What helps dark circles and puffiness under the eyes?

Why are your under eyes dark?

Dark circles can come from extra pigment, visible blood vessels or shadows, which is an inconvenient amount of variety for one cosmetic complaint. With age, thinner skin reveals blood vessels, while hollows called tear troughs cast shadows. Sun exposure increases pigment. Genetics, eczema, allergies and eye rubbing can also contribute.1

Dark circles can be a clue to fatigue, but their appearance alone does not tell you the cause. Dehydration can make the skin around the eyes look sunken. These are reasons to consider your sleep and hydration alongside the colour, rather than treating every dark area as a skincare problem.2

What can you do at home?

• At night, aim for at least seven hours of sleep. Raising your head with extra pillows can help prevent fluid collecting beneath the eyes.
• For puffiness, try a cool compress or cold spoons over the eyes.
• Use sunscreen on your face, including around your eyes, and wear sunglasses.
• Avoid rubbing or scratching your eyes, which can worsen swelling.

Are allergies causing the puffiness?

Puffiness with itchy, red, watery eyes can occur with allergic conjunctivitis, an allergic reaction in the clear tissue covering the eye and lining the eyelids. Puffy eyelids are often worse in the morning. Pollen, dust mites, mold and pet dander are common triggers. Symptoms can be seasonal, and pollen symptoms can worsen on hot, dry, windy days.3

• Reduce exposure to the trigger where possible. Cool compresses and lubricating eye drops can ease symptoms.
• Oral antihistamines or antihistamine eye drops can offer relief, but can also make eyes dry.
• Do not use antihistamine or decongestant eye drops with contact lenses in place. Do not use decongestant eye drops for more than five days because congestion can return.
• If home care does not help, a clinician can assess whether prescription drops are appropriate. Steroid eye drops require an eye specialist's assessment, including checks of pressure inside the eye.

Allergy symptoms often settle with treatment, but can persist if exposure to the trigger continues. Seek medical advice if treatment is not helping, your vision changes, eye pain is severe or worsening, or a headache accompanies the symptoms. Redness or swelling of the eyelids or surrounding skin also warrants medical advice.3

What if there is a lump, crusting or pain?

A distinct eyelid lump or crusty eyelashes points to a different problem from ordinary dark circles. A stye is a small, red, painful bump caused by infection in an oil gland. A chalazion is a painless lump that can form after a stye. Blepharitis, inflammation of the eyelids, can cause redness, itching, burning and crusty eyelashes.4

An eye examination can identify the cause and guide treatment. Keeping eyelids clean helps prevent irritation and infection. Some eyelid problems are treated with warm compresses, medicines, ointments or eye drops, so a cooling routine for cosmetic puffiness is not a treatment for every swollen eyelid. An infection of the eyelid and nearby skin needs assessment; if infection spreads behind the eye, immediate medical care is necessary.4

Can creams or procedures help?

Vitamin C creams and hydroquinone can lighten dark circles. Clinical options include peels for pigment, lasers for resurfacing and tightening, fillers for lost volume, and eyelid surgery to remove excess skin and fat. Discuss the cause and suitable treatment with a clinician. Concealer covers the colour, which is a camouflage job rather than a repair job.1

When should you get dark circles checked?

Contact a healthcare provider for darkness or swelling beneath just one eye, persistent dark circles, or excessive swelling.1