How do I get rid of dark under-eye circles?

We've all have had those mornings: the ones where too little rest results in awful under-eye shadows. But dark circles are a regular occurrence for many of us, regardless of how often we get a solid night's sleep.

Dermatologists say discoloration under the eyes is one of the most common complaints they hear from patients. But exhaustion usually isn't the culprit: There are many contributing factors, as well as a number of remedies that can help banish those bags.

Here's what three local doctors had to say.

Dr. Rhoda Narins, Dermatology Surgery & Laser Center, White Plains

There are three main causes of chronic dark circles, which can affect any skin color. Genetics is often a factor: Excess pigmentation is a particular problem among blacks and Asians. Another reason is that dilated blood vessels — reddish-blue in color — sit close to the very thin skin under the eye, which gets even thinner with age. And what frequently looks like dark circles are actually shadows cast by hollows that develop under the eye, another side effect of aging.

Narins treats many patients by injecting fillers like Restylane and Juvederm Voluma to plump the skin in that area. Fillers can last between one and two years, and whenever you need it again, less is needed to do the job.

"People look younger and healthier because they don't have that darkness. The filler is a 'wow' procedure."

But Narins warns that it's a procedure that should only be performed by a board-certified dermatologist or cosmetic surgeon — and not at a spa, salon or neighborhood party.

"This should not be done by a person who's had a weekend course. It has to be done by someone who knows what they're doing. This is a very sensitive area."

Dr. Wendy Epstein, dermatologist in West Nyack

Epstein notes that a doctor should first rule out illnesses associated with dark circles, including Addison's disease, hypothyroidism and anemia.

But when it comes to medical therapies, fillers are not the answer for everyone. Lighter-skinned patients, for example, may see better results with a CO2 (carbon dioxide) laser. This stimulates the production of collagen, causing the skin to thicken and tighten. Epstein also sometimes recommends chemical peels under the eyes to reduce pigmentation.

Still, some patients are not good candidates for any of these regimens.

"You have to know when not to treat people."

As for topical creams, Epstein prefers not to promote specific products, and she points out that many of those on the market don't work. Even those that are somewhat effective, such as products containing caffeine (which constricts blood vessels), provide only temporary relief.

Often, Epstein's best recommendation is a simple one.

"Sometimes, a good cosmetic is better than anything."

Dr. Neil Goldberg, dermatologist, Bronxville and White Plains

Goldberg, too, believes that makeup can be just as good as medical intervention. He's also a huge fan of self-tanners, which he says are not harmful.

"They sometimes make the pigment and dark circles less visible, because they eliminate contrast between the dark circles and the rest of the face."

It's also much safer than natural sun exposure, which damages skin and exacerbates dark circles. Not surprisingly, he advises wearing daily sunblock and sunglasses.

"They physically protect the eye and the structures around it. Find sunglasses you like – the bigger, the better."

And while a lack of sleep and poor eating habits don't cause under-eye circles, you can minimize red, puffy eyes by getting enough rest and cutting back on salt.

"In general, anything you do that increases sleep, decreases stress and improves your diet, only makes your eyes look better."