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Could the circles under a child’s eyes be related to allergies?
Q: My 22-month-old daughter frequently has dark purple circles under her eyes. At first I thought it was due to sleep, but they seem to be there when she wakes up and during the day. Could something be wrong? She is basically a healthy child. She eats lots of peanut butter, veggies and fruit.
A: Sunshine, the dark circles under your daughter’s eyes could be a normal part of her appearance—many people naturally have darker skin under their eyes. However, they could also be caused by allergies. Allergists typically descote this appearance as “allergic shiners.” The dark circles can indicate congestion in the tissues and blood vessels around the eyes, nose and sinuses commonly caused by allergies.

Are there allergies, asthma or eczema (skin rashes) in the family, either on your side or her father’s? If so, it is more likely that your daughter has allergies, which are hereditary.

Has your daughter shown any other signs or symptoms of allergies? For example, has she had a persistent congested/runny/itchy nose, watery/itchy eyes and sneezing, especially during a specific season? Has she been allergic to a specific food, insect stings or medication? Has she had asthma or wheezing? Has she developed frequent skin rashes?

If your daughter has had any of these symptoms, you need to try to figure out what she’s allergic to. Then do everything you can to avoid exposure to these allergens. If she has the dark circles under her eyes every day, she might be allergic to something in her daily environment, for example:
  • Food: Over 90% of food allergies are to eight common foods: milk, soy, wheat, peanuts, tree nuts, eggs, fish and shellfish. You say your daughter loves peanut butter—that could be the culprit. You might try eliminating these foods from her diet for a week or two and see whether she gets better. If so, then add back each of the foods, one at a time for a few days, and try to determine which one might be causing the allergy

  • Household allergens: Children are commonly allergic to tobacco smoke, cats and dogs, mold, dust mites and cockroaches. Try to remove these common allergens and see whether your daughter gets better. Since children spend many hours in their bedrooms, allergists often recommend making the bedroom allergy-free by keeping pets out, avoiding wool blankets and feather pillows, removing carpeting and cleaning frequently.
Talk with your daughter’s doctor about her symptoms. The doctor can help you determine whether your daughter might have an allergy, and to what. If your daughter appears uncomfortable with any symptoms of allergies, the doctor might prescote a medication that could help.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician