Eye circles

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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Dark circles or Eye circles are dark blemishes around the eyes. Also known as "bags under the eyes," there are many etiologies to cause this symptom.[1] For instance, by lack of sleep, by deficiency of vitamin K, by heredity and by bruising.

## Causes

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### Common Causes

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#### Heredity

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Like varicose veins, dark circles under the eyes are usually an inherited trait. The skin under the eye is very thin. When blood passes through the large veins close to the surface of the skin it can produce a bluish tint. The more transparent the skin -- also an inherited trait -- the darker the circles appear.

In people with a deep-set bone structure, shadowing contributes to the dark color under the eyes.

#### Allergies, asthma, and eczema

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Any condition that causes the eyes to itch can contribute to darker circles due to rubbing or scratching the skin around them. Hay fever sufferers particularly will notice under-eye "smudges" during the height of the allergy season. Some food allergies can also cause the area under the eyes to appear darker.

#### Medications

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Any medications that cause blood vessels to dilate can cause circles under the eyes to darken. Because the skin under the eyes is very delicate, any increased blood flow shows through the skin.

#### Anemia

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The lack of nutrients in the diet, or the lack of a balanced diet, can contribute to the discoloration of the area under the eyes. It is believed that lack of mineral iron can cause dark circles as well. Iron deficiency is the most common type of anemia and this condition is a sign that not enough oxygen is getting to the body tissues.

The skin can also become more pale during pregnancy and menstruation (due to lack of iron), which again allow the underlying veins under the eyes to become more visible.

#### Fatigue

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A lack of sleep or excessive tiredness can cause paleness of the skin, which again allows the blood underneath the skin to become more visible and appear more blue or darker.

Some skin care experts say that fatigue has nothing to do with the dark circles, but it has to do with when one lies down. Gravity can cause fluid to collect in the lower eye lid.

#### Age

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Dark circles are likely to become more noticeable and permanent with age. Excess folds of skin under the eyes will also make dark circles more pronounced.

#### Medical conditions

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Another cause may be bad blood circulation. Cardio exercise increases blood circulation and may help the dark circles to disappear.

The area directly located under the eyes are closely related to kidneys and liver, so the appearance of dark circles may indicate problems or weakness in the kidney or liver activity.

Dark eye circles could be a sign of excessive loss of water from the body (dehydration).

### Causes by Organ System

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Cardiovascular | Capillary dilatation, Vasodilators

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Chemical/Poisoning | No underlying causes
Dental | No underlying causes
Dermatologic | Atopy, Bruising, Capillary dilatation, Eczema, Periorbital hyperpigmentation
Drug Side Effect | Anticoagulant medications, Aripiprazole, Fentanyl, Lysergic acid diethylamide, Methylphenidate, Morphine, Phenelzine, Selegiline, Tranylcypromine, Vasodilators
Ear Nose Throat | Allergic rhinoconjunctivitis, Atopy, Nasal congestion
Endocrine | No underlying causes
Environmental | No underlying causes
Gastroenterologic | Liver disease
Genetic | Inherited trait, Phenol sulfotransferase deficiency
Hematologic | Anemia, Anticoagulant medications, Coagulopathy, Hematoma
Iatrogenic | No underlying causes
Infectious Disease | No underlying causes
Musculoskeletal/Orthopedic | No underlying causes
Neurologic | No underlying causes
Nutritional/Metabolic | Iron deficiency, Vitamin k deficiency
Obstetric/Gynecologic | Menstruation, Pregnancy
Oncologic | No underlying causes
Ophthalmologic | Acute allergic conjunctivitis, Allergic rhinoconjunctivitis, Allergic shiners, Blunt trauma to the eye, Eyelid injury, Frequent eye rubbing, Perennial allergic conjunctivitis, Persistent eye rubbing, Seasonal allergic conjunctivitis
Overdose/Toxicity | No underlying causes
Psychiatric | Insomnia, Sleep deprivation, Sleep difficulty, Stress
Pulmonary | Asthma
Renal/Electrolyte | Dehydration
Rheumatology/Immunology/Allergy | Acute allergic conjunctivitis, Aesculus pollen allergy, Airborne allergy, Alder tree allergy, Allergic rhinoconjunctivitis, Allergic shiners, Allergy, Alternaria allergy, Amaranthus allergy, American feverfew allergy, Ash juniper tree pollen allergy, Ash tree allergy, Aspergillus spp allergy, Asthma, Atopy, Aureobasidium allergy, Beech tree allergy, Beet allergy, Bermuda grass allergy, Birch tree allergy, Bluegrass allergy, Box elder tree allergy, Canary grass allergy, Candida albicans allergy, Capeweed allergy, Cladosporium allergy, Cocklebur allergy, Cypress tree allergy, Daisy allergy, Dandelion pollen allergy, Dust allergy, Dust mite allergy, Eczema, Elm tree allergy, English plantain allergy, Epicoccum allergy, European ash tree allergy, Fusarium allergy, Goosefoot allergy, Grass allergy, Grass pollen allergy, Guayule allergy, Hay fever, Hazel tree allergy, Helminthosporium allergy, Hemp allergy, Hickory tree allergy, Hop shrub allergy, Hornbeam tree allergy, Horse chestnut tree allergy, House dust allergy, Hypersensitivity to pollen, Johnson grass allergy, Kentucky bluegrass allergy, Maple tree allergy, Marsh elder allergy, Mold allergy, Monteroy pine tree allergy, Mountain cedar tree allergy, Mucor allergy, Mugwort tree allergy, Nettle allergy, Oak tree allergy, Olea tree pollen allergy, Olive tree allergy, Orache allergy, Orchard grass allergy, Patterson's curse allergy, Pecan trees allergy, Penicillium allergy, Perennial allergic conjunctivitis, Phoma allergy, Pigweed allergy, Plane tree allergy, Plantago pollen allergy, Poplar tree pollen allergy, Ragweed allergy, Rapeseed oil allergy, Redroot allergy, Redtop grass allergy, Rhizopus allergy, Ryegrass pollen allergy, Sagebrush allergy, Seasonal allergic conjunctivitis, Smut allergy, Sorrel allergy, Sunflower pollen allergy, Sweet chestnut tree allergy, Sweet vernal grass allergy, Tilia tree pollen allergy, Timothy grass allergy, Tree pollen allergy, Tumble weed allergy, Velvet grass allergy, Wall pellitory allergy, Walnut tree allergy, White cedar tree allergy, Willow tree allergy, Willow tree pollen allergy
Sexual | No underlying causes
Trauma | Blunt trauma to the eye, Eyelid injury, Physical injury
Urologic | No underlying causes
Miscellaneous | Ageing, Dehydration, Fatigue, Frequent eye rubbing, Insomnia, Lack of sleep, Menstruation, Persistent eye rubbing, Pregnancy, Sleep deprivation, Sleep difficulty, Stress, Wasting

