Tuesday, May 8, 2012

Dark Circles Under Your Eyes?


Along with sneezing, stuffy nose, cough, and sore throat, seasonal allergies can also affect your eyes. Itchy, red eyes may respond to an oral antihistamine, but often they are better treated with a prescription eye drop that prevents the release of histamine (which is what causes the redness and itch to begin with.) Olopatadine ophthalmic solution, brand name Patanol, is applied twice daily, and is generally well tolerated. There is also a newer preparation, Pataday, by the same pharmaceutical company that is only once daily-newer, more convenient, likely more pricey (depends on your insurance.) Both work well.

I find many of my patients try to use over-the-counter eye drops that "get the red out"...only to find that they need more and more of these drops to accomplish the same results. The only time that I recommend these OTC products (with vasoconstrictors to eliminate red eyes) is for extremely short-term use, such as if you are giving a presentation or taking pictures. If you use these products for more than a couple days, you will develop rebound symptoms of increased redness, and risk getting pulled into the cycle of red eyes, use drops, worse red eyes when drops "wear off", more drops, etc.

What about BELOW the eye-those dark black circles that make you look a hundred years old? Those are called "allergic shiners" in the medical world. Congested sinuses slow down return of blood through the small veins under your eyes, causing them to swell and make the skin above them appear purple or black.
What helps? Oral antihistamines, plus or minus a decongestant, will often do the trick if it is mild. For people who suffer for weeks at a time, I'd recommend talking to your doctor and considering prescription nasal steroid sprays. "Spa" treatments like cucumbers and frozen tea bags work very transiently- I'm not sure it isn't just the coldness of these objects that cause vasoconstriction (shrinking of the veins), but they do seem to have non-scientifically proven positive effects, with few to no negative side effects.

BOTTOM LINE: If you have chronic issues with dark circles or "bags" under your eyes, talk to your doctor about treatment options.


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