Dark circles and under-eye bags: causes, remedies and innovative treatments

Dark circles and under-eye bags: causes, remedies and innovative treatments

Publication date: 11-05-2022

Updated on: 03-05-2023

Topic: Dermatology

Estimated reading time: 1 min

Swollen or surrounded by a dark halo eye is a very common problem. In fact, both women and men can confirm that they have suffered from it at least once in their life. Sleep a little less, spend a few hours in a smoky environment, indulge in food or alcoholic drinks to wake up the next morning with so-called dark circles or/and bags under the eyes.

Frequently, these imperfections are caused by a genetic predisposition or other pathologies. Professor Antonino di Pietro, scientific director of the Dermoclinical Institute Vita Cutis at the Palazzo della Salute - Wellness Clinic, helps us understand what exactly these unsightly eye contour defects are and how to mitigate them.

Under-eye bags and dark circles: different and misunderstood imperfections

“They are two very common skin defects that affect the most sensitive part of the face: eye contour. Here the skin is thinner and more delicate and therefore much more exposed to the appearance of bags and dark circles. It is important to specify that these two disorders have different characteristics and are caused by different factors,” - explains Professor Di Pietro.

Dark circles: origins and causes

Dark circles appear as a bluish-gray halo on the skin under the eyes caused by:

  • excessive dilation of the capillaries under the eyelid;
  • a buildup of melanin.

People with an olive complexion suffer from it more often: the melanin concentrates on the skin around the eyes making it dark. It can also appear in those with fair skin. In this case, the reason is often a slowed microcirculation in the capillaries.

Under-eye bags: origins and causes

The so-called 'bags' manifest themselves as a swelling of the skin under and over the eyelid, caused by:

  • an increase in the amount of orbital fat that normally surrounds the eye;
  • a buildup of whey and water between fat cells.

This condition is caused by a loss of tissue elasticity, which increases with the passing of the years and is favored by poor lymphatic and blood circulation.

Temporary or permanent: cause factors

“Both dark circles and under-eye bags can be a temporary disturbance, or mark the eye contour permanently. Temporary dark circles may be caused by:

  • insufficient hours of sleep;
  • too many coffees;
  • food excesses;
  • physical and mental stress.

Instead, permanent dark circles are defined in those who have a particular anatomical conformation of the sub-eyelid area. In this case they may appear at a young age and tend to become even more pronounced if one has an unregulated lifestyle, for example:

  • lack of sleep;
  • physical and mental fatigue;
  • incorrect nutrition.

However, when the swelling becomes constant, it can be caused by thyroid, heart and kidney diseases, and eye infection,” continues the specialist.

Natural remedies: cold, good sleep and friendly foods

“There are some simple and healthy habits that can help reduce dark circles and bags naturally. First of all, it would be advisable not to expose yourself to excessive heat sources, for example, tanning lamps. Heat only worsens the problem, as it acts negatively on the microcirculation and further dilates the capillaries.

Cold, on the other hand, can help reduce swelling and sunken eyes. Good results against dark circles are alsoobtained by applying a compress with cold chamomile on the eye contour. This flower contains bisabolol (natural chamomile alcohol), which acts on the capillaries as a vasoconstrictor and leads to a consequent attenuation of the dark halo.

To remove the stagnation of liquids, narrow the vessels and reduce swelling, an ice cube wrapped in a clothcan be appled for a few minutes on the under the eyes area.

Good sleep is also essential to combat these two imperfections. It is therefore advisable to sleep regularly, resting your head on a 2-finger high pillow, so as to avoid blood stagnation in the eye contour area.

Nutrition also helps against swollen and sunken eyes, such as foods with bioflavonoids (help proper functioning of blood vessels), for example berries. In addition, foods rich in vitamin C (kiwi, citrus, peppers and asparagus), vitamin K (grapes, plums, aubergines, cucumbers) that strengthen the walls of the capillaries, should not be missing from the diet”, explains the dermatologist.

Dermocosmetics against dark circles and under-eye bags

“Paying attention to the beauty routine is essential in the case of circled eyes and puffiness. You should always:

  • carefully remove make-up in the evening;
  • every day apply the most suitable cream for the type and severity of the imperfection (on the advice of the dermatologist)”.


“Excellent are those containing Fospidina (phospholipids and glucosamine), a regenerating compound derived from soy and shellfish that contributes to the production of collagen (protein that tonifies the skin) and elastin and promotes regeneration of skin tissue. Vitamins K and C are also fundamental in dermocosmetics to strengthen the microcirculation and prevent the blood vessels from clotting. Eye-creams with glucosamine are recommended, it restores capillary elasticity”, adds Professor Antonino Di Pietro.

