Have you ever noticed that your eyes look like two dark circles under your eyes? Some people think that this is due to lack of sleep or fatigue. However, this is not always the case. Sometimes the cause of this can be a condition called "Allergic Shiners" that we are going to talk about today. Don't worry, this is not a serious disease, but it is very important to be aware of this.

What are allergic shiners?

Simply put, allergic shiners are when the skin under your eyes appears dark, sometimes dark brown, gray, blue-gray, or purple. It looks like a bruise if someone has hit you in the eye. But it's not a bruise. This condition is mainly caused by a stuffy nose caused by an allergic condition called "hay fever," or medically known as allergic rhinitis.

This is also known as `(periorbital hyperpigmentation)` and `(allergic facies)`. However, in everyday speech, most people only know it when we say ``allergic shiners.''

Why are there dark circles under the eyes? What is the cause?

Okay, now let's see how this happens. When you have an allergy to something, your body's immune system starts to fight it. As part of this reaction, the mucous membrane, the moist lining of the inside of your nose, can swell (mucosal edema).

Imagine, when there is a small swelling inside the nose, the blood flow through it gets a little blocked, right? Similarly, the blood flow in the delicate blood vessels surrounding the air-filled cavities (paranasal sinuses) around the nose also slows down due to this swelling. These blood vessels are very close to the skin under our eyes. So, when these veins are swollen and filled with blood, the skin in that area looks dark and maybe a little puffy. That's what allergic shiners are called. Do you understand?

How common are allergic shiners?

This is actually a more common condition than you might think. It is especially common among people with "hay fever" (allergic rhinitis). However, not everyone with hay fever gets allergic shingles. It is important to remember that too.

What are the symptoms of this?

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

In addition, you may have other allergy-related symptoms, such as:

• Itching in the eyes, nose, or throat.
• Redness or watering of the eyes.
• Runny nose.
• Nasal congestion.
• Frequent sneezing.

One or more of these characteristics are seen together with allergic shiners.

Main causes of allergic shingles

As mentioned earlier, the main cause of this is hay fever (allergic rhinitis). So, the main allergens that cause hay fever are the cause of this. Let's see what they are?

• Pollen: The pollen found in flowers and trees.
• Pet dander: Small pieces of hair that fall off the skin of animals like dogs and cats.
• Dust mites: Invisible insects that live in dust.
• Mold: A type of mold that grows in damp places.

Some people may be allergic to just one of these, while others may be allergic to several. Seasonal allergies occur during the peak pollen season, usually in the spring, summer, and early fall. However, year-round allergens, such as animal dander and dust mites, can cause allergic shiners at any time of year.

Another thing is that we often rub our eyes because our eyes are itchy or watery. Rubbing our eyes like that can further damage the skin under our eyes and make allergic shiners worse. So try to reduce eye rubbing as much as possible.

Is this a contagious disease?

Absolutely not. Allergic shiners are not contagious. You can't spread it to someone else just because you have it. So don't worry about it.

Who is more likely to develop allergic shiners?

Anyone with hay fever can get allergic shingles. However, young children, especially those with allergies, are more likely to get allergic shingles than adults. Some doctors think this may be because young children don't blow their nose as often as adults (perhaps by wiping or picking their nose). However, there isn't enough research to confirm this is the exact cause.

What complications can this cause?

To be honest, allergic shiners do not cause much harm to your physical health. That is, they do not cause any pain. However, these dark circles under the eyes can make you feel a little uncomfortable and embarrassed. For some, they can even cause mental stress and anxiety. If you feel that way, it is definitely a good idea to talk to a doctor.

How does a doctor recognize this?

If these dark circles under your eyes have been there for more than a few weeks, or if they appear at certain times of the year, it's best to see a doctor. The doctor will ask about your past medical history, ask about your symptoms, and then perform a physical examination.

If your doctor suspects that this could be allergic shingles, he or she may refer you to an allergist. That doctor can do tests to find out exactly what you are allergic to.

What kind of tests will be done?

Your doctor may perform several allergy tests to determine if you have allergic shingles. The most common tests are skin prick tests and blood tests.

• Skin prick test:In this, a doctor or nurse will prick a few small spots on your skin, usually on your arm or back, with a thin needle or plastic stick. Then, they will put small amounts of different common allergens into the pricked areas. If you are allergic to one of the allergens, within about 15 minutes, the area will turn red, develop a small blister, and may change color. The doctor will measure the extent of the reaction. Then, a steroid cream will be applied to the area to reduce itching and skin reactions. This test is often used to detect allergic shiners because it gives quick results and is not too difficult.

• Blood test: In this test, your doctor takes a small sample of blood from a vein in your arm (with a needle as thin as a regular earring post). The sample is sent to a lab. The lab then tests your blood for common allergens and looks for allergy antibodies. If you have high levels of antibodies to a particular allergen, you may be allergic to that allergen. However, sometimes blood tests are not as accurate as the skin test.

How to cure allergic shingles? / What are the treatments for this?

The most effective way to avoid allergic shiners is to stay away from the allergens you are allergic to as much as possible. However, it is not always easy to stay away from them. Sometimes, even if you do, you may not be able to completely stop allergic reactions.

But don't worry, there are both over-the-counter (OTC) and prescription medications available for this.

Important: It is essential to seek medical advice before using any medication, especially when giving it to children.

