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Dark Circles vs Eye Bags: Difference between Eye Bags and Dark Circles

Updated: Jan 7, 2022

It has often been said that the eyes are the windows to the soul. If that is true, we should be dark-circles-vs-eye-bags-difference-between-eye-bags-and-dark-circlescareful to maintain bright, youthful looking eyes.

One of the first things we notice when we meet someone, is whether their eyes look lively or tired, warm or cold. After pulling an all-nighter, one often develops tired-looking, puffy eye bags and dark eye circles. These are often apparent the next day and can be very hard to hide at the all-important pitch meeting or highly anticipated dinner date. Certainly, dark eye circles and eye bags are a frequent focus of patient consultations at my clinical practice.

Attractive, youthful looking eyes are characterised by firm, smooth, unwrinkled eyelids, with clear unpigmented skin and absence of puffiness or eye bags. Certainly, one should not have dark eye circles or eye bags.

I often get asked by patients, dark circles vs eye bags: what is the difference; which do I have? This curiosity seems warranted especially when one gets conflicting comments from family and friends, with one saying you have dark eye circles, and another saying you have eye bags.

So, dark circles vs eye bags, which do you have, and how do you tell them apart?

Let us look at some characteristics of people who have dark circles and eye bags, and identify the causes.


If you have allergies, chances are, those are not eye bags, but dark eye circles, as frequently happens in persons with allergies. Individuals with allergy-associated dark eye circles usually develop them at a young age. Frequent rubbing of the eyes and poor-quality sleep contribute to your dark circles too. The dark circles would get better with treatment using antihistamines, as well as other measures to keep the allergies under control.



If you notice that with the passing of the years, you now have a shadow below your eyes, and wonder whether those are dark eye circles or eye bags, it is likely you have both.

  • Aging skin can become hyperpigmented and thin, giving one an appearance of dark eye circles.

  • Weakening of skin over the eyelid causing herniation, or protrusion, of the fat around the eye causes eye bags

  • Tear troughs are depressions under the eyelids caused by loss of bone, and loss of cheek/malar fat, making eyebags look more severe.

  • These eye bags bring about a shadowing effect below the eyes, which would give the appearance of dark eye circles, or worsen the appearance of already existing eye circles.

Skin type

Asians tend to be more prone to dark eye circles. This is because we have more pigment in our skin. In addition, with the passing of the years, we may develop excess pigmentation (periorbital hypermelanosis) aka dark eye circles. This is often compounded by venous blood stasis or pooling of blood under the lower eyelids which often shows through the thin skin, giving dark eye circles.


So you hardly exercise, don’t get enough sleep and are a habitual smoker. Are those dark eye circles or eye bags you see in the mirror? Chances are that if you are young, what you are seeing are dark eye circles, though they may be eye bags too.

Festoons are protrusions over the lower eyelid and cheek that can look like eyebags and give one an aged appearance. They could be due to genetics, sun exposure and aging, but could also be due to smoking. Fractured collagen and elastic fibers in this region cause fluids to collect, resulting in swollen skin in the lower eyelid and cheek regions.

Having a healthy lifestyle, getting regular exercise and avoiding smoking will help reduce both dark eye circles and eye bags, and prevent premature aging. These lifestyle changes may seem troublesome, time-consuming, even painful, but these changes reap many benefits, including brighter, livelier eyes.

Other Causes

What else could causing you under eye problems?

Dark eye circles can be caused by genetic conditions and autoimmune disease. Even the medication you use could be responsible for dark eye circles such as glaucoma eyedrops.

Managing Dark Eye Circles and Eye Bags

Managing Dark Eye Circles and Eye Bags

Dark circles and eye bags often coexist in the same person. The key then for a physician is to accurately diagnose the problem, to understand the patient needs and perspectives, and so prevent or treat dark circles and eye bags.

There are different ways to manage dark circles and eye bags on your own:

  1. Home remedies that work Applying cold wet tea bags over dark eye circles has a vasoconstrictive effect, and so reduces the venous blood stasis.

  2. Cosmetic concealers With some interest and research, the internet should provide most of the information and tools you need to be a camouflage expert for your dark eye circles. For professional medical advice, look for an aesthetic clinic that carries quality make-up for different skin-types.

  3. Lifestyle changes

Adequate sleep, regular exercise, sun protection, a healthy diet and avoiding excessive salt intake. Apart from helping dark circles, these anti-aging measures also slow the development of eye bags.

Getting the Help of a Physician for Dark Eye Circles and Eye Bags

Getting the Help of a Physician for Dark Eye Circles and Eye Bags

Given that there are many causes of dark eye circles, the doctor consultation is important so that he can design an individualized treatment plan to achieve the best result. For eye bags, there needs to be an anatomical and etiological diagnosis. Simply put, the doctor needs to know where the problem is and identify the aggravating causes. The patient can then choose from a range of treatments ranging from the simple to the more complex. For both dark circles and eye bags, the plan of treatment should be arrived at with the input of the patient, taking into account patient expectation and risk tolerance.


For dark circles, active ingredients such as tretinoin, hydroquinone, kojic acid, retinol, vitamin C, arbutin and nicotinamide are what I prescribe for my patients in my practice. Tretinoin- based creams can promote skin turnover to improve skin tone and reduce pigmentation. This product has among its ingredients, a few that promote collagen production to reduce sunken eyes. Hydroquinone or arbutin creams act to reduce pigmentation and treat dark eye circles effectively, especially in Asian skin. I also like giving my patients this serum which contains copper peptide along with other hydrating, brightening ingredients.

Eye bag treatments

Physician administered treatments include injections of fillers, periorbital fractional resurfacing and high intensity ultrasound (HIFU). Broadband Light firming treatments are popular among my patients too. Often a combination of different treatments or modalities may give the best results.

Laser treatments

These can reduce the pigmentation in dark circles. Some lasers can even target the venous stasis to improve dark eye circles that are common in Asian skin.


In summary, the desire to improve the appearance of one’s face and to have youthful looking eyes, leads one to wonder if the problem is dark eye circles or eye bags. Often, both dark eye circles and eye bags need to be addressed together, as they often happen in the same person. Having a careful diagnosis of the issue with a medical doctor, followed by an individualized treatment plan after a consultation, and taking into account the patient perspective are important steps in achieving a satisfactory outcome.

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