Over time, you have become increasingly aware of the dark circles around your mother’s eyes and how she seems so fatigued; in fact, she appears to be more exhausted than she has in the past. On the days when she has slept well and feels okay, you still can’t help but wonder if that is due to her age or if her dark circles are a sign that something else is going on with her body.
Millions of families wonder the same thing about their loved ones, and the answer may be more complex than most people assume.
Dark circles under the eyes occur frequently in older adults. According to the American Academy of Ophthalmology, dark circles under the eyes occur more often in older people than in any other age group. In most cases, dark circles under the eyes are purely cosmetic, but they can sometimes indicate a more serious underlying health issue, such as dehydration, anemia, thyroid problems or renal disease.
This guide explains why seniors can develop dark circles under the eyes, at what point families should start paying attention to the presence of dark circles under the eyes, and how to help provide a better appearance for your loved one.
Is It Normal for Seniors to Have Dark Circles Under Eyes?
Yes — dark circles are very common in older adults. But normal does not always mean harmless.
Darkness under the eye is typically a sign of the aging process due to collagen & elastic tissue being broken down and thinned out, causing tiny imperfections to be viewed. As the veins under the delicate skin of the eye become more visible as we age, the resulting appearance will usually be more pronounced or dyschromic than when we were younger.
However, it is absolutely critical that families hear this key point more often than not; however, not every elder with dark circle is that way due to natural aging alone. According to UCLA Health, dark circles can arise from anemia, poor circulation, hormonal shifts, malnutrition, and diseases that affect the liver or kidneys. So, while dark circles are normal — persistently worsening suddenly appearing, or one-sided dark circles always deserve a closer look.
The key is knowing what you are looking at — and that starts with understanding when the changes happen.
At What Age Do Dark Circles Get Worse in Seniors?
Dark Circles usually start to look worse after 60 years, with the age of 70 being when they are most visible. Here is why the timeline is important.
Dark Circles Can Appear At Any Age:
Dark circles can affect people at any age. But aging skin behaves very differently from young skin — and the changes accelerate in stages:
In your 50s: For people in the 50’s, there will be a noticeable decline in collagen production; the fat pads under the eyes begin to thin; first onset of dark circles or times when they are worse than in previous years.
In your 60s: there is an even faster loss of skin elasticity; the orbital fat (the fat cushion surrounding the eye socket) will migrate and thin; blood vessels will be more visible than in previous years; and dark circles will be present every day, not just on occasion.
In your 70s and beyond: According to the Cleveland Clinic, aging causes the skin under the eyes to thin significantly — and blood vessels become clearly visible through tissue that can no longer hide them. Shadows deepen. The under-eye area takes on a sunken appearance as volume loss increase speed. This is the stage when most families begin to notice the change and worry.
The gradual nature of these changes is actually reassuring — because gradual darkening over months and years is almost always cosmetic. It is the sudden changes that deserve medical attention.
The 10 Most Common Causes of Dark Circles in Seniors eyes
1. Natural Aging and Skin Thinning
The most common and most expected reason. As you age, your skin gets thinner and you lose subcutaneous fat (the fat that is underneath your skin). Consequently, the blood vessel(s) underneath the delicate skin under your eyes will become increasingly visible. Dark circles that are created because the skin is thinner than it used to be tend to be very stable, appearing every day no matter how much you’ve slept or drunk, and getting worse slowly over a number of years rather than suddenly showing up one day. This is simply biology doing what biology does. There is no way to stop this, but it is manageable!
2. Dehydration — Most Common Fixable Cause
This is a reason that many families don’t think about, and one of the fastest and most readily visible fixes when addressed. Seniors are particularly vulnerable to this reason because they have a significantly reduced sense of thirst as they age. Therefore, many seniors do not even get thirsty when they are very much dehydrated. Additionally, many medications commonly given to seniors have a diuretic effect and, therefore, result in seniors becoming dehydrated during the day.
The fix is simple — but it requires consistency. A caregiver who offers fluids regularly throughout the day makes this entirely preventable.
3. Poor Sleep Quality
Poor sleep sources dark circles — but in seniors it is rarely the only cause. It is almost always a contributing factor layered on top of other issues.
According to Cleveland Clinic, when sleep is insufficient the skin becomes paler — making blood vessels more visible — and fluid can pool under the eyes creating puffiness and shadows.
For seniors already dealing with thinning skin and reduced collagen — even ordinary sleep disruption significantly worsens the appearance of dark circles. A senior who woke up frequently last night will often show markedly darker circles in the morning.
4. Anemia — The Medical Cause Most Families Miss
This one matters enormously. And families miss it constantly.
Anemia, specifically iron deficiency anemia, is a confirmed and clinically significant contributor to periorbital dark circles (aka bags under your eyes). According to Healthline, iron deficiency anemia may cause dark circles. A 2014 research study revealed that 50% of subjects with significant dark circles under the eyes had anemia, and most of them had their dark circles resolved with the treatment of their anemia.
How does anemia cause dark circles? When your hemoglobin levels are low, you are unable to deliver adequate amounts of oxygen to your body’s tissues. Therefore, the blood under your skin is going to look darker, especially when that is visualized through the already thin under-eye skin.
