Allergic Shiners

What are allergic shiners?

Allergic shiners are dark, discolored circles under your eyes that may look like black eyes (bruises). They appear due to nasal congestion brought on by hay fever (allergic rhinitis).

As your immune system responds to allergies, you may develop swelling in the moist inner lining of your nose (mucosal edema). The swelling slows blood flow in the veins around the air-filled cavities around your nose (paranasal sinuses). These veins are close to the surface of the skin under your eyes. When they swell, the area looks darker and puffy.

Other names for allergic shiners include periorbital hyperpigmentation and allergic facies.

How common are allergic shiners?

Allergic shiners are common. In the United States, approximately 15% to 25% of people have hay fever, though not all people who have hay fever get allergic shiners.

What are the symptoms of allergic shiners?

The main symptom of allergic shiners is a dark, discolored (black, brown, dark gray, gray-blue or purple) circular area under your eyes.

You may also have related allergy symptoms, including:

• Itchiness around your eyes, nose or throat.
• Red or watery eyes.
• Runny nose.
• Stuffy nose (nasal congestion).
• Sneezing.

What causes allergic shiners?

Hay fever causes allergic shiners. The most common hay fever allergens include:

• Pollen.
• Pet dander.
• Dust mites.
• Mold.

Seasonal allergies occur when pollen counts are higher, usually in the spring, summer and early fall. However, allergens that are always around — like pet dander and dust mites — can cause allergic shiners year round.

Itchy or watery eyes can also make the appearance of allergic shiners worse. Rubbing your eyes for relief may cause further irritation to your skin.

Are allergic shiners contagious?

No, allergic shiners aren’t contagious. You can’t spread allergic shiners to another person.

Who do allergic shiners affect?

Anyone who has hay fever may develop allergic shiners. However, children who have allergies are more likely to have allergic shiners than adults. Some healthcare providers suspect children may be more likely to have allergic shiners because they don’t properly blow their noses as often as adults — they may only wipe their noses or sniff. There isn’t enough research to be certain that this is why children are more prone to allergic shiners.

What are the complications of allergic shiners?

Allergic shiners don’t hurt and won’t affect your physical health. However, their appearance may make you feel self-conscious. Talk to a healthcare provider if allergic shiners cause you to feel emotional stress or anxiety.

How are allergic shiners diagnosed?

Talk to a healthcare provider if you have dark circles under your eyes that last longer than a few weeks or generally appear during certain times of the year. They’ll review your medical history, ask about your symptoms and conduct a physical examination. If they suspect your dark circles are allergic shiners, they may refer you to an allergist. An allergist is a healthcare provider who specializes in allergies. They can conduct tests to help diagnose the allergies that cause your allergic shiners.

What tests will be done to diagnose allergic shiners?

Your healthcare provider may order allergy tests to help diagnose allergic shiners. The most common allergy tests are a skin prick (scratch) test and blood tests.

During a skin prick test, a healthcare provider uses a thin needle or plastic pick to scratch small areas of your skin with different common allergens. If you’re allergic to any of these allergens, you may develop a discolored bump and/or discoloration at the site of the application within 15 minutes. The provider will measure the size of the skin reaction and then apply a steroid cream to the site. The steroid cream will soothe the itching and skin reaction. Providers prefer skin prick tests to diagnose allergic shiners because they’re noninvasive and provide quick results during the visit.

During a blood test, a healthcare provider uses a thin needle (about the size of a standard earring post) to draw a small amount of blood from a vein in your arm. They send the sample to a lab, where providers add common allergens to the sample and then measure the amount of allergy antibodies. You may be allergic to a particular allergen if you have higher levels of certain antibodies. Blood tests aren’t as accurate as a skin prick test.

How can I get rid of allergic shiners?

Avoiding allergens is one of the most effective ways to get rid of allergic shiners. However, avoiding allergens isn’t always possible, and avoidance may not completely stop your allergic reactions. Over-the-counter (OTC) and prescription allergy medications can help. These may include:

Antihistamines

• Fexofenadine (Allegra®).
• Loratadine (Claritin®).
• Cetirizine (All Day Allergy-D® or Zyrtec®).
• Levocetirizine (Xyzal®).