Here are some such medications:

Antihistamines

These are the most commonly prescribed medications for allergies. They control the allergic reaction. Examples:

• Fexofenadine (e.g. Allegra®)
• Loratadine (e.g. Claritin®)
• Cetirizine (e.g. All Day Allergy-D® or Zyrtec®) - This is something that many people in Sri Lanka are familiar with.
• Levocetirizine (e.g. Xyzal®)

Nasal sprays

These are very helpful for nasal congestion and allergy symptoms.

• Steroid nasal sprays: such as fluticasone (e.g. Flonase®), mometasone (e.g. Nasonex®), budesonide (e.g. Rhinocort®).
• Antihistamine nasal sprays: such as azelastine (e.g. Dymista®), olopatadine (e.g. Patanase®).
• Cromolyn nasal spray (e.g. Nasalcrom®) .

Eye drops

These are good for symptoms like itchy and red eyes.

• Antihistamine eye drops: such as olopatadine (e.g. Pataday®), azelastine (e.g. Optivar®).
• Ketorolac eye solution (e.g. Acular®).
• Naphazoline eye solution (e.g. AK-Con®).

Medicines for nasal congestion `(Decongestants)`

These reduce swelling in the nose and make it easier to breathe. However, it is not good to use them continuously. Use them only as directed by your doctor.

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

Nasal irrigation

This is not a cure, but it is a very effective method. It involves rinsing your nostrils with a saline solution (salt water) that you can buy at the pharmacy. This removes allergens and mucus from the inside of your nose. You can use something like a "Neti pot" for this.

Ice or cold compresses

To reduce swelling under the eyes, place a few ice cubes, a cloth soaked in cold water, or a light towel over your eyes for about 10 minutes several times a day.

Immunotherapy

If other medications don't help, your doctor may recommend this treatment. This is also called allergy shots . It is sometimes given as a tablet under the tongue (sublingual immunotherapy). This involves slowly introducing very small amounts of the allergens you are allergic to into your body. Over a few months, your body becomes used to the allergens and becomes less reactive. This can lead to the disappearance of allergy symptoms, such as allergic shingles.

How long do allergic shiners last?

It's hard to say for sure, it varies from person to person. If you treat your allergies properly and keep them under control, allergic shiners will usually disappear within a few weeks. As the veins heal, the dark color under the eyes may gradually turn to a lighter color (like green, yellow, or brown).

If left untreated, your allergy may go away on its own within a few weeks of your last exposure to the allergen, until you are exposed to it again.

What happens if I have allergic shiners?

As mentioned earlier, allergic shingles can be a bit uncomfortable, but it's not a serious health problem. They can come and go throughout your life. Most people manage their condition by avoiding the things they're allergic to as much as possible and using over-the-counter medications.

Can allergic shiners be prevented?

Yes, you can. The best way isStaying away from things you know you're allergic to, and taking daily allergy medication as directed by your doctor, can also help prevent allergic shingles.

Here are some more things you can do:

• Vacuum the house regularly: Remove allergens like dust and animal dander.
• Keep windows closed during high pollen times and use an ``Air Conditioner - AC'' if possible.
• Use a `HEPA (High-Efficiency Particulate Air)` filter: This helps remove allergens from the air in your home.
• Use a humidifier: This can help reduce discomfort if the tissues inside your nose are dry.
• If you are allergic to animals, minimize touching, cuddling, and petting them as much as possible.
• Wear sunglasses and a hat when going outside: This helps protect your eyes from pollen.

Do you need to see a doctor?

Although allergic shiners don't cause any major health problems, the other allergy symptoms (such as nasal congestion and itching) that come with them can be a bit bothersome. If allergic shiners are causing you stress, or if they're interfering with your daily activities, you should definitely see a doctor. Your doctor can determine the exact cause of your allergic shiners and recommend the best treatment.

When do you need to go to the Emergency Treatment Unit (ETU) ?

If you have allergic shingles and develop symptoms of a severe allergic reaction (anaphylaxis), such as difficulty breathing, facial swelling, or fainting, go to the nearest emergency room immediately. This is an emergency.

What questions should you ask the doctor?

When you go to see a doctor, you can ask questions like these:

• How exactly can you tell if the dark circles under my eyes are due to allergies?
• What kind of things am I allergic to?
• What kind of medications do you recommend?
• Do I need to take the medicine every day, or is it enough to just take it when I have allergic shingles?
• Are there any side effects from the medications you prescribe?
• Do I need to see an allergist? Can you recommend one?

What is the difference between allergic shiners and normal dark circles under the eyes?

This is a question that many people ask. Allergic shiners are caused by allergies. This means that the nose becomes congested, the blood vessels around it swell, and the skin under the eyes becomes dark.

However, there can be many other reasons for dark circles under the eyes. For example:

• Common cold.
• Flu.
• Sinus infection.
• Eczema.
• Bruising.
• Lack of sleep for a long time.
• Nasal polyps.
• Inflamed adenoids.
• Dehydration.
• Genetic causes that come from heredity.

Therefore, it's best to see a doctor to find out for sure whether the dark circles under your eyes are caused by allergic shiners or something else.

Finally, things to remember

So, allergic shiners are not a serious condition to be afraid of. But they can make you feel uncomfortable and embarrassed. The other allergy symptoms that come with them can also be a bit annoying.

The most important thing is to find out what you are allergic to, stay away from those things as much as possible, and seek appropriate treatment as advised by a doctor.

If you do that, you can get great relief from the problem of dark circles under your eyes. If you have any more questions about this, don't be shy and ask a doctor. He or she will help you!

` Allergic shiners, dark circles under the eyes, allergies, hay fever, nasal congestion, skin symptoms, allergies in children