17 Mar Dark Eye Circles: Causes and Treatments in Singapore
Dark Eye Circles: Causes, Types and What Helps
By Dr Rachel Ho. Updated 6th September 2026
Dark eye circles are among the most frustrating concerns my patients bring up. Dark under eyes often leave patients looking perpetually tired or older despite adequate rest. While the beauty industry frequently markets eye creams as universal remedies for causes of dark eye circles, the reality is that “dark circles” is an umbrella term for distinct anatomical variations and pathologies resulting in darkness in the under eye region.
Dark eye circles can be due to hollowness in the under eyes or volume loss that casts physical shadows, vascular congestion visible beneath thin periorbital skin, true dermal or epidermal melanin deposition, or a combination of these factors working together. Achieving a refreshed, naturally restored under-eye area relies on moving past generic topical fixes to accurately diagnose your specific anatomical subtypes. In this doctor’s guide, we will break down the biological drivers of dark eye circles and examine the evidence-based medical treatments that address each root cause.
Pigment, vascular visibility and hollow related shadows can contribute to under eye darkness. Skin thickness and texture may influence their appearance, and several features can occur together
What causes dark eye circles?
Dark eye circles refer to a darker appearance beneath the eyes, and this appearance ca be due to different causes¹. A commonly used clinical classification separates them into pigmented, vascular, structural and mixed patterns¹.
Types and causes of dark eye circles
| Pattern of dark eye circle | What contributes to the darkness | Typical appearance |
|---|---|---|
| Pigmented | Increased melanin within the skin | Brown or grey brown discolouration¹,² |
| Vascular | Visible vessels and underlying tissues through thin eyelid skin | Blue, purple or reddish tones¹,² |
| Structural | Shadows from tear trough hollowing, eye bags or changes in surrounding contours | Darkness that varies with lighting and facial position¹,⁴ |
| Mixed | More than one contributing feature | A combination of colour and shadow¹ |
Most patients in my practice have mixed causes of dark eye circles, which can make evaluation less straightforward¹. Thin or crepey skin due to ageing can also influence the appearance, alongside the pigment, vessels and contours beneath it⁴.
Pigmentation, inflammation and eye rubbing causing dark eye circles
Hyperpigmentation around the eyes can be inherited genetically or acquired through chronic skin inflammation. Inflammatory triggers such as eczema, contact allergies, or unsuitable skincare products stimulate local melanin production, a process frequently worsened by UV exposure and the physical friction of repeatedly rubbing itchy eyes². This leads to post-inflammatory hyperpigmentation, where the skin deposits excess pigment in response to low-grade trauma or irritation. From a clinical perspective, identifying and stabilizing any active skin irritation, itching, or flaking is a critical first step; attempting cosmetic laser or whitening treatments on an actively inflamed skin barrier risks further aggravating the skin and paradoxically darkening the area.
Visible vessels and thin skin causing dark eye circles
The skin of the lower eyelid is the thinnest on the human body, supported by minimal subcutaneous fat to cushion the surface from underlying muscle and blood vessels⁴.As a result, the natural purplish or bluish hue of these superficial vasculature can show through in the abscence of excess melanin. These obvious vessels can be inherited or due to atopic conditions like allergic rhinitis. In such patients, pigmentation treatments such as lasers and brightening topicals frequently fail to resolve vascular dark circles.
In treating vascular casuses of dark eye circles, successful treatment results requires treating the underlying causes of the obvious vessels as well as collagen-stimulating therapies to thicken fragile skin.
Tear trough hollowing and loss cheek support causing dark eye circles
The tear trough is the anatomical depression extending from the inner corner of the eye down toward the mid-cheek⁵. Its depth is determined by a complex interplay of facial anatomy, including skin thickness, orbital fat pad positioning, and underlying bony support⁵. As this groove deepens, it creates a physical hollow that casts an overlying shadow and exaggerating the projection of an adjacent eye bag⁵. Crucially, because the periorbital area relies heavily on the structural foundation of the upper cheek, treating the lower eyelid in isolation frequently misses contribution from midface support is often necessary to lift the undereye tissues.
Is there any research on dark eye circles in Singapore?
A study by National Skin Centre in Singapore screened 1,000 clinic attendees and examined 200 people with periorbital hyperpigmentation³. This study in Singapore found that patients with dark eye circles typically had several contributing patterns, including vascular, constitutional, inflammatory and shadow related features, providing helpful insight and evidence that dark eye circles in patients in Singapore has several possible contributors³.
Why do I have dark circles despite enough sleep?
