What Are Allergic Shiners: Risk, Causes, Symptoms, Treatment, Lifestyle Changes

What Are Allergic Shiners?

Allergic shiners, as the name suggests, is a condition resulting from allergy; the condition being development of dark circles below the eye area due to sinus and nasal congestion(1, 2). Allergic shiners look like bruises, i.e. they are dark and shadowy in appearance. Among the many causes for dark circles, if the cause for them is allergies, then those dark circles are known as allergic shiners. Other names for allergic shiners include peri-orbital hyperpigmentation and allergic facies.

What Are Allergic Shiners?

What are the Causes of Allergic Shiners?(3, 5)

The causes of allergic shiners include stuffy nose (nasal congestion) due to allergy. A person suffers from nasal congestion when there is excessive production of mucus and swelling in the blood vessels and tissues in the nose. Nasal congestion or stuffy nose is caused by allergies or allergic rhinitis(2).

When suffering from an allergy, the immune system of the body identifies harmless substances, such as dust mites or pollen, to be something dangerous and this substance is termed as allergen(5).  As a result, the immune system signals the body to produce antibodies as a defense mechanism from the allergen and this result in widening of the blood vessels and in production of histamine(3). The production of histamine causes allergy symptoms like stuffy nose, runny nose and sneezing along with the famous allergic shiners. 

Allergic shiners develop when there is congestion and swelling in the sinuses resulting in congestion of the minute veins present under the delicate eye region(3). This causes pooling of blood under the eyes and the dilated and darkened veins give the classic appearance of allergic shiner that is the dark circles.

Nasal Allergy Of Any Form Can Cause Allergic Shiners Such As:

  • Indoor allergens like pet dander, dust mites, mold or cockroaches.
  • Allergy to some foods items.
  • Outdoor allergens like ragweed pollen or grass; or hay fever.
  • Environmental allergens such as pollution, cigarette smoke, perfumes etc. 

Who is at Risk for Allergic Shiners?

Individuals who suffer from allergies involving the eyes, such as allergic conjunctivitis, are at increased risk for developing allergic shiners. The symptoms of allergic conjunctivitis consist of red, itchy eyes with puffiness too. The patient rubs their eyes frequently thus worsening the darkness of the allergic shiners. 

Other Causes of Dark Circles (Allergic Shiners)

Allergic shiners are commonly related with allergies, however, there are other causes of stuffy nose, which also cause dark circles under the eyes and these are: flu/cold, nasal congestion, sinus infection etc.

Non-Medical conditions which cause the development of dark circles are:

Loss of facial fat and thinning skin under the eye from aging; lack of sleep; excessive sun exposure; atopic dermatitis or eczema; heredity; trauma or surgery of the face; nasal polyps; sleep apnea; dehydration; enlarged adenoids; 

What are the Symptoms of Allergic Shiners and When Do They Get Worse?

  • Bruise like appearance under the eyes with a purplish or bluish tint.
  • Pigmentation, which is shadowy and round under the eyes.
  • Other allergy symptoms, such as sneezing, itchy throat, watery and itchy eyes, eye redness (allergic conjunctivitis), runny nose, sinus pressure and nasal congestion.
  • People suffering from allergies (indoor/outdoor) have worsening of symptoms at particular times of the year; depending on the allergen.
  • Summer and late spring is the time for worsened allergic shiners if the allergen is grass pollen.
  • If the allergen is tree pollen, then allergic shiners along with other symptoms are worse during the spring season.
  • If ragweed pollen is the allergen then the allergy symptoms worsen during the fall.
  • If allergic shiners are due to indoor allergies, such as dust cockroaches, mites, fungus mold or pet dander, then be prepared to brace this condition year-round and expect it to worsen during the winter when the houses are closed up. 

How to Differentiate Between Allergies and Sinus/Cold Infection?

The primary difference between any sinus infection and an allergy is that when a person suffers from flu or sinusitis, then there also will be some body aches and fever. 

When Should You Visit A Doctor?

Consult your doctor if:

  • There is a high fever.
  • If the symptoms are hindering day-to-day activities.
  • Not getting relief from OTC allergy medications.
  • There is green nasal discharge with pain in the sinuses.
  • If suffering from asthma and worsening symptoms.
  • If the allergic shiners are present all through the year.
  • If suffering from side effects of allergy medications.
  • If you are not happy with your appearance, i.e. for cosmetic purposes. 

What is the Treatment for Allergic Shiners?(6)

Avoiding the allergen is the most effective way for treating allergic shiners and the causative allergies. However, this is easier said than done. Some of the over-the-counter medications for treating seasonal allergies are: decongestants, antihistamines, anti-inflammatory eye drops and nasal steroid sprays.

Montelukast (Singulair) is a prescription drug, which is effective in stopping the inflammation resulting from allergies. However, there is an increased risk for mood and behavioral changes and it should only be used when absolutely necessary(4).

Immunotherapy or Allergy shots can also be undertaken. They comprise of series of injections containing proteins that cause allergy. Gradually, the body develops a tolerance to the causative allergen and thus preventing allergy and its symptoms, including allergic shiners. 

Lifestyle Changes for Managing Allergic Shiners

  • Use an air conditioner that has a HEPA filter.
  • Keep your windows closed and make use of the AC during allergy season.
  • Always stay hydrated.
  • Always fix the water damage, which leads to development of mold in the house.
  • Using a humidifier will give moisture to the air and this will soothe the swelling and the irritated tissues of the nose.
  • Always keep your house clean, especially of pet dander.
  • Always wear sunglasses when stepping out to prevent pollen from getting into your eyes.
  • Always use allergy-proof covers for your pillows, blankets and mattress.
  • Always wash your hands after petting an animal.
  • Get rid of cockroaches in your house by calling an exterminator.
  • Stay indoors when the pollen count is highest outside.
  • A nasal saline mist is beneficial for clearing mucus and removing pollen from the nose.
  • You can also use a neti-pot to rinse your nose.
  • Use turmeric when cooking your food, as it benefits in combating allergic reactions.
  • Consumption of organic/ local honey also helps with seasonal allergies.

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245436/
  2. http://www.theasthmacenter.org/index.php/disease_information/allergic_rhinitis/
  3. https://linkinghub.elsevier.com/retrieve/pii/S0091674908034763
  4. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug
  5. https://www.aaaai.org/conditions-and-treatments/allergies/eye-allergy
  6. https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S3

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