Other signs of anemia in older adults are fatigue, paleness of the skin, shortness of breath, light-headedness and/or cold hands and/or cold feet. If you have dark circles under your eyes along with any of those other signs, a blood test is not an option. It is a necessity.
5. Kidney Problems — A Warning Sign Worth Taking Seriously
This is the connection that surprises most families. But the research is consistent and clear.
When your kidneys are having difficulty regulating your body’s waste products and fluid levels appropriately, the results can be evident through excessive fluid buildup in very sensitive areas of your face, such as your eyelids and the area just underneath your eyes. This generally results in dark circles under your eyes standing out more prominently. A major indicator here is having morning puffiness around your eyes along with darkness under your eyes, especially if those issues have only recently begun to occur. Underlying kidney disease issues are usually experienced upon awakening due to excessive amounts of fluid pooling overnight when you are laying down.
6. Thyroid Disease
Every thyroid disorder, whether hypothyroid (underactive) or hyperthyroid (overactive), can either create or contribute to the worsening of dark circles under your eyes. Research performed by Raymond Douglas, M.D. demonstrates several ways that thyroid disease can contribute to the development of dark areas under one’s eyes. These mechanisms include: fluid retention, impaired blood circulation, and the metabolic effects of thyroid dysfunction on skin quality and collagen synthesis.
The metabolic rate in individuals with an underactive thyroid gland (also referred to as being “hypothyroid”- which is commonly seen in the elderly) is significantly slowed down. This slow metabolism results in excessive fluid retention in the body and results in excessively thickened and/or dry skin. The collagen and elastin levels underneath the eyes are also lowered, resulting in a loss of skin elasticity meaning that the skin around the eyes tends to sag and droop even more than the original area of dark circles under your eyes.
7. Poor Circulation
You may find that the area beneath your eye is one of the first places to show signs of poor circulation. Poor circulation is impacted by our habits such as smoking, drinking too much alcohol, dehydration, not exercising enough, etc. These effects show up first on the thinner skin around our eyes because it is so sensitive.
8. Allergies and Sinus Congestion
Allergies may produce what doctors refer to as allergy shiners – a certain kind of shadow beneath our eyes, caused by nasal congestion or inflammation.
According to UCLA Health, both hay fever and allergies may be responsible for dark crescent moon shadows (dark circles) under your eyes. If we have congestion in the nasal passages, the amount of direction of blood flow through the veins draining from our eyes will slow down, thus increasing the pooling of blood which causes the bluish/purplish halo effect on either side of our eyes.
People who suffer from chronic sinus problems may develop the same effect. If your dark circles seem worse during certain months of the year or coinciding with the development of nasal symptoms, you may find that allergies or sinus issues provide a more reasonable answer than does age or disease.
9. Nutritional Deficiencies — Vitamin B12 and Iron
Specific nutritional deficiencies can worsen the appearance of dark circles. According to Healthline, low levels of vitamin B12 can increase pigmentation of the skin, thereby contributing to dark circles under the eyes. In addition, when one is iron deficient (even without having full-blown anemia), their blood vessels become more prominent since hemoglobin (which provides blood with its bright red color) will be decreased.
Other important nutrients for healthy skin under the eyes include vitamin C (which is necessary for collagen production), vitamin K (which supports blood vessel health) and vitamin E (which helps protect your skin from oxidative damage).
As we age, our bodies become less able to absorb nutrients from foods despite adequate diets, resulting in many seniors being at a higher risk of suffering from nutritional deficiencies.
10. Medications
Many medications commonly taken by seniors contribute directly to dark circles.
According to UCLA Health, certain medications can contribute to darker skin beneath the eyes. Diuretics may lead to dehydration and exacerbate dark circles; blood pressure medications may alter circulation to under eye areas; and some glaucoma drops have been documented to directly result in the darkening of skin around the eyes.
If a senior has noticed dark circles appear or become significantly more pronounced following a new medication, it is beneficial to let the prescribing physician know the timeframe of when this occurred.
What Color Are the Dark Circles — and What Does It Mean?
| Color | Most Likely Cause |
|---|---|
| Blue or Purple | Visible blood vessels, aging, poor circulation, or thin skin |
| Brown or Black | Hyperpigmentation caused by sun exposure, genetics, or inflammation |
| Pink or Red | Active inflammation, allergies, eczema, or skin irritation |
| Dark Gray | Combined vascular and pigmentation changes commonly seen in seniors |
| Yellow or Brown | Possible liver-related concerns worth discussing with a doctor |
| Sudden Dark Circle in One Eye | Always warrants medical evaluation and is not considered normal aging |
Is Dark Circles a Sign of Illness in Seniors?
Usually no — but sometimes yes. Here is how to tell the difference.
Most dark circles in seniors are superficial. They are the expected and completely normal result of aging skin — and they do not need medical treatment.
But dark circles can sometimes signal something that needs interest. According to Cleveland Clinic, if dark circles continue or you have extreme swelling — talk to a healthcare provider to rule out an original medical condition.
