Dark Under Eye Circles
I see a lot of kids with circles under their eyes. There's a lot of confusion as to what causes them. Dark circles under the eyes may simply be hereditary - a trait that runs in families, but they also can signify chronic disease.
I'll cover some causes that are feared but not likely and common causes that can be treated to help decrease the dark appearance of the circles.
Not likely causes
Anemia
Many parents worry that anemia, or a low red blood cell count, is causing their child's under eye circles. I'm not sure why this thought is so prevalent, but it's not the first thing I think about when I see dark circles under the eyes of a child.
Iron deficiency is linked to anemia because iron is a building block of a red blood cell. Iron deficiency is relatively common in kids due to poor diet, so if your kids don't eat foods rich in iron, you should talk to their doctor.
Anemia can happen in kids, but if under eye circles is the only symptom, it's not likely. If there are other symptoms then blood work might be indicated.
Symptoms of anemia may include:
Pale skin, including the inner eyelids
Irritability
Feeling tired or having low energy
Poor focus and attention
Weakness
Craving of ice or eating non-food items (pica)
Rarely (with more severe anemia)
Yellow jaundice (yellow eyes and skin)
Rapid heart rate
Fast breathing
Swelling of hands, feet, or puffy eyelids
Poor sleep
Yes, we often think of circles under the eyes from poor sleep. Poor sleep is not usually the cause of under eye circles in a child, especially when they otherwise appear well rested.
Kids who have chronically poor sleep can appear tired and sluggish, but they also have other symptoms, such as irritability, hyperactivity, poor school performance, and increased injuries.
If you're worried about your child's sleep, talk to your pediatrician.
Vitamin deficiency
There are many products containing various vitamins that are sold to help decrease under eye circles, but evidence is lacking that vitamin deficiencies are common causes of under eye circles in children.
Unless there are other significant problems, it is not recommended to check vitamin levels to evaluate under eye circles.
If your child is a picky eater and has a limited intake of nutrients, talk to your pediatrician.
What does cause dark under eye circles?
The skin under the eyes is very thin, so when blood passes through the thin skin it can produce a dark color, much like the blue color of your veins. If the blood circulation slows, the blue color can be more noticeable.
Congestion in your sinuses can lead to congestion in the small veins under your eyes. The blood collects in the skin under your eyes and these swollen veins dilate and darken. This creates the effect of dark circles and puffiness.
Dark circles are of course more noticeable in fair skinned people.
The most common cause of under eye circles is chronic congestion, but chronic congestion can be from various causes.
Allergic shiners
Allergies are probably the most common cause of dark circles under the eyes, so the circles are also called "allergic shiners." They get this name due to the purplish hue of the skin, resembling a black eye, AKA "shiner."
If allergies are the cause, you will usually see other symptoms of allergy, such as
Runny nose
Itchy, watery eyes
Sneezing
Itchy throat
Itchy roof of mouth
Sinus pressure or fullness
Treating the allergies can often make the allergic shiners disappear.
Upper respiratory tract infections
Viruses that cause nasal congestion can also lead to dark circles under the eyes. These can be brief if the cold clears quickly, or seem to come and go with recurrent infections, as often happens during the cold and flu season.
Sinus infections can cause chronic congestion, leading to dark under eye circles.
Though there's no quick fix to most upper respiratory tract infections because they're caused by viruses, you can use saline nasal rinses to help clear some of the congestion.
Smoke exposure
Smokers and their children often have chronic congestion.
Studies show that second hand smoke leads to more frequent upper respiratory tract infections and ear infections in kids. It's not surprising that these kids also develop chronic circles under their eyes.
Mouth breathing
Mouth breathing can itself be from many causes.
Commonly nasal congestion from allergies and upper respiratory tract infections leads to mouth breathing.
Large adenoids can also contribute to mouth breathing and under eye circles, as explained by Ear, Nose, and Throat specialist, Dr. Deborah Burton in GET THE TRUTH ABOUT THE CONSEQUENCES OF MOUTH BREATHING.
Dehydration
Dehydration can make dark circles look more prominent due to sluggish blood flow.
The eyes also appear to sink into the sockets when we're dehydrated, which can accentuate the dark circle appearance.
Treating and preventing under eye circles
The best ways to prevent dark circles include many things that help us stay healthy anyway.
Teach kids to wash their hands and keep hands away from their face to help prevent infections
Drink plenty of water
Use sunscreen (sun damages skin over time)
Give a healthy balance of foods and talk to your pediatrician if your child isn't eating a good variety of nutrients
Ensure plenty of sleep for age
Use nasal saline rinses (see below)
If chronically congested or mouth breathing, talk to your child's doctor to find and address a cause
Avoid smoke and secondhand smoke, which lead to chronic congestion
Use moisturizers if skin is dry
Avoid pollution as much as possible, since it can contribute to chronic congestion
Saline rinses
I often refer to Nasopure's website because it has great instructions on how to rinse the nose for kids as young as 2 years of age. It also has videos to help kids get comfortable with the idea. I refer to the site simply because I like it, and I receive no compensation for the recommendation.