A common misconception among many patients is that dark eye circles are a symptom of fatigue or sleep deprivation. In clinical reality, adequate rest cannot alter structural facial anatomy such as a deep tear trough groove, visible vessels or hyperpigmentation²,⁴. When under-eye darkness has been present since youth or runs in your family, it is primarily driven by genetic pigmentation patterns and underlying anatomical architecture rather than lifestyle choices.
Dark circles describe colour or shadow, eye bags describe fullness, and tear troughs are hollows between the lower eyelid and cheek. These concerns can coexist and may need different treatment approaches.
Are dark circles the same as eye bags?
Dark eye circles describe colour or shadow, whereas eye bags describe fullness beneath the lower eyelid, usually due to pseudoeherniation of the orbital fat⁴. A tear trough is a depression, and all three features can occur together in the same patient⁴. My guide to to eye bags and nonsurgical treatment explains these structural differences and when surgery may be more appropriate.
Can eye creams and skincare improve dark eye circles?
Sun protection and skin barrier supporting skincare are helpful when pigmentation or inflammation contributes to dark eye circles². Selected active ingredients in eye creams can improve the skin’s moisture barrier, but they do not replace volume loss or treat visible vasculature. My article Do Eye Creams Work? discusses what skincare can realistically achieve and where procedures may have a different role.
Pico laser helps selected pigmentary dark circles, but results vary with the device and treatment protocol.
Pico laser for pigmented dark eye circles
How does pico laser help for dark eye circles?
Picosecond lasers deliver very short pulses of energy to lighten hyperpigmentation through a photoaccoustic effect. Pico lasers have been studied for reducing infraorbital pigmentation and the yield of pico lasers in treating dark eye circles is highest in patients with excess pigment contributes to the darkness, rather than a shadow caused mainly by hollowing¹,⁶. My blogpost to picosecond lasers, Pico Lasers: What the Evidence Shows, explains the science of pico laser for treating dark spots in greater detail.
What does the evidence show for pico lasers for treating dark eye circles?
In two small prospective studies, three treatments with a fractional 755 nm picosecond laser improved infraorbital pigmentation, while one treatment with a fractional 1064 and 532 nm system did not produce significant improvement⁶.
A later study involving 12 women found that picosecond KTP and fractional thulium treatment could provoke post inflammatory hyperpigmentation rather than visible improvement⁷. These findings reinforce the importance of skin type, wavelength and treatment selection, particularly when the skin is prone to pigmentation⁷.
RF microneedling may improve fine wrinkles and selected skin texture changes around the eyes.
RF microneedling for skin tightening and texture
RF microneedling delivers radiofrequency energy through fine needles to produce controlled heating within the skin and collagen remodelling. Collagen remodelling improves dermal density, and skin quality to reduce the appearance of wrinkles and skin texture changes around the eyes⁹.
A study of 21 women with mixed dark circles found improvements in overall appearance and periorbital wrinkles after fractional RF microneedling¹⁰. Changes in melanin measurements were not statistically significant, supporting a role in structural and skin quality improvement rather than assuming direct pigment removal¹⁰.
My clinic’s RF microneedling guide explains the procedure in greater detail.
ECM skin booster research has reported improvements in facial skin quality, including hydration and wrinkle measurements.
ECM skin boosters for under eye skin quality
ECM refers to extracellular matrix, the material surrounding cells that contributes to tissue structure¹². In Singapore, ECM skin boosters contain processed human acellular dermal matrix, derived from donor skin with cellular components removed¹². My posts ECM Skin boosters Explained and ECM Skin Booster Controversies: Safety and Ethics discusses in depth the science and controversies behind this popular skin treatment for under eye rejuvenation. In my personal experience of administering ECM skin boosters to the under eye for rejuvenation of the tear trough, I have found the results to be effective in reducing skin crepiness, wrinkles and sagging. Patients often notice a lifting, tightening and improvement of undereye skin quality in about 4 weeks after administration of ECM skin boosters.
View this post on Instagram
What does the research on ECM skin boosters show?
A 2026 randomised study compared one injectable human acellular dermal matrix formulation with hyaluronic acid in 20 adults with cheek roughness¹². Over 20 weeks, the investigators reported improvements in several measurements, including skin density, elasticity, wrinkles and hydration¹².
What do ECM skin boosters involve?
My clinic’s guide ECM skin booster under eye guide explains the my approach to using ECM for the under eye. Essentially, ECM skin boosters are introduced very superficially into the skin of the undereye to replenish the skin’s matrix and induce collagen building processes for skin health.