Aesthetic techniques against dark circles

“In the case of particularly pronounced bags and dark circles, which do not fade with the use of specific creams, the specialist can suggest to intervene with a series of aesthetic treatments aimed at the type of imperfection. As previously mentioned, since these are two different skin problems, the most effective techniques to mitigate them are also different”, explains the expert.

Hyaluronic acid for dark circles

Treatments based on pure hyaluronic acid, a substance naturally present in the connective tissue (skin, tendons, cartilage, etc.) and necessary for keep the skin elastic and well hydrated in depth. Among the most innovative there are Overlap® and Picotage®.


It is an exclusive anti-aging therapy developed by Professor Di Pietro that promotes revitalization, elasticity and deep hydration of the eye contour.

“It consists of a series of micro-injections of pure hyaluronic acid. The action is therefore not only filling, but also revitalizing for the skin: it stimulates the production of collagen, endogenous hyaluronic acid and elastin, gives the skin firmness and consistency, strengthens the natural defenses against the sun's rays, restructures and hydrates the matrix. Specifically, it allows to attenuate the furrows under the eyes, filling them, and thus limiting the dark halo of the eye area”, explains the dermatologist.


The term picotage derives from the French “picoter” meaning “to prick” and is another exclusive technique of Professor Di Pietro. This technique promotes the revitalization, elasticity and deep hydration of the thin and delicate skin around the eyes.

“A series of micro-injections are made at a depth of about 1 millimeter and at a distance of 1 cm from each other with pure hyaluronic acid. This technique does not work by filling wrinkles from the inside, like the filler, or paralyzing expressions, as happens with Botox, but by stimulating the production of collagen and elastin and keeping the skin naturally hydrated. With picotage, dark circles do not disappear completely, but are visibly faded and the face gains brightness”, adds Professor Antonino Di Pietro.


In addition, a new hyaluronic acid filler with restructuring, lightening and filling properties has been introduced to reduce dark circles. The substance specifically fills the furrow created by the dark circles and restores lost volume without giving swollen effect to the lower eyelid. This allows to mitigate the emptying caused by time and also a certain laxity of the skin which leads to a 'dark effect' under the eyes.

Enhance the benefits with the Rimage

To optimize results, an exclusive anti-aging facial treatment Rimage® can be used, which combines hyaluronic acid with:

  • radiofrequency treatment based on the effects of electromagnetic waves;
  • biorevitalization techniques which, through superficial micro-injections of biocompatible and resorbable substances, stimulate the skin making it more elastic, turgid and well hydrated.

"Treatment is based on the synergistic action of 3 techniques:

  • electroporation: consists in the application of a very weak electric current on the skin, which opens the pores and promotes penetration of fospidin (a complex of phospholipids and glucosamine);
  • radiofrequency: electromagnetic waves transform electrical energy into heat that homogeneously reaches the dermis (the deepest layer of the skin located under the epidermis);
  • cold infrared light: effectively stimulate skin cells, enhance the action of fospidin, forming new collagen and making the skin around the eyes firmer, smoother and even.

It is particularly indicated against dark circles because it allows to nourish dehydrated and thinned skin and reduce discoloration”, underlines Prof. Di Pietro.

Aesthetic techniques against under-eye bags

There are techniques with hi-tech equipment indicated to attenuate and deflate under-eye bags: the CO2 laser and radiofrequency.

CO2 laser

“The treatment is carried out with an ultra-pulsed CO2 laser that vaporizes water contained in the cells without damaging or burning the surrounding tissues. Then, laser performs a skin resurfacing, i.e., peeling that leads to cell regeneration, with production of new collagen, deflates under-eye bags and gives the skin more toned and smooth appearance”, explains the specialist.

Radio frequency

“This technology transforms the electrical energy of electromagnetic waves into heat and homogeneously penetrates tissues up to the dermis, stimulating both the production of new collagen and the reorganization of already present collagen and elastic fibers. In the case of under-eye bags, radiofrequency reduces their formation through restoring tone and elasticity of the skin. This way eye contour becomes more compact and luminous”, concludes Prof. Di Pietro.

Read others

Dermatology, Orthopedics, Urology

What is PRP for and how is it used at the Istituto di Cura Città di Pavia


What does cause white spots on the skin?


Ruby angiomas and seborrheic keratoses: what they are and when to worry?