Nasal sprays

• Steroid nasal sprays, including fluticasone (Flonase®), mometasone (Nasonex®) and budesonide (Rhinocort®).
• Antihistamine nasal sprays, including azelastine (Dymista®) and olopatadine (Patanase®).
• Cromolyn nasal spray (Nasalcrom®).

Eye drops

• Antihistamine eye drops, including olapatadine (Pataday®) and azelastine (Optivar®).
• Ketorolac eye solution (Acular®).
• Naphazoline eye solution (AK-Con®).

Decongestants

• Oxymetazoline nasal spray
• Phenylephrine (Sudafed PE® or Sudogest PE®).
• Pseudoephedrine (Contac® or Sudafed®).

Nasal irrigation

Nasal irrigation is an over-the-counter treatment that rinses out your nasal passages with a saline (salt) solution. It helps clear out allergens and mucus.

Ice or cold compresses

Apply ice or a cold compress wrapped in a light towel over your eyes for up to 10 minutes several times a day to help reduce puffiness.

Immunotherapy

If over-the-counter and prescription medications don’t get rid of your allergic shiners, your provider may recommend immunotherapy (allergy shots) and sublingual immunotherapy (allergy tablets or drops you apply under your tongue). These treatments expose you to small amounts of allergens. The dosage increases over several months until your body builds up a tolerance to the allergens, and you no longer have allergic shiners or other allergy symptoms.

How long do allergic shiners last?

It depends. With proper treatment to alleviate your allergies, allergic shiners usually go away within a few weeks. As your veins heal, the color of your allergic shiners may change from a darker color to a lighter color, including green, yellow or brown.

Without treatment, allergic shiners may go away a few weeks after your last exposure to allergens.

Can allergic shiners be prevented?

The best way to prevent allergic shiners is to avoid known allergens. You can also take over-the-counter or prescription medications daily to help prevent allergic shiners from appearing.

The following tips can also help lower your risk of allergic shiners:

• Regularly vacuum your home to help remove allergens.
• Keep your windows shut and use an air conditioner during pollen seasons.
• Use a high-efficiency particulate (HEPA) air filter to remove airborne allergens from your home.
• Use a humidifier to help relieve irritation in the mucosa tissues in your nose.
• Avoid petting, hugging or kissing animals if you have animal allergies.
• Wear sunglasses and a hat while outside to help protect your eyes from pollen.

What can I expect if I have allergic shiners?

Allergic shiners may make you feel self-conscious, but they aren’t a serious health problem. They may appear and disappear throughout your life. Many people who have allergic shiners manage them by avoiding known allergens and taking over-the-counter medications.

When should I see a healthcare provider?

Allergic shiners don’t cause serious health problems, though accompanying allergy symptoms may be annoying. Talk to a healthcare provider if allergic shiners cause stress or if allergy symptoms affect your day-to-day life. A provider can help determine the exact cause of your allergic shiners and recommend the best treatment.

When should I go to the ER?

Go to an emergency room immediately if you have allergic shiners and develop more serious allergy symptoms, such as anaphylaxis.

What questions should I ask my doctor?

Questions to ask your provider include:

• How can you tell that allergies are causing dark circles under my eyes?
• What am I allergic to?
• What medications do you recommend?
• Should I take medications every day or only when allergic shiners appear?
• Do your recommended medications have any side effects?
• Can you recommend an allergist?

What is the difference between allergic shiners and dark circles?

Allergies cause allergic shiners. Other conditions may cause dark circles to form under your eyes. These may include:

• Common cold.
• Flu.
• Sinus infection.
• Eczema.
• Bruising.
• Prolonged lack of sleep.
• Nasal polyps.
• Inflamed adenoids.
• Dehydration.
• Genetics.

A note from Cleveland Clinic

Allergic shiners occur when congestion in your sinus cavities causes swelling in the veins under your eyes, which in turn causes discoloration. Though allergic shiners aren’t painful or harmful to your health, they may make you feel self-conscious or embarrassed. They may also appear alongside annoying allergy symptoms. A healthcare provider can help provide relief. They can identify the allergens responsible for your allergic shiners and recommend over-the-counter or prescription medications or treatments.