ECM skin boosters are not tear trough fillers, and not create a volumising effect. For tear trough hollowness, tear trough fillers are a better treatment. For more about tear trough fillers please refer to my clinic’s Guide to Tear Trough Fillers.
A small study of a PDLLA and hyaluronic acid formulation reported improved tear trough appearance and skin quality ratings. These findings are preliminary and do not establish pigment removal or a standard result timeline.
PDLLA skin boosters for dark eye circles
PDLLA stands for poly D,L lactic acid, a biodegradable polymer used in collagen stimulating injectables¹⁴. Human studies have shown improvements in texture alongside collagen and elastic fibre changes with this treatment¹⁴.
The aim of PDLLA skin booster is to trigger collagen repair mechanisms that restore collagen loss in the skin. This results in a firmer, thicker and smoother under eye apperance.
PDLLA skin boosters for under eyes in Singapore and Malaysia: what did the study show?
A 2026 prospective study conducted in Singapore and Malaysia evaluated 15 women receiving three treatments with a PDLLA and hyaluronic acid formulation¹⁵. Investigators and patients reported improvements in tear trough appearance and ratings of under eye skin quality¹⁵.
Tear trough filler may reduce hollow related shadowing, while cheek support may help when midface volume contributes to the contour. Filler changes volume rather than removing pigment; the comparison shown is a simulation, not a treatment result.
Tear trough filler for darkness caused by hollowing
Hyaluronic acid tear trough filler can reduce tear trough depression and structural shadowing by volumising the depression ⁵,¹⁷.
Tear trough fillers are administered precisely using a needle or cannula after assessing the lower eyelid. A meta analysis of 31 reports involving 2,556 participants found a pooled satisfaction rate of 91 per cent after hyaluronic acid treatment for tear trough deformity¹⁷.
Possible complications of tear trough fillers in Singapore include swelling, bruising, lumps and bluish discolouration from superficially placed filler¹⁷,¹⁸. Rare vascular complications can cause skin injury or vision loss¹⁸.
When does cheek filler support help dark eye circles?
Cheek filler is a consideration for dark eye circleswhen reduced midface support contributes to the lower eyelid and cheek transition¹⁹. The aim of cheek fillers in this instance is to address the anatomical contribution rather than add cheek volume routinely¹⁹. My guide to cheek filler injections explains this area in more detail. The need for direct tear trough treatment should still be assessed separately⁵,¹⁹.
Dark eye circle treatments compared
Treatments for dark eye circles compared
| Treatment for dark eye circles | Main concern it may address | Important limitation |
|---|---|---|
| Pico laser | Selected pigmentary dark circles⁶ | Results vary by protocol; pigmentation can worsen⁷ |
| RF microneedling | Fine wrinkles, texture and selected skin laxity⁹,¹⁰ | Improvement in appearance does not establish pigment removal¹⁰ |
| ECM skin boosters | Skin quality concerns accompanying darkness¹² | Direct evidence for clearing dark circles remains limited¹² |
| PDLLA skin boosters | Selected under eye skin quality and contour concerns¹⁵ | Evidence is preliminary; nodules can occur¹⁶ |
| Tear trough filler | Shadowing from a suitable hollow¹⁷ | Adds volume rather than removing pigment; swelling can worsen the appearance¹⁸ |
| Cheek filler | Deficient midface support contributing to the eyelid and cheek contour¹⁹ | Appropriate only when the anatomy supports its use¹⁹ |
Frequently asked questions about dark eye circles
What helps vascular dark circles?
Assessment should distinguish a discrete visible vessel from more diffuse colour showing through thin skin⁴. Depending on the finding, your doctor may recommend treatment directed at the vessel or associated skin and contour concerns like vascular lasers and long pulsed lasers.
Can dark eye circles be completely removed?
Treatment can improve contributing factors toward dark eye circles, facial anatomy and ongoing ageing may continue to influence appearance²,⁴.
How many treatment sessions are needed for dark eye circles?
Published protocols for laser and injectable directed treatments of dark eye circless differ⁶,¹²,¹⁵. Given the varied nature of dark eye circles and severity across patients in Singapore, it’s best to discuss with your aesthetic doctor about the best approach for your dark eye circles.
Choosing dark eye circle treatment in Singapore
Assessment of dark eye circles has to take into consideration a combination of factors such as pigmentation, vessels, hollowing, eye bags, skin quality and previous treatment⁵. For a treatment focused overview, read the dark eye circle assessment and treatment guide at The Skin Longevity Clinic.
