Under-Eye Dark Circles: How to Treat Them, the 4 Types and Dermatologist Treatments

Under-eye dark circles (Periorbital Dark Circles) are a common cosmetic concern that can make you look more tired than you are. Many people treat them without hitting the cause because they assume dark circles have a single cause. In fact, dark circles fall into 4 main types, each with a completely different mechanism and treatment. Identifying the correct type is therefore the most important first step of treatment.

The 4 types of under-eye dark circles and how they differ

A dermatologist classifies under-eye dark circles into types so that the treatment matches the mechanism.

• 1. Pigmentary type: caused by accumulated pigment, from post-inflammatory hyperpigmentation (PIH) or genetics. Treated with Hydroquinone, Tretinoin and Pico Laser.

• 2. Vascular type: caused by thin under-eye skin that lets blood vessels show through. Treated with vascular lasers such as PDL/V-Beam and Vitamin K creams.

• 3. Structural/hollow type: caused by a deep groove under the eye (tear trough) that creates a shadow. Treated with fillers (Hyaluronic acid filler) or fat grafting.

• 4. Mixed type: several mechanisms occur together, so a combined approach is needed according to the proportion of each factor.

What causes under-eye dark circles?

Besides the four main types, other factors can make dark circles more noticeable, such as not getting enough sleep, frequent eye rubbing that stimulates pigment, nasal allergies that cause blood to pool under the eyes, ageing that thins the skin and reduces under-eye fat, and sun exposure that stimulates pigment. An assessment with a doctor helps identify which factor is the main contributor in each person.

Effective treatments for under-eye dark circles

Commonly used procedures and care, chosen according to the type of dark circle, include:

• Pico Laser: helps reduce dark spots and pigment around the eyes in the pigmentary type, usually done as a course of about 4–6 sessions.

• Hyaluronic Acid Filler: fills the under-eye groove (Tear Trough) to reduce shadowing. Suitable for the structural type.

• PDL/V-Beam: a vascular laser suited to the vascular type, where blood vessels are clearly visible.

• Topical medications/creams: creams containing Retinol 0.3–1%, Niacinamide 5%, Vitamin C and Caffeine eye cream help nourish the skin and reduce pigment over the long term.

• Mesotherapy: Mesotherapy such as DMK, PRP or Vitamin B12 injection helps rejuvenate the skin around the eyes.

The choice of method depends on the type of dark circle and each person's skin condition. Some topical medications, such as Hydroquinone and Tretinoin, should be used under a doctor's guidance because the skin around the eyes is thin and sensitive to irritation.

How to care for yourself to improve under-eye dark circles

• Rest: getting enough regular sleep helps reduce blood pooling under the eyes.

• Sun protection: apply sunscreen around the eyes every day to prevent pigment from darkening.

• Reduce irritation: avoid rubbing your eyes, and treat nasal allergies if they contribute.

Frequently asked questions

Can under-eye dark circles go away on their own? Dark circles caused by temporary lack of sleep may improve on their own with enough rest, but dark circles from pigment, blood vessels or a deep under-eye groove usually do not go away on their own and need treatment that matches the type.

Do eye creams really help dark circles? Creams containing Retinol, Niacinamide, Vitamin C and Caffeine can help nourish the skin and reduce pigment to a degree, especially in the pigmentary type, but the vascular or structural types usually need a procedure as well to see a clear result.

Is under-eye filler suitable for everyone? No. Hyaluronic Acid Filler mainly suits the structural type caused by a deep under-eye groove. For the pigmentary or vascular type, filler may not help, so a doctor should assess the type first.

How many Pico Laser sessions are needed under the eyes? Generally a course of about 4–6 sessions is done for the pigmentary type, but the actual number depends on how dark the pigment is and how each person responds. A doctor should assess each person individually.

Each type of under-eye dark circle needs a different treatment. Assessing the correct type before starting treatment is the key to a good result. Consult a dermatologist at Siam Dermatology, call +66 61 448 7000 or LINE @siamderm.

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed 16 July 2026