‘You look tired’ even when you’re not? The hidden causes and treatments for dark circles

gettyimagesbank

Click here for more articles by Kormedi.com.

Dark circles under the eyes are a common concern for people of all ages. If you often hear, “You look tired,” despite getting enough sleep, the cause may go beyond fatigue or lack of rest.

Dark circles refer to the discoloration and shadowing of the skin beneath the eyes. They come in several types: vascular dark circles, which appear bluish or purplish due to visible blood vessels under thin skin; structural dark circles, caused by shadows formed by protruding fat or bone structure differences; pigmented dark circles, resulting from melanin buildup; and mixed dark circles that combine two or more of these factors.

Allergies and aging among main culprits

Allergic rhinitis is a frequent cause of vascular dark circles. When nasal membranes become swollen and inflamed, blood flow around the nose and under the eyes slows down, creating bluish or purplish discoloration. Rubbing the eyes due to itching can also lead to melanin accumulation, producing brownish pigmentation.

Aging can worsen structural dark circles. As people reach middle age, the orbital septum — the tissue that supports fat under the eyes — weakens, causing fat to protrude and cast shadows between raised and hollow areas. In such cases, lower eyelid fat repositioning surgery can help. Instead of removing fat, the procedure redistributes it downward to fill hollow areas and smooth the under-eye contour.

Medical treatments and cosmetic options

Ko Hyo-sun, a plastic surgeon at Seran Hospital, said, “When puffiness under the eyes is reduced through fat repositioning surgery, the shadows fade, improving structural dark circles and making the under-eye skin appear smoother.” However, she noted that “the procedure has limited effect on vascular or pigment-related dark circles.”

Plastic surgeons often combine different treatments depending on the cause. For vascular dark circles, vascular lasers and skin boosters can help strengthen thin skin. For pigment-based dark circles, dermatologists recommend lifestyle improvements, sun protection, and laser toning using pico lasers.

Treating the root causes and adjusting daily habits

Ko added, “The most well-known treatment is lower eyelid fat repositioning surgery, but if allergic rhinitis, conjunctivitis, or atopic dermatitis persists, dark circles can reappear. Treating the underlying condition is crucial.” She emphasized the importance of lifestyle changes, including adequate sleep, stress management, and fatigue recovery.

This article from Kormedi.com, Korea’s top health care and medical portal, is translated by a generative AI system and edited by The Korea Times.