95661

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P:(530) 237-4730 T:Text Us E:[email protected] 589 Tahoe Keys Blvd Suite E-2
South Lake Tahoe, CA 96150

West Sac

P:(916) 617-2331 T:Text Us E:[email protected] 2240 Lake Washington Blvd
Suite 130
West Sacramento, CA 95691