Dark circles under the eyes are a common cosmetic concern that can make people appear tired or older than they actually are. Dark circles under the eyes can be caused by various factors including being tired, allergies, atopic dermatitis (eczema), vascularity on the upper and lower eyelids, hollowness, true brown pigment, eyebags (fat), anatomy like recessed skull bones like the orbital rim, and the normal aging process. Dehydration can also cause the skin beneath the eyes to appear dull and sunken. Lack of sleep, poor sleeping habits, and hyperpigmentation due to increased melanin production from rubbing, the sun, irritation from cosmetic creams or products, and allergies can also lead to the development of dark circles under the eyes. Visible blood vessels beneath the skin’s surface can create dark shadows that are particularly noticeable in individuals with darker skin tones. In children, nasal congestion can cause veins around the nose to become dilated, leading to the appearance of shadowy dark circles under the eyes. Certain lifestyle choices such as smoking, excessive alcohol consumption, and poor nutrition can contribute to the development of dark circles under the eyes. To reduce the appearance of dark circles under the eyes, a variety of treatment options are available. These may include using cold compresses, applying creams containing retinol or vitamin C, getting enough sleep, staying hydrated, and reducing salt intake. However, persistent dark circles that do not improve with lifestyle changes may improve with non-surgical procedures such as dermal fillers or laser treatments. Dr. Rokhsar likes to use restylane or collure in the lower eyelids for treatment of hollowness. He can use vascular lasers such as the Vbeam laser or the Cool Touch Varia for the treatment of purpleness or vascularity. Dr. Rokhsar also likes to resurface the skin of the eyelids with either the Fraxel laser or the co2 laser to generate new skin. This is a complex problem and you need to see Dr. Rokhsar in person to find out what the best strategy is for your specific issues and your individualized goals.