Allergy, Nose & Sinus

Your Dark Undereye Circles May Be Caused by Nasal Allergies

February 1, 2020

Allergic shiners appear as dark circles under the eyes, with dark and shadowy pigments that resemble bruises or “black eyes”. Also known as allergic facies and periorbital venous congestion, they occur when congestion in the sinus cavities cause vascular congestion in the veins under the eyes. When these small blood vessels are blocked and blood drainage is restricted, the blood pools and causes swollen veins, creating the appearance of dark circles.


Accompanying symptoms include itchy throat, runny nose, sinus pressure, watery eyes and coughing – which can be mistaken for flu, cold, and sinus infections. However, allergic shiners occur due to nasal congestion that is caused by allergic rhinitis, or allergies. Let’s take a closer look at this condition.



How are they different than black eyes



Allergic shiners can have the appearance of blue or purple-coloured tint under the eyes, and they are caused by blood vessels around and under the eyes that have difficulty draining blood from facial veins. As such, the blood vessel swells and results in discolouration in the undereye.


On the other hand, black eyes are caused by impact or trauma, and there is actually bleeding under the skin due to damaged capillaries or veins. Both types are highly visible as the skin under the eye area is very thin.



Diagnosis of allergies


Nasal allergy occurs when the immune system mistakenly identifies a harmless substance, known as allergens, as something harmful. This will trigger an allergic reaction, and histamine is released as part of the immune system response. This histamine reaction leads to allergy symptoms like runny or stuffy nose, and sneezing.


Common allergens that cause allergic shiners include pollen, mold and fungus, and dust mites. Doctors will use various methods to diagnose allergies, including conducting a clinical history, blood tests, skin prick tests to test for specific allergens and nose scope (nasoendoscopy).


In a skin prick test, different droplets of allergens are placed on the forearm and a very small needle is used to prick the other part of the skin, allowing the allergen to enter. A naseoendoscopy procedure involves the use of a thin, flexible scope with a camera on one end (nasoendscope) that is inserted through the nasal cavity to look inside the nose, the throat (pharynx) and the voicebox (larynx).



How can it be treated



If you frequently suffer from nasal congestion, it is recommended to visit an ENT specialist in Singapore so you can receive the appropriate treatment and relieve your symptoms. It is also important to seek medical help when there are other serious symptoms present such as high fever, green nasal discharge with pain in sinus area, and occurs with another condition like sleep apnoea or asthma.


The aim of the treatment is to reduce congestion in the nasal and sinus cavities, hence releasing any blockage that prevents blood from flowing freely. Treatment options include nasal steroid sprays and oral antihistamines. In suitable patients with allergic rhinitis, sublingual immunotherapy may be recommended which involves spraying the allergen under the tongue to build tolerance to the allergen and reduce the allergic symptoms. If these treatments do not work, ENT specialists may suggest a sinus surgery to be carried out to open the pathways of the sinuses and clear blockages. 



Medically reviewed by Dr Gan Eng Cern


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