Looking in the mirror and seeing dark circles under your eyes is an unpleasant way for anyone to start their day. If you have lupus, under-eye discoloration or puffiness may be frequent and unwelcome visitors that affect your quality of life.

“I’ve had puffy dark circles under my eyes for months now,” said one MyLupusTeam member. “It’s making me feel haggard and old and hurts my self-confidence.”

In this article, we share reasons you might have dark under-eye circles with lupus and five ways to manage and prevent them. If you have questions about lupus symptoms and side effects, schedule an appointment with your health care provider or a dermatologist.

Does Lupus Cause Dark Under-Eye Circles?

Lupus is an autoimmune disorder that most often affects the skin, blood vessels, heart, joints, lungs, kidneys, and central nervous system. However, it can affect any part of the body, including the eyes. There are several types of lupus, including systemic lupus erythematosus — the most common type — and cutaneous lupus erythematosus, which affects only the skin.

If you suspect a connection between the dark circles under your eyes and your lupus diagnosis, you could be right. According to the Lupus Foundation of America, eye-related symptoms of lupus include:

• Dry eyes
• Scleritis (inflammation of the outer layer of the eyeball)
• Damage to the nerves that control eye movement
• Retinal vascular lesions (changes to the blood vessels in the retina)
• Changes to the eyelids and skin around the eyes

When lupus causes changes to the skin near the eyes, what does that look like? Some MyLupusTeam members have shared their descriptions. “Sometimes my eyes look bruised,” one said. “Sometimes they are swollen and itchy, but not always.”

Another member said, “Mine look like puffy, blue, purple bags.”

Sometimes, what appear to be under-eye circles could be related to another symptom or condition. People with lupus might get a specific butterfly-shaped rash called a malar rash, which can develop spontaneously or after sun exposure. The rash spreads across the face and cheeks but is often distinguishable from under-eye circles because it’s red and raised rather than dark and puffy.

Raynaud’s disease is a lupus-related condition that constricts blood vessels and can turn skin blue, purple, red, or white. It generally shows up in fingers and toes, but when it affects the face, it discolors the lips, nose, and chin rather than the under-eye area. If you aren’t sure whether your skin discoloration indicates dark circles, a malar rash, Raynaud’s, or something else, ask your doctor for help pinpointing the cause.

Lupus Medications and Dark Circles

When you have a lupus flare-up, you might rely on nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (sold as Motrin and Advil) or naproxen (Aleve and Naprosyn) to help alleviate your joint pain and other symptoms, but NSAIDs can cause under-eye discoloration too.

Possible side effects of NSAIDs that may contribute to dark circles include easy bruising, fluid retention, and high blood pressure. NSAIDs are generally used short term, so your doctor will likely monitor your health with regular blood tests if they recommend taking a longer course.

Corticosteroids (steroids) can also contribute to dark circles by promoting fluid retention. Health care providers often prescribe prednisone and other steroids to treat lupus because these drugs reduce the activity of your immune system, easing symptoms.

Another lupus medication, hydroxychloroquine (Plaquenil), is associated with eye issues but not dark circles. Hydroxychloroquine can cause retinal toxicity at high doses. Ask your doctor about the potential side effects of hydroxychloroquine before taking it.

Other Causes of Dark Circles

Dark under-eye circles are not just an issue for people with autoimmune diseases — anyone can experience this unpleasant but usually painless skin condition. Other common causes of dark circles include:

• Genetics
• Aging
• Excessive alcohol use
• Stress
• Smoking
• Dehydration
• Dermatitis (skin irritation)
• Rubbing eyes

Dark under-eye circles are not a serious medical issue for most people.

5 Tips for Managing Dark Circles

Dark circles can be embarrassing and uncomfortable, but you will likely be able to address them at home. The following tips may help you reduce and prevent discoloration and puffiness around your eyes.

1. Apply a Cold Compress

When blood vessels dilate (widen), more blood flows through them. If this happens to blood vessels under your eyes, it can result in dark circles and puffiness. Fortunately, cold compresses can help. “I use a frozen eye pack in the morning, and it helps a ton,” shared one MyLupusTeam member.

Cold compresses reduce under-eye shadows and puffiness by constricting (narrowing) the blood vessels. The good news is that you don’t need to buy a fancy eye mask. You can achieve the same effect using items around the house, such as:

• A chilled spoon
• A frozen wet washcloth
• A bag of frozen vegetables

Remember to keep a barrier like a cloth or paper towel between any frozen compress and your skin to prevent irritation, as one member described: “I use a bag of frozen peas wrapped in a hand towel.”

2. Elevate Your Head

Piling pillows beneath your head while you sleep may help reduce or alleviate dark circles. Fluid accumulating in your lower eyelids can result in under-eye puffiness that contributes to the appearance of shadows and circles. Elevating your head with an extra pillow or two can help prevent fluid from pooling while you sleep.

If you sleep on your side or stomach, try lying on your back instead. It’s more difficult for gravity to cause a fluid buildup under your eyes if you sleep on your back and keep your head above your heart.

3. Look Into Over-the-Counter Products

Depending on the source of your dark circles, over-the-counter (OTC) products might help. “I thought it was just old age catching up with me,” one MyLupusTeam member said. “I’m trying an under-eye cream now, and it seems to be helping.”

The variety of under-eye creams available at your local drugstore can be overwhelming. You may need to experiment with a few before finding one that works. To find out which creams other people use, try posting a question to MyLupusTeam members, or find a local support group.

Another OTC product, sunscreen, can help prevent rather than treat dark circles. Sun exposure causes your body to produce melanin, which gives your skin its color. Too much sun exposure can cause hyperpigmentation (skin discoloration) anywhere on your body, including under and around your eyes. Use a high-SPF sunscreen daily, and remember to reapply when outdoors.

Although eye creams and sunscreen are generally safe, ask your doctor for medical advice before trying any OTC creams, medications, or supplements.

4. Get More Shut-Eye

Some MyLupusTeam members report tiredness and lack of sleep as reasons for their under-eye issues. “Exhaustion is the biggest cause of dark circles under my eyes,” said one member.

“I notice them when I am very tired or not feeling well,” another said.

Others have ruled out lack of sleep as the culprit, like this member: “I used to think it was because of my sleeping being pretty poor, but they still won’t go away.”

Whether or not tiredness is responsible for your under-eye discoloration, fatigue is a common symptom of lupus. Lack of sleep can make the skin around your eyes appear paler, so the blue color of your blood vessels is more likely to show through. A sleep shortage can also worsen existing circles and dark shadows.

For more restful nights, try to maintain a consistent bedtime schedule, reduce screen time before turning in, and set up a peaceful sleeping environment. Getting enough shut-eye is essential to overall health and wellness. For frequent or ongoing sleep issues, ask your doctor for help.

5. Talk to Your Doctor or a Dermatologist

Although at-home remedies like cold compresses and adequate sleep help improve dark circles for some people, these strategies may not work for you. Your health care provider is the best person to talk to about lupus symptoms and other medical issues, so making an appointment to discuss your concerns is an important step. For under-eye circles or puffiness, they may refer you to a dermatologist (a specialist in skin disorders).

You are not alone. Help is available, and your health care team is there to help you feel — and look — your best while living with lupus.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you experience under-eye circles with lupus? Do you have any strategies to make them less dark and puffy? Share your experience in the comments below or on your Activities page.