Dark circles under the eyes.

Ugh.

They’re the bane of many a woman’s existence, and men aren’t immune, either. They make us look older, more tired, sadder and more stressed out than we actually are, and if the volume of products lining drug store shelves are any indication, these less-than-desirable facial features have reached epidemic levels. People are desperate for products that can make them disappear—or, if not disappear, then at least cover them up. Technically called “periocular or periorbital hyperpigmentation”—yes, of course there’s a tongue-twisting scientific name for it—is typically considered a cosmetic problem. Dark eye circles are aesthetically unpleasing and may make people look more run down than they are, but that’s about it. Get more sleep, cut back on coffee, and they’ll go away, right?

Not exactly. Dark circles under the eyes are more than skin deep. They don’t appear without rhyme or reason. They could be a sign of something going on inside. Something more than insufficient sleep or rubbing your eyes too much.

Home remedies, such as cool compresses (often made with tea bags or cucumber slices), can help improve the appearance of dark circles or “bags” under the eyes, as can luxury cosmetics and expensive surgical procedures. And as some observant researchers have noted, “The extent of the problem is reflected in the sheer number of products on the market advertised to either lighten or cover the pigmentation.” There are entire drugstore shelves dedicated to such products. And while these interventions might help mask the discoloration and skin looseness, they don’t address the underlying causes—assuming there are some.

There isn’t much consensus on the issue. Some researchers say that while dark under-eye circles are a cosmetic concern for a large number of people, they’re not a medical issue. One thing that is known is that while we might have a knee-jerk association between these dark circles and people of older age, they affect young and old alike. 

So what might be behind these subtle and not-so-subtle “decorations” on our faces?

According to one study’s authors, “In most cases, we have little information regarding etiology and no gold-standard treatment option.” On the other hand, other researchers say that dark circles “are caused by multiple etiologic factors that include dermal melanin deposition, postinflammatory hyperpigmentation secondary to atopic or allergic contact dermatitis, periorbital edema, superficial location of vasculature, and shadowing due to skin laxity.” In plain English: it could be fluid retention near the eyes, sagginess of the skin under the eyes, blood vessels being located closer to the skin in that area, or more melanin in the area—with melanin being the pigment responsible for skin color.  

If there’s agreement on anything, it’s that dark circles have multiple possible causes. One potential cause that doesn’t garner as much attention as the others is food sensitivities. These can manifest in surprising and disparate ways. The most obvious are severe allergies, such as to shellfish, peanuts or tree nuts, which can be immediately life-threatening, and of course there’s celiac disease, the strongest adverse reaction to gluten. Beyond celiac, though, there’s a range of reactions attributed to what is called non-celiac gluten sensitivity, including manifestations in the skin. Since gluten is known to affect the skin in sensitive individuals, there’s a not-so-small chance that food intolerances—whether to gluten or to some other compound—contribute to under-eye circles. Food sensitivities can cause digestive, emotional, cognitive and neurological symptoms, so it shouldn’t shock us that dark circles could be a result of food intolerance.

Some researchers are making headway along this trail, saying that dark circles “may be a final common pathway of dermatitis, allergy, systemic disorders, sleep disturbances, or nutritional deficiencies…” The Mayo Clinic is on the scent, too, listing allergies, atopic or contact dermatitis, or hay fever among the potential causes. They also include the thinning of skin and loss of fat and collagen in the face that occur with aging as making “the reddish-blue blood vessels under your eyes more obvious,” but this doesn’t account for the noticeable dark circles in children.

Food sensitivities aren’t the only potential diet and lifestyle-related causes of dark under-eye circles. Others are smoking, excessive alcohol intake, and too much sodium, especially when coupled with inadequate potassium. For people with income to spare, expensive creams, eye serums, and even surgery might be worth the money, at least to some degree. But for those who don’t have the budget for those, or for people who can afford costly treatments but would prefer to tackle the underlying cause—identifying what this underlying cause is might be a better way of eliminating dark circles, rather than just covering them up.  

Sources

1. Roberts WE. Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment. J Drugs Dermatol. 2014 Apr;13(4):472-82.
2. Alsaad SM, Mikhail M. Periocular hyperpigmentation: a review of etiology and current treatment options. J Drugs Dermatol. 2013 Feb;12(2):154-7.
3. Roh MR, Chung KY. Infraorbital dark circles: definition, causes, and treatment options. Dermatol Surg. 2009 Aug;35(8):1163-71.
4. Freitag FM, Cestari TF. What causes dark circles under the eyes? J Cosmet Dermatol. 2007 Sep;6(3):211-5.