Do you or others notice those dark circles under your eyes?  They can be very prominent and compel people to seek remedies including “make up.”  Before spending your money on “make up” to cover up those dark circles, think about finding the underlying cause.

Dark Circles under eyes:  Causes

• Allergies:  With nasal congestion, the small veins in the infraorbital (under eye) area become engorged with blood leading to the dark discoloration that is termed “allergic shiners.”  An allergist can perform allergy testing to identify the cause and develop a treatment plan that will, over time, lessen those dark circles.
• Colds and sinus infections:  any disorder that leads to frequent or ongoing nasal congestion can result in dark circles including recurrent colds or chronic sinus infections.  This occurs from engorgement in the small veins that are close to the surface.
• Irritant rhinitis:  the symptoms feel just like allergies, but the triggers are substances that are irritating to the nasal and eye mucosa.  This includes smoke, perfume, cologne, air fresheners, cleaning chemicals, and candles to name just a few.
• Atopic Dermatitis:  this is also called “allergic eczema.”  The eye findings include small creases on the lower lids called Dennie’s Lines and frequently puffy lower eyelids.  Many people with eczema also have allergies.
• Hereditary:  Mother had dark circles, Grandmother had dark circles, and Great Grandmother had dark circles and so on.  This physical attribute can run in families.  Also, deep set bone structure of the orbits can lead to shadows that appear as darkening around the eyes.
• Rubbing of the eyes:   Frequent rubbing of the thin skin surrounding the eyes can lead to skin trauma manifesting as puffiness and even small capillary breakage with resulting dark circles.
• Sleep deprivation: a lack of sleep and fatigue may lead to a paleness of the skin under the eyes which accentuates the blood vessels.  In addition, rubbing the eyes from being sleepy can lead to puffiness.
• Sun Exposure:  the quantity of melanin pigment in the skin increases with sun exposure leading to darkening.  The degree of darkening is dependent upon the total number, size and distribution of melanin granules.   Other pigmentation irregularities can be seen in blacks and Asians.
• Aging:  As we age, it is common to have thinning of the skin and a loss of fat and collagen.   This can make the blood vessels under the eyes more obvious.
• Anemia:  a person who is anemic (low blood hemoglobin) may have pallor (paleness) and this would accentuate the blood vessels in the thin skin around the eyes.
• Medications:  any medication that leads to venous engorgement can potential also affects the eyelids.  There are cases of certain chemotherapy medications including gemcitabine and docetaxel leading to TEC (toxic erythema of chemotherapy) of the eyelids.
• Periorbital bruising (ecchymosis).  This is also called “Panda sign” or “raccoon eyes.”  “Panda sign” is associated with a skull base fracture from trauma, but rarely can be related to severe coughing as seen in an asthma attack or severe sneezing.  “Raccoon eyes” can be related to infiltration by tumors of the orbit (eye socket) including multiple myeloma, Kaposi’s sarcoma, lymphoblastic lymphoma or neuroblastoma in children.  Certain infections can present with bruising around the eyes including Dengue Fever or even Hepatitis B.  Another condition that is rarely associated with periorbital bruising is amyloidosis (amyloid protein build up).  Typically with these conditions, there are other signs or symptoms that will provide important clues to the physician.

At Family Allergy Asthma & Sinus Care, we acknowledge those dark circles and will work to find the cause and solution. It’s not magic and you won’t need make up!