### Causes in Alphabetical Order

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* Acute allergic conjunctivitis

* Aesculus pollen allergy

* Ageing

* Airborne allergy

* Alder tree allergy

* Allergic rhinoconjunctivitis

* Allergic shiners

* Allergy

* Alternaria allergy

* Amaranthus allergy

* American feverfew allergy

* Anemia

* Anticoagulant medications

* Aripiprazole

* Ash juniper tree pollen allergy

* Ash tree allergy

* Aspergillus spp allergy

* Asthma

* Atopy

* Aureobasidium allergy

* Beech tree allergy

* Beet allergy

* Bermuda grass allergy

* Birch tree allergy

* Bluegrass allergy

* Blunt trauma to the eye

* Box elder tree allergy

* Bruising

* Canary grass allergy

* Candida albicans allergy

* Capeweed allergy

* Capillary dilatation

* Cladosporium allergy

* Coagulopathy

* Cocklebur allergy

* Cypress tree allergy

* Daisy allergy

* Dandelion pollen allergy

* Dehydration

* Dust allergy

* Dust mite allergy

* Eczema

* Elm tree allergy

* English plantain allergy

* Epicoccum allergy

* European ash tree allergy

* Eyelid injury

* Fatigue

* Fentanyl

* Frequent eye rubbing

* Fusarium allergy

* Goosefoot allergy

* Grass allergy

* Grass pollen allergy

* Guayule allergy

* Hay fever

* Hazel tree allergy

* Helminthosporium allergy

* Hematoma

* Hemp allergy

* Heredity

* Hickory tree allergy

* Hop shrub allergy

* Hornbeam tree allergy

* Horse chestnut tree allergy

* House dust allergy

* Hypersensitivity to pollen

* Inherited trait

* Insomnia

* Iron deficiency

* Johnson grass allergy

* Kentucky bluegrass allergy

* Lack of sleep

* Liver disease

* Lysergic acid diethylamide

* Maple tree allergy

* Marsh elder allergy

* Menstruation

* Methylphenidate

* Mold allergy

* Monteroy pine tree allergy

* Morphine

* Mountain cedar tree allergy

* Mucor allergy

* Mugwort tree allergy

* Nasal congestion

* Nettle allergy

* Oak tree allergy

* Olea tree pollen allergy

* Olive tree allergy

* Orache allergy

* Orchard grass allergy

* Patterson's curse allergy

* Pecan trees allergy

* Penicillium allergy

* Perennial allergic conjunctivitis

* Periorbital hyperpigmentation

* Persistent eye rubbing

* Phenelzine

* Phenol sulfotransferase deficiency

* Phoma allergy

* Physical injury

* Pigweed allergy

* Plane tree allergy

* Plantago pollen allergy

* Poplar tree pollen allergy

* Pregnancy

* Ragweed allergy

* Rapeseed oil allergy

* Redroot allergy

* Redtop grass allergy

* Rhizopus allergy

* Ryegrass pollen allergy

* Sagebrush allergy

* Seasonal allergic conjunctivitis

* Selegiline

* Sleep deprivation

* Sleep difficulty

* Smut allergy

* Sorrel allergy

* Stress

* Sunflower pollen allergy

* Sweet chestnut tree allergy

* Sweet vernal grass allergy

* Tilia tree pollen allergy

* Timothy grass allergy

* Tranylcypromine

* Tree pollen allergy

* Tumble weed allergy

* Vasodilators

* Velvet grass allergy

* Vitamin k deficiency

* Wall pellitory allergy

* Walnut tree allergy

* Wasting

* White cedar tree allergy

* Willow tree allergy

* Willow tree pollen allergy

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## Cures

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Although to date, there has been no end-all to curing or reducing dark circles, there are many home-made ingredients that can help make the dark circles less visible. For example it is said that putting teabags under the eyes, drinking plenty of fluids and a lot of rest can suffice. Make-up can be used to change the coloration of any exposed skin.

Vasoconstrictors

The Preparation H version with phenylephrine HCl 0.25% will constrict the capillaries resulting in the temporary reduction of the appearance of dark circles.

The cream has less petrolatum than the ointment which is important to avoid the greasy appearance.

Other vasoconstrictors such as tetrahydrozoline hydrochloride as found in Visine may offer similar temporary results. Use should be limited in order to avoid a rebound effect.

## References

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1. ↑ "What causes the dark circles that sometimes appear under my eyes?". Mayo Clinic women's healthsource. 7 (6): 8. 2003. PMID 12838159.

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