Dark circles under your eyes may point to other health risks

You've had seven hours of sleep. And you're generous when it comes to layering on the eye cream.

So why does the person staring back at you in the mirror still look so tired, and shadowed by grim, dark undereye circles to boot?

Well, that could possibly mean one thing: That you're suffering from an allergy that you aren't aware of.

The purplish welts beneath your eyes are likely allergic shiners, which occur when blood and fluids collect in the thin tissue around the eyes due to allergies and nasal congestion. Those with the condition often look like they've been hit right under the eye, hence the term "shiners".

The telltale signs that your dark undereye circles aren't necessarily the result of late nights and early mornings? Dark rings that persist even after a good night's rest, coupled with allergic rhinitis symptoms like a stuffy nose and itchy, tired eyes. Babies and children are not exempted from this condition.

The ailment could be more common than you think, since it is estimated that one in three Malaysian adults suffers from some form of allergy, while one in five children is at risk of developing an allergy.

Certainly, the annual haze situation within the region has not helped matters. Allergic shiners may be experienced by people with allergic asthma.

Nevertheless, the condition can easily escape undetected by your family doctor, simply because it shares such similar traits to the common cold and sinusitis.

"Allergic shiners often get misdiagnosed because in some people, the symptoms may be mild or occur infrequently," says otolaryngologist Dr Sushil Brito-Mutunagayam.

It's all too easy for one to just wave it off as the flu, and most will end up self-medicating at the pharmacy, he adds.

While that isn't wrong, there are long-term complications that may arise from not treating the root of the problem, which is the allergy.

"When your cold doesn't get better, you should seek professional help from an ear, nose and throat specialist," says Dr Sushil, who urges swifter action when the condition involves children.

Keep things clean around you

To reduce the risk of allergic shiners, try to determine what causes the allergy in the first place. The possible causes could be a simple case of mould, dust, pollen, or even cat or dog fur build-up.

However, identifying the precise cause can be a challenge, as it can take hours after exposure to the allergen before any symptoms occur. But once the triggers are identified, try to avoid them as much as possible.

According to Dr Sushil, the first line of treatment for allergic shiners is environmental control at home - investing in dust mite-proof covers for the mattress, duvet and pillows, and possibly, a good quality vacuum cleaner with a HEPA filter, which is engineered to remove allergens.

"If your child often falls sick with flu and cough, try clearing up the household to see if it will help ease the situation. Clean and dust around the house regularly. Treat the lawn with products that can eliminate pollen and weeds. If the problem is pets in the home, try to find a breed that has little or no shedding," he says.

Finding a new home for the family pet is inevitable, Dr Sushil adds, if your allergies are indeed exacerbated by the shedding of pet fur.

While a dose of antihistamine can keep the allergies at bay, the drug is only a symptom reliever and not a practical solution for the long term.

"If you're regularly going to the doctor only to be treated with antihistamines, then something else needs to be done. Getting too many infections and leaving them alone may eventually get you hospitalised for upper respiratory tract infection," says Dr Sushil.

For quick, but temporary relief, he recommends using a nasal spray which, when used before the symptoms start, can help to prevent an allergic reaction altogether.

Alternatively, applying a cold compress on the eyes can help relieve itching and swelling, while a hot towel over the eyes and nose can reduce puffiness and help drain the nasal passages.

"The process will need to be repeated several times a day to help clear up and prevent the nasal passages from getting congested," says Dr Sushil.

Before you jump ahead to invest in an expensive air purifier system, it pays to know if the device will help to clear up the air, so to speak.

"I think patients should consult a doctor before buying an air purifier because they don't come cheap. It may turn out to be an unnecessary cost and may only be a short-term remedy, especially if you've done little to clear up possible allergens present in your home," he says.

Try immunotherapy

If all the recommended attempts at remedying the situation has failed, immunotherapy in the form of allergy shots, may be considered.

Also known as desensitisation, immunotherapy has been said to be the closest thing to a cure for allergies, particularly for those to some stinging insects and allergic rhinitis.

How it works: Firstly, a skin prick test and also a blood test will need to be done to determine the cause of your allergies. Following that comes the administration of gradually increasing doses of allergen extracts over a period of years, given to patients by injection or tablets under the tongue.

That being said, immunotherapy is time-consuming and expensive, and may not be suitable for everyone. It is generally reserved for the treatment of potentially life-threatening allergic reactions to bee and wasp stings, as well as severe allergic rhinitis (hay fever).

"Immunotherapy isn't a 100 per cent cure for allergies, but it can help you feel better. The problem is, you'll have to be treated for three to five years, and it may even take that long to see any improvement. The cost itself is another factor," says Dr Sushil.

But one thing is for sure: allergic shiners rarely resolve "on its own".

Intervention is vital to prevent the "allergic march", which refers to how allergic diseases, when left untreated, progress from one spectrum to another, says Dr Sushil.

"Lets say your child starts off with a cough and runny nose. Before you know it, it has become a bacterial infection, and you'll need antibiotics to get better. There'll be fever and phlegm, and they'll go away only to come back later. This cycle of falling sick will put your child at risk of developing asthma."

Further complications include nasal polyps, fleshy swellings that grow from the lining of your nose or sinuses, which are caused by inflammation of the membranes of the nose. If these polyps grow large enough, or in clusters, they can interfere with breathing, reduce sense of smell and block the sinuses, leading to sinusitis.

Middle ear infections, where fluid collects in the middle ear and it becomes infected, leading to earache, fever, hearing loss and even a mild loss of balance, are also probable.

For children, concentrating in class can become a problem, as they are more likely to have difficulty sleeping.

This makes it that much more important to nip the condition in the bud at a young age, says Dr Sushil. "You're talking about the quality of life of the whole family - the child, and also, the parents who will have to care of the sick child. There'll be absenteeism from school and work.

"Allergies are something that you can control. Don't allow yourself to live with the symptoms if you can do something to prevent them."