Worth discussing with a doctor:
- Dark circles that appeared suddenly or recently
- Accompanied by swelling — particularly pronounced in the morning
- Only one eye affected
- Accompanied by fatigue, breathlessness, or pallor — possible anemia
- Accompanied by changes in urination or swollen hands and feet — possible kidney issues
- Accompanied by thyroid symptoms — weight changes, cold sensitivity, outer eyebrow thinning
- Appeared around the same time a new medication was started
- Worsening despite getting enough sleep nightly and properly hydrating
- Have an unusual coloration (i.e. yellow or brown) versus the more common (i.e. blue/grey/purple) colorations of dark circles.
How to Get Rid of Dark Circles in Elderly People
You cannot get rid of age-related dark circles fully — but you can reduce them extensively. Here are the approaches that actually work.
Drink Plenty of Water Daily.
Dehydration is the leading cause of shadows that develop beneath the eyes in older adults and is also one of the easiest to fix. However, the challenge is that older adults typically do not feel thirsty when they are dehydrated, so they do not drink enough fluid. Therefore, your goal should be to have your senior drink approximately eight glasses of fluid each day (with water being the best choice) and ensure that water is available at all times. The easiest way to achieve this is by having a caregiver provide your senior with fluid at frequent intervals throughout the day if they are not reluctant to drink by themselves.
Sleep with Your Head Elevated.
It’s simple, free, and effective. The American Academy of Ophthalmology states that sleeping with your head slightly elevated will help to keep fluid from accumulating beneath the eyes overnight. A simple solution is to sleep with your head on an additional pillow or with the head of your mattress elevated slightly. Seniors who have significant puffiness and shadows around their eyes will see a visible improvement upon waking.
Use Daily Cold Compresses.
Using a cold compress on the eyes helps to constrict dilated blood vessels, thus reducing puffiness and shadows. Cold compresses can be made by simply placing a cold spoon, slice of chilled cucumber, or a damp cloth that has been placed in the refrigerator for about 10 minutes on the eye. All of these items will give an instant (but temporary) reduction in puffiness and shadows under the eye.
Reduce use of salt in the Diet
High sodium intake causes fluid retention — including under the eyes. According to the American Academy of Ophthalmology, limiting salt in the diet helps reduce fluid retention overnight — which directly reduces under-eye puffiness and shadowing.
For seniors already managing blood pressure or kidney conditions — reducing sodium has benefits well beyond dark circles.
Protect From Sun Exposure
According to Healthline, excess sunlight can cause melatin production to increase, which can result in coloration developing under our eyes and hyper-active circles developing. Applying SPF 30+ daily on our eye area and wearing UV-protective sunglasses outside will help to prevent the buildup of darkness over time, through maintaining proper sun exposure.
Stop Smoking and Reduce Alcohol
According to Taban MD and the American Academy of Ophthalmology, that smoking will accelerate the breakdown of collagen within the skin, which will add to the thinning of the skin caused by dark circles. Chronic and/or excessive alcohol use can also lead to chronic dehydration and dilation of the blood vessels under the eyes, both leading to dark circles.
If a person has the will power to drop at least partial smoking or heavy drinking, they should be able to visibly see improvements in the condition of their skin over a period of time.
Improve the quality of one’s sleep – not just quantity of sleep
Most families do not realize that poor quality of sleep contributes significantly to the presence of dark circles. Going to bed earlier hardly ever cures the problem of poor sleep quality. Directly addressing arthritic pain at bed time, waking up for the bathroom during the night, taking medication at inappropriate times, and/or anxiety; will result in having dark circles diminish as a result of improving their sleep quality.
How a Caregiver Helps With Dark Circles in Seniors
At Assisting Hands Home Care, we provide more than daily care. Our caregivers are there every day and notice changes before they escalate to a crisis.
Hydration support: Seniors, though dehydrated, often do not feel thirsty. Caregivers, through consistent hydration throughout the day, will help to reduce dark circles.
Nutritious meals Iron-rich, low-sodium, vitamin-balanced meals are prepared for your loved one daily, addressing the most common nutritional contributors to dark circles. Supplements are not necessary to achieve these results.
Early observation Deepening shadows. New morning puffiness. Change in color. Caregivers observe these changes early and can report them to family members.
Medication reminders Taking or missing a medication can dehydrate you and reduce circulation; both increase dark circles. Caregivers will ensure that medications are taken correctly and adjusted when necessary.
The Bottom Line
The majority of the time (but not always) that dark circle under an older person’s eyes is from biology doing its thing. Aging, thinner skin, and reduced collagen will lead to the small amount of blood vessels being able to show through a thinner layer of tissue than they could have years ago.
But sometimes — not always, not even usually, but sometimes — those shadows are telling you something. About hydration. About anemia. About the kidneys, the thyroid, the circulation. About something that can be found, treated, and addressed.
Paying attention costs nothing. For the families who notice something has changed — it is almost always worth one honest conversation with their doctor.
If your loved one has a dark circle under his/her eye that is of concern to you, or, you simply wish to provide consistent & high quality care with attention to your loved one on a daily basis with the goal of enhancing their overall health & well-being, we are here to aid.