Conclusion on dark eye circle treatment in Singapore
Dark eye circles are often due to a combination of factors that reflect pigment, vascular colour, structural shadowing or a combination¹. Pico laser, RF microneedling, ECM skin boosters and PDLLA skin boosters, tear trough filler and cheek support each have a different role in addressing dark eye circles. The appropriate treatment depends on identifying those contributors ⁵,¹⁰,¹².
References
- Huang YL, Chang SL, Ma L, Lee MC, Hu S. Clinical analysis and classification of dark eye circle. International Journal of Dermatology. 2014;53(2):164 to 170.
- Sarkar R, Ranjan R, Garg S, Garg VK, Sonthalia S, Bansal S. Periorbital hyperpigmentation: A comprehensive review. Journal of Clinical and Aesthetic Dermatology. 2016;9(1):49 to 55.
- Ranu H, Thng S, Goh BK, Burger A, Goh CL. Periorbital hyperpigmentation in Asians: An epidemiologic study and a proposed classification. Dermatologic Surgery. 2011;37(9):1297 to 1303.
- Vrcek I, Ozgur O, Nakra T. Infraorbital dark circles: A review of the pathogenesis, evaluation and treatment. Journal of Cutaneous and Aesthetic Surgery. 2016;9(2):65 to 72.
- Liew S, Doreian S, Kunathathorn W, et al. Lower eyelid dark circles: Tear trough and lid cheek junction. A stepwise assessment framework. Aesthetic Surgery Journal. 2024;44(7):NP476 to NP485.
- Vanaman Wilson MJ, Jones IT, Bolton J, Larsen L, Wu DC, Goldman MP. Prospective studies of the efficacy and safety of the picosecond 755, 1,064, and 532 nm lasers for the treatment of infraorbital dark circles. Lasers in Surgery and Medicine. 2018;50(1):45 to 50.
- AlRamthan A, Shaban M, AlSaqer F, et al. Evaluation of the effectiveness of picosecond KTP and fractional thulium lasers on pigmented type periorbital dark circles. Lasers in Medical Science. 2024;39:173.
- Huang A, et al. Ocular injury in cosmetic laser treatments of the face. Journal of Clinical and Aesthetic Dermatology. 2018.
- Kim KE, Park JH, Seul TW, Kim IH, Ryu HJ. Periorbital skin rejuvenation of Asian skin using microneedle fractional radiofrequency. Annals of Dermatology. 2023;35(5):360 to 366.
- Wu X, Liu Y, Zhu J, Yu W, Lin X. A prospective trial of the microneedle fractional radiofrequency system application in the treatment of infraorbital dark circles. Clinical, Cosmetic and Investigational Dermatology. 2022;15:1293 to 1300.
- US Food and Drug Administration. Potential risks with certain uses of radiofrequency microneedling. Safety communication. October 15, 2025.
- Lee YI, Chau NH, Nguyen NH, et al. Injectable particulated human acellular dermal matrix booster for skin restoration: An integrated randomized, split face, double blinded clinical trial and preclinical study. International Journal of Molecular Sciences. 2026;27(5):2193.
- Sung SW, Lee SY, Seok J, Kim BJ. Vascular complication following injection of particulated human acellular dermal matrix: A case report. Journal of Cosmetic Dermatology. 2026;25:e71049.
- Seo SB, Park H, Jo JY, Ryu HJ. Skin rejuvenation effect of the combined PDLLA and non crosslinked hyaluronic acid: A preliminary study. Journal of Cosmetic Dermatology. 2024;23(3):794 to 802.
- Young SM, Lau EKH. Hybrid biostimulator and hyaluronic acid injectable for tear trough rejuvenation. Aesthetic Plastic Surgery. 2026;50:5337 to 5343.
- Seo SB, Wan J, Yi KH. Energy based device management of nodular reaction following poly D,L lactic acid injection for tear trough rejuvenation. Journal of Cosmetic Dermatology. 2025;24:e16575.
- Liu X, Gao Y, Ma J, Li J. The efficacy and safety of hyaluronic acid injection in tear trough deformity: A systematic review and meta analysis. Aesthetic Plastic Surgery. 2024;48(3):478 to 490.
- Zein M, Tie Shue R, Pirakitikulr N, Lee WW. Complications after cosmetic periocular filler: Prevention and management. Plastic and Aesthetic Research. 2020;7:44.
- Kato K, Kajiwara T, Furuyama N, Liew S. Filler based correction of tear trough depressions and eye bags in Japanese patients: A classification system and treatment algorithm. Journal of Cosmetic Dermatology. 2023;22(2):439 to 448
No Comments