Looking in the mirror and seeing dark circles under your eyes can be an unpleasant way to start the day. If you live with lupus, under-eye discoloration or puffiness may be a frequent and frustrating symptom that can affect how you feel — both physically and emotionally.

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

In this article, we’ll explain why people with lupus may develop dark under-eye circles, and we’ll share five ways to help manage and prevent them. If you have questions about any lupus symptoms or side effects, talk with your healthcare provider or a dermatologist (a specialist in skin conditions) to find the best care options for you.

Does Lupus Cause Dark Under-Eye Circles?

Lupus is an autoimmune disorder, meaning the immune system mistakenly attacks healthy tissues in the body. The condition most often affects the skin, blood vessels, heart, joints, lungs, kidneys, and central nervous system. However, lupus can affect any part of the body, including the eyes and the skin around them.

There are several types of lupus, including systemic lupus erythematosus (SLE) — the most common type — and cutaneous lupus erythematosus, which mainly affects the skin.

If you think the dark circles under your eyes may be related to your lupus, 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 affects the skin near the eyes, what does that look like? Some MyLupusTeam members shared their experiences. “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.”

What appears to be under-eye circles may sometimes be related to another symptom or condition. People with lupus might develop a malar rash — a butterfly-shaped rash across the nose and cheeks that may appear spontaneously or after sun exposure. The rash looks different from under-eye circles because it’s usually raised and may appear red, purple, or brown — depending on your skin tone — rather than dark and puffy.

Raynaud’s disease is a lupus-related condition that causes blood vessels to constrict (narrow), reducing blood flow and changing skin color. This condition usually affects the fingers and toes, but when it shows up on the face, it can cause discoloration of the lips, nose, or chin — typically, not the area under the eyes. Raynaud’s can cause skin to turn blue, purple, red, or white, depending on the blood flow in that moment.

If you aren’t sure whether the skin discoloration around your eyes is caused by dark circles, a malar rash, Raynaud’s, or something else, talk to your doctor. They can help you identify the cause and recommend the right treatment.

Lupus Medications and Dark Circles

During a lupus flare-up, you might rely on nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn) to help ease joint pain and other symptoms. However, NSAIDs may also contribute to under-eye discoloration due to side effects such as easy bruising, fluid retention (swelling), or high blood pressure. NSAIDs are generally used short term, so your doctor may recommend regular blood tests if you need to take them for a longer period.

Corticosteroids (steroids) such as prednisone are also commonly prescribed for lupus to help calm the immune system and reduce symptoms. But steroids can cause swelling, leading to under-eye puffiness and dark circles.

Another lupus medication, hydroxychloroquine (Plaquenil), doesn’t usually cause dark circles but can lead to other eye-related side effects, such as retinal toxicity at high doses. Hydroxychloroquine may also cause bluish or gray patches on the face, though these don’t typically appear around the eyes.

Swelling Around the Eyes

Some people with lupus develop puffy or swollen skin around the eyes, especially after sun exposure. Wearing a wide-brimmed hat and sunglasses that offer protection from ultraviolet (UV) rays can help shield the delicate skin around the eyes.

Swelling and discoloration may affect one or both eyes. For some people, this is one of the first symptoms of lupus. Getting treatment for lupus can help reduce or resolve this issue.

Discoid Lesions

Discoid lupus is a type that affects the skin and can cause discolored, scaly patches on the face. These symptoms sometimes appear under the eyes and, when they heal, may leave a scar.

If you think your under-eye discoloration may be caused by discoid lupus, talk to your healthcare provider. They can recommend a treatment plan to help manage the lesions and reduce the risk of scarring.

Other Causes of Dark Circles

Dark under-eye circles aren’t linked only to autoimmune conditions like lupus — anyone can get them. Other common causes of dark circles include:

• Genetics (family history)
• Aging
• Excessive alcohol use
• Stress or lack of sleep
• Smoking
• Dehydration
• Dermatitis (skin irritation)
• Rubbing your eyes frequently

For most people, dark under-eye circles aren’t a serious medical issue.

5 Tips for Managing Dark Circles

Dark circles can be uncomfortable and frustrating, but you can likely manage them at home. The following tips may help reduce and prevent discoloration and puffiness around your eyes.

1. Apply a Cold Compress

When blood vessels under your eyes dilate (widen), more blood flows through them. This can lead to dark circles and puffiness. A cold compress helps by constricting the blood vessels, which can reduce swelling and improve appearance. “I use a frozen eye pack in the morning, and it helps a ton,” one MyLupusTeam member shared.

You don’t need a special 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

Be sure to place a cloth or paper towel between the frozen item 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 While Sleeping

Sleeping with your head slightly raised can help keep fluid from collecting under your eyes overnight. This pooling can lead to puffiness that makes dark circles look worse.

Try using an extra pillow or two. If you normally sleep on your side or stomach, consider lying on your back instead. Keeping your head above your heart makes it harder for gravity to pull fluid into your lower eyelids.

3. Explore Over-the-Counter Products

Depending on the cause of your dark circles, over-the-counter (OTC) products like creams and concealers 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 available products can be overwhelming, and finding one that works for you may take some trial and error. Before spending a lot of money, ask your dermatologist for advice to avoid irritation or reactions.

Another OTC product, sunscreen, doesn’t treat dark circles but can help prevent them from forming or worsening. Too much UV exposure can cause hyperpigmentation (skin discoloration) anywhere on your body, including around your eyes. Use a broad-spectrum sunscreen with SPF 30 or higher daily, and remember to reapply regularly when outdoors.

Eye creams and sunscreen are generally safe, but it’s best to check with your doctor or dermatologist before trying new products or supplements.

4. Get More Shut-Eye

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

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

However, not everyone sees a connection. “I used to think it was because of my sleeping being pretty poor, but they still won’t go away,” reported another member about their under-eye circles.

Whether or not lack of sleep contributes to your under-eye discoloration, fatigue — tiredness that doesn’t improve with sleep — is a common symptom of lupus, and not getting enough rest can make circles darker. The skin around your eyes may appear paler, making blood vessels under the eyes more visible. A sleep shortage can also worsen existing circles and dark shadows.

For more restful nights, try to:

• Keep a consistent bedtime schedule.
• Reduce screen time before turning in.
• Set up a quiet, calm sleeping environment.

Getting quality rest is important for managing both lupus symptoms and overall health. If you have frequent or ongoing sleep issues, ask your doctor for help.

5. Talk to Your Doctor or a Dermatologist

Although at-home remedies may help some people, these strategies may not work for everyone. If dark circles or puffiness continue, talk to your healthcare provider. They may refer you to a dermatologist. Remember, your healthcare team is there to help you feel your best as you manage all aspects of 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 235,000 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.