Have Dark Circles and Under-Eye Bags? Here’s What to Do

Under-Eye Darkness & Bags 101

Here’s a quick primer on your under-eyes: Chances are you’ve had bags or dark circles since you were a kid—genetics do play a factor here—but environmental stressors like air pollution, along with certain lifestyle choices (like dehydration), can exacerbate both. And while genetically induced pigmentation is more common in women with darker skin, everyone is susceptible to it. There’s actually a trick to determine if your under-eyes are a gift from your parents or not. Dr. Alexis Parcells, a board-certified facial and reconstructive surgeon, reveals that you can gently pull this area of skin until it’s taught. “If the pigment lessens or improves dramatically, then the cause is less likely genetic and more likely due to the reflection of the sun onto the thin skin and tiny blood vessels under your eyes.” Science!

Under-Eye Fillers: Friend or Foe?

That’s all well and good, but most of us want to know if there is anything we can do to permanently lessen or eliminate under-eye darkness and bags. Considering that facial fillers are more popular than ever—over 2.7 million people got some variety of soft-tissue filler in 2019, according to the American Society of Plastic Surgeons—we’d assume that they were the most common option. And they are—sort of. You may not have realized it before, but the FDA has not approved fillers for this area, which, according to Dr. Parcells, means that there are no on-label training courses or standardization methods for the procedure.

Both doctors agree that, despite the lack of FDA approval, filler can be an effective treatment for the under-eye area for the right candidate. Dr. Liotta explains that this person is “someone whose under-eye darkness is the result of ‘hills and valleys’ under the eye. The ‘valleys are hollow, sunken spots that, when they’re beside normal, plump areas (‘hills’), create shadowing—and the perception of dark circles.” She says that to determine whether someone is a good fit for this procedure, she has her or him sit in her office with the overhead lighting and has them hold the mirror over her or his head. “If the darkness under the eyes disappears, it’s shadowing that’s causing the circles. If the darkness remains, the problem is probably excess pigmentation in the skin, something filler will not address.”

Since there is a lack of training involved in this procedure, there is slightly more risk than with lip or cheek fillers. Says Dr. Parcells, “Each person’s eye anatomy is slightly different, and the results of this treatment may vary dramatically from one person to the next. We have incredibly small and delicate blood vessels under the eye, and if placed incorrectly, this filler could enter a blood vessel, block its circulation, and result in devastating consequences, including blindness,” a rare but possible outcome. If you’re curious as to whether this could be the right fit for you, it’s crucial to visit a board-certified plastic surgeon or dermatologist who has experience with under-eye filler. And just remember—like all fillers, the results you achieve are not permanent and will fade in approximately three to six months. 

Additional Treatment Options

If you’re not quite convinced by the under-eye filler route (and truly, you shouldn’t be until you talk to your plastic surgeon or dermatologist), both doctors say that there are a few more options you can explore. Dr. Liotta explains that if the “hills and valleys” problem still presents itself, you can undergo surgery to remove the fat around the eyeball that starts to protrude with time.

There are also treatments that create micro-injuries in the skin in order to promote collagen production and cell turnover, which will help with that lingering puffiness and darkness under the eyes. Of these, Dr. Parcells notes laser resurfacing, microneedling with platelet-rich plasma (PRP), and medical-grade skin-care products as possible options, but she stresses that “because the skin around the eyes is so thin and delicate, there are limitations on the strength and depth of these procedures.”

Regardless of your willingness to undergo an in-office procedure, making healthy lifestyle choices like drinking enough water, avoiding smoking, wearing SPF, and getting adequate sleep will all improve your overall skin tone and texture. Bonus—they’re all available at a fraction of the cost.



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