Dark Circles Under Eyes in Children

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What is dark circles under eyes in children?

Dark circles are the appearance of dark spots or discolorations under your eyes. Typically, they are not painful, uncomfortable, or associated with other symptoms, but the discolorations can project the appearance of age, fatigue, or illness. Circles under the eyes are primarily found in adults, but they can occur in children, as well. This appearance has also been described as ‘raccoon eyes’.

Dark circles can occur when the skin under your eyes thins, exposing the blood vessels, which produces the dark discoloration. Fatigue and aging are the most common causes of dark circles in adults, but allergies, anemia, nasal congestion, eczema, lifestyle factors, and irregular pigmentation can also contribute to the existence of dark circles. Eye irritation, history of sun exposure, loss of skin elasticity, and heredity can also cause dark circles. Either accidental or nonaccidental (abuse) trauma can cause dark circles to appear as a consequence of superficial or deep hemorrhages.

Dark circles in children are unusual, but they can be caused by allergies and congestion. Frequent nasal and sinus congestion, in particular, can cause visible discoloration in the veins under the eyes. The color of the skin from the increase in blood flow is tinted purple or blue, rather than a darker skin tone. Anemia from iron deficiency is a possible cause in children, but not as common a cause as nasal congestion. The most worrisome condition that causes dark circles around the eyes of children is neuroblastoma – a malignant tumor arising from immature cells of the sympathetic nervous system.

If your child continues to experience dark circles under the eyes, seek prompt medical care. This may be attributed to a respiratory infection, anemia,or dehydration. A medical evaluation can help you rule out serious causes, determine the underlying cause, and begin treatment if necessary. Even if the under eye circles are due to nasal congestion, there are treatment options.

What other symptoms might occur with dark circles under eyes in children?

Dark circles under the eyes may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Allergy symptoms that may occur along with dark circles

Dark circles may accompany other symptoms affecting the eyes, throat and sinuses including:

  • Conjunctivitis (inflammation of the eye surface)
  • Coughing
  • Difficulty breathing
  • Difficulty hearing
  • Discharge from the eye
  • Headache
  • Runny nose (nasal congestion)
  • Sore throat
  • Stuffy nose or nasal congestion

Other symptoms that may occur along with dark circles

Dark circles under eyes may accompany symptoms related to other body systems including:

Symptoms that might indicate a serious condition

In some cases, dark circles in children may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if your child has dark circles along with other serious symptoms including:

  • Blurry vision
  • Coughing up clear, yellow, light brown, or green mucus
  • Persistent or prolonged cough
  • Stuffy nose with facial swelling
  • White spots on the throat or tonsils

What causes dark circles under eyes in children?

Dark circles in children are typically caused by allergies and nasal congestion, which can thin the skin around the eyes, revealing the blood vessels. Congestion is swelling in the tissues that line the inside of the nose. Congestion dilates blood vessels, which increases blood flow in the area. The top layer of skin—the epidermis—will appear a bluish-purple shade.

Allergies are a common cause of congestion. Common childhood allergies include foods (including strawberries, peanuts, shellfish, and dairy), pet hair or dander, pollen or ragweed, and chemicals. Other common causes of congestion are the flu, the common cold, and sinus infections. 

Allergic/inflammatory causes of dark circles under the eyes in children

Dark circles under the eyes can also be caused by allergies or irritation as a result of:

  • Certain foods

  • Cosmetics, dyes or detergents

  • Enlarged adenoids, which will increase congestion

  • Industrial chemicals such as those found in elastic, latex or rubber

  • Metallurgic substances such as metal, copper or wire

Infectious causes of dark circles under the eyes in children

Dark circles under the eyes can be caused by infections including:

Other causes of dark circles under the eyes in children

Dark circles under the eyes can be caused by other factors including:

  • Anemia, due to iron deficiency 

  • Facial structure, which can overemphasize the color of the skin under the eyes

  • Frequent rubbing or touching eyes

  • Heredity

  • Hyperpigmentation of the epidermis and dermis—the thick layer of skin under the epidermis, due to overproduction of melanin. Skin color will be browner than the bluish-purple hue seen with changes in only the epidermis. 

  • Neuroblastoma

  • Phenol sulfotransferase deficiency (rare disorder in which the body is unable to break down and process toxins)

  • Sleep deprivation

  • Trauma or injury (including child abuse)

Serious or life-threatening causes of dark circles under eyes in children

In some cases, dark circles under the eyes may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Anaphylaxis (life-threatening allergic reaction)

  • Dehydration (loss of body fluids and electrolytes, which can be life threatening when severe and untreated)

Questions for diagnosing the cause of dark circles under eyes in children

To diagnose the condition, your doctor or licensed health care practitioner will ask you several questions related to the dark circles under the child’s eye including:

  • Does he or she have a cold or flu?

  • Has he or she recently begun any new medications?

  • Does he or she have any known allergies?

  • Has your child been getting enough sleep lately?

  • Do dark circles under eyes run in your family?

What are the potential complications of dark circles under eyes in children?

Although the appearance of dark circles under the eyes is not a serious symptom in itself, the underlying cause can be, especially if it is a serious illness. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for your child to reduce the risk of potential complications including:

Treatment for dark circles under the eyes depends greatly on the cause. There are many treatment options for nasal congestion, from avoiding any known allergic causes to over-the-counter decongestants and antihistamines. Sometimes treatment is not necessary. If a nutritional deficiency is causing the problem, then supplements are a possible remedy. However, it is not safe to give a child iron supplements without the advice of a pediatrician. Blood tests can diagnose certain nutritional deficiencies. In non-urgent cases, dietary changes are preferred over supplements.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 22
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