Context. The dramatic dimming episode of the red supergiant Betelgeuse in 2019 and 2020, caused by a partial darkening of the stellar disk, has highlighted gaps in the understanding of the evolution of massive stars.

Aims. We analyzed numerical models to investigate the processes behind the formation of dark surface patches and the associated reduction in the disk-integrated stellar light.

Methods. With the CO5BOLD code, we performed global 3D radiation-hydrodynamical simulations of evolved stars, including convection in the stellar interior, self-excited pulsations, and the resulting atmospheric dynamics with strong radiative shocks.

Results. We attribute dimming phenomena to obscuring clouds of cool gas in the lower atmosphere, forming according to three different scenarios. One process transports material outward in a strong shock, similar to what occurs in 1D simulations of radially pulsating asymptotic giant branch (AGB) stars. However, in 3D models, deviations from spherical symmetry of the shock front can lead to further local density enhancements. Another mechanism is triggered by a large convective upflow structure, in combination with exceptionally strong radial pulsations. This induces Rayleigh-Taylor instabilities, causing plumes of material to be sent outward into the atmosphere. The third and rarest scenario involves large-amplitude convective fluctuations, leading to enhanced flows in deep downdrafts, which rebound and send material outward. In all cases, the dense gas above the stellar surface cools and darkens rapidly in visible light. AGB stars show localized dark patches regularly during intermediate phases of their large-amplitude pulsations, while more massive stars will only intermittently form such patches during luminosity minima.

Conclusions. The episodic levitation of dense gas clumps above the stellar surface, followed by the formation of complex molecules in the cooling gas and possibly dust grains at a later stage, can account for the dark patches and strong dimming events of supergiant stars such as Betelgeuse.