Dark Circles Under the Eyes
Dark circles are one of the most common location-specific concerns. They aren’t always caused by lack of sleep – many are tied to genetics, vascular changes, or systemic conditions.
- Genetics and Family History: Research confirms that periorbital hyperpigmentation often runs in families, with hereditary traits considered the primary factor for many patients .
- Iron Deficiency and Systemic Triggers: Studies show nearly half of patients with dark circles had iron deficiency anemia – and correcting anemia often improved the appearance .
- Skin Thinning and Vascular Prominence: The eyelid’s thin, transparent skin exposes the vessels and muscles beneath, making the area look darker .
The Mayo Clinic notes that topical depigmenting agents, lasers, and chemical peels may improve appearance, but addressing systemic causes like nutrition or hormones is equally important .
Puffy Eyes and Under-Eye Bags
Morning puffiness and persistent under-eye swelling often signal fluid retention and lymphatic stagnation, not just “tired eyes.”
- Vascular and Inflammatory Factors: Blood vessel permeability increases in the thin skin around the eyes, allowing fluid to collect. This creates visible swelling and shadowing .
- Hormonal and Lifestyle Links: Hormonal shifts, allergies, and even prolonged screen use can make puffiness worse, while aging naturally weakens tissue support around the eyes.
- Systemic Connections: Thyroid conditions and hormonal changes such as PCOS have been reported alongside chronic periorbital changes. Disorders were present in ~14.6% of patients with periorbital hyperpigmentation
Understanding whether puffiness is occasional (like in the morning) or chronic helps guide whether it’s a circulation issue, an inflammatory response, or tied to systemic health.
Hair Thinning and Shedding
Hair changes often appear along the scalp or crown, where they’re most visible. Unlike patterned hair loss, telogen effluvium is usually temporary and linked to stress or systemic imbalance.
- Stress and Systemic Triggers: Significant life stressors – major illness, postpartum hormone shifts, thyroid imbalance – can push large numbers of follicles into a resting phase. Hair then sheds suddenly a few months later .
- Medication Links: Common culprits include retinoids, beta-blockers, anticoagulants, and thyroid medications .
- Prognosis: Most cases resolve within 3-6 months, with regrowth visible within a year once the trigger is corrected .
Mayo Clinic and Harvard Health emphasize that telogen effluvium is self-limiting – the key is addressing the underlying condition, whether nutritional, hormonal, or stress-related .
Quick Comparison Table
| Concern | Common Causes | Systemic Links | Typical Course | Evidence-Based Notes |
|---|---|---|---|---|
| Dark Circles | Genetics, melanin/hemosiderin buildup, thin skin | Iron deficiency, hormonal imbalance | Chronic but manageable | Often hereditary; anemia correction improves |
| Puffy Eyes | Fluid retention, vascular changes | Thyroid, hormonal shifts | Episodic or persistent | Linked to lymphatic stagnation |
| Hair Thinning (TE) | Stress, illness, medications | Thyroid disease, iron deficiency | Usually self-limiting in 3-6 months | 95% of cases resolve |
