6 Things You Should Know About Allergic Shiners
Here's what to know about these dark under-eye circles that look like bruises or "black eyes," but are really an allergy symptom.
What are allergic shiners?
There are many reasons for dark circles under the eyes, so how do you know if they are from lack of sleep, genetics, or allergies?
Well, if you get hay fever (allergic rhinitis), you’re already familiar with the ongoing symptoms, such as a runny nose and itchy, watery eyes.
It’s this runny nose that amps up mucous production and inflammation inside the nasal passage and sinuses, leading to congestion. It can result in allergic shiners, which are allergy-related “black eyes” or dark under-eye circles that are also known as allergy facies or periorbital venous congestion.
The shiner is from the backflow of the fluids in the veins that return the blood to circulation around the eyes, says Rebin Kader, DO, an internal medicine doctor specializing in allergy and immunology at UCHealth Allergy and Immunology Clinic at UCHealth Cherry Creek Medical Center in Denver, Colorado.
And the itchy eyes you can’t stop rubbing are partially to blame, too. “Rubbing itchy, watery eyes can cause further irritation of the skin due to the underlying allergic response that causes itchy, watery eyes in the first place,” explains Dr. Kader.
Here’s what you need to know about allergy-related dark under-eye circles, including who is at risk and how to prevent and treat these shiners.
Who gets allergic shiners?
One popular theory is that children aren’t as good at clearing out their nasal passages as adolescents and adults. They might wipe their nose or sniff and snort but not blow properly blow their nose, resulting in persistent congestion that might contribute to allergic shiners, Dr. Kader says.
In addition to allergic shiners, children tend to do an upward rubbing of their nose with the palm of their hand, dubbed the “allergic salute.” “This can create an allergic nasal crease that shows up as a distinct horizontal skin folder over the lower part of the nose,” adds Dr. Kader.
Symptoms of allergic shiners
People who develop allergic shiners are most likely to have one or a combination of these common allergy symptoms.
- Stuffy nose
- Runny nose
- Itchy eyes
- Watery eyes
- Itchy nose
- Bloodshot eyes
- Puffy eyes
- Itchy nose
- Mucus in the throat
- Throat clearing
- Itchiness on the roof of the mouth
- Itchy ears
What do allergic shiners look like?
An “allergy black eye” may look a lot like a black eye on the surface, but underneath it’s a different story.
Say you get hit on the face with a volleyball. The blow to your face damages the tiny blood vessels around the eye, causing blood and other fluids to pool under the skin, leaving bruising and swelling on the skin around the eye or portions of it.
On the other hand, allergic shiners are from the backflow of the venous system around the eyes that creates blue-gray or purple circles under the lower eyelids. There might also be a puffy appearance around the skin of the eyes. The intensity of discoloration and puffiness depends on the individual.
“Sometimes allergic shiners look really bad in the morning and fade in the afternoon, or they may be an everyday occurrence,” says allergist Daniel Sullivan, MD, an otolaryngologist and surgeon specializing in allergies at the Health First Medical Group in Melbourne, Florida.
“Some people may have worse shiners during high pollen count days,” he adds.
Unlike a blow to the eye, allergic shiners usually affect both eyes, as the inflamed nasal passages and backflow of fluids affect both sides of the face.
However, it is possible to have one eye that is worse than the other, says allergist Daniel Sullivan, MD, an otolaryngologist and surgeon specializing in allergies at the Health First Medical Group in Melbourne, Florida.
For instance, you can irritate one eye if you are rubbing it more than the other eye. Sleeping on one side could help improve one eye by offering compression. Conversely, one shiner could worsen if your eye is squished into the pillow, putting more strain on your eye.
How to prevent allergic shiners
“The first step in prevention is to identify possible triggers so that the patient and their doctor can identify ways to help prevent exposure and reduce potential allergic reactions leading to sinus or nasal congestion,” says Dr. Kader.
If you suspect you have allergies, a board-certified allergist/immunology specialist can give you an allergy skin test to determine which allergens you are allergic to. From there, you and your doctor can decide which is the best route to mitigate exposure and how to reduce the symptoms of allergies, including allergic shiners.
“In general, prevention and avoidance of an allergic reaction and exposure to an allergen is the name of the game in the field of allergy,” says Dr. Kader. Sidestepping airborne allergens before they have a chance to take up residence in your nose is easier when you follow these suggestions:
Keep up with vacuuming and dusting
Reduce dust mites by vacuuming and dusting frequently. And change air filters monthly and encase mattress and bedding with allergy-proof casings.
Prioritize air quality
Restrict mold growth by utilizing dehumidifiers to keep humidity levels between 30 and 50 percent. Repair leaks right away and ensures humid areas such as the bathroom and laundry room have good ventilation with a window or fan.
Opt for protective measures
Shield yourself from the pollen of trees, weeds, and grass by closing doors and windows during high pollen count days. Use HEPA filters to trap indoor and outdoor allergens.
Wear long-sleeve shirts and pants to limit skin exposure, and a hat and sunglasses to keep pollen out of your hair eyes. Wash clothing worn outdoors before wearing them again.
Limit pet access
Cut back on pet dander by keeping the bedroom door closed or at least limiting their access to your bedroom. Run an air purifier designed to trap pet hair in your bedroom, especially for cat allergies, as their dander is light and easily spreads through the house.
Pollen collects on fur and hair, so be sure to bathe pets frequently.
Treatment for allergic shiners
The good news is that allergic shiners are primarily a cosmetic issue, Dr. Sullivan says. The bad news is, they’re fickle and might stick around for a while or come and go.
Since allergic shiners are symptoms of allergic rhinitis, allergy treatments that help cut nasal inflammation and soothe scratchy and itchy eyes (antihistamines, saline nasal rinses, nasal sprays, and immunotherapy with allergy shots or drops), will help to some extent, Dr. Sullivan says.
In addition to those treatments, there’s a couple of things you can do to help soothe and reduce the appearance of allergic shiners.
Joseph Zahn, MD, a dermatologist and assistant professor of dermatology at the George Washington University Medical Faculty Associates, Washington, D.C., says to try a cold compress for five to 10 minutes to reduce the swelling and fluid in the area.
“Be careful never to let ice directly touch the delicate skin under the eye.” One other measure would be to elevate the head a few inches while resting and sleeping to help the fluid drain,” adds Dr. Zahn. If your concerns are more cosmetic-related, try this clever makeup tip to conceal allergic shiners.
Next, check out how to reduce allergens.
- Rebin Kader, DO, allergy and immunology at UCHealth Allergy and Immunology Clinic at UCHealth Cherry Creek Medical Center in Denver, Colorado.
- Daniel Sullivan, MD, an otolaryngologist and surgeon specializing in allergies at the Health First Medical Group in Melbourne, Florida.
- Joseph Zahn, MD, a dermatologist and assistant professor of dermatology at the George Washington University Medical Faculty Associates, Washington, D.C.
- American Academy of Allergy, Asthma and Immunology, "Hay Fever/Rhinitis"
- The Journal of Allergy and Clinical Immunology, "Quantitative assessment of allergic shiners in children with allergic rhinitis"