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Dermatology/darkening of skin around eyes

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Question
Dear Doctor fisher,
Please can you tell me what would cause the skin on my eyelids to go dark. They started off just on the lower lid, a deep yellowing, then this is the entire skin over the eye, from socket to brow and sort of spreading outward/ So dark I dont need to wear eyeshadow. My eyes themselves are not yellowed just the skin. Not underneath the eye either.  I have undiagnosed health problems and as I also have multiple spider nevi all over my chest and no answer from the doctor, please can you help direct me to the correct doctor and shed any light on this strange skin problem.

Kind Regards
Rebecca

Answer
Dark circles under the eyes can be caused by a variety of conditions, including trauma, infection, inflammation, allergies, and lifestyle factors. Dark circles under the eyes and other types of discoloration are often caused by relatively minor conditions, such as fatigue and minor allergies, but may also result from more serious conditions, such as an invasive eye infection. If your symptoms are persistent or cause you concern, contact your physician or medical professional.
Diseases, disorders and conditions that cause dark circles under the eyes
Dark circles and discoloration under the eyes can be caused by certain medical conditions including:
Allergies
Anemia
Dehydration
Malnutrition
Periorbital/orbital cellulitis (invasive infection of the eye, soft tissues, and structures around the eye)
Traumatic causes of dark circles under the eyes
Dark circles and discoloration under the eyes can arise from injury or trauma including:
Eye area injury
Eye surgery
Facial surgery, including nasal surgery and plastic surgery procedures
Fracture of the nose, face or orbits, which are the bones around the eyes
Severe head injury. For example, a basal skull fracture can result in “raccoon eyes,” severe swelling, and bruising around the eyes.
Lifestyle and general causes of dark circles under the eyes
Dark circles under the eyes or discoloration can occur from lifestyle, genetic or everyday causes including:
Aging, which causes already delicate skin under the eye to become thinner
Alcohol, caffeine or sodium consumption
Certain medications, such as birth control pills
Crying
Fatigue
Inherited (genetic) factors
Insomnia or poor quality sleep
Shadows created by swollen lower eyelids or deep set eyes
Smoking
Stress
Sun exposure
What are the potential complications of dark circles under the eyes?
Complications associated with dark circles under the eyes vary depending on the underlying cause. It is important to contact your health care provider when you have unexplained dark circles under the eyes, particularly when they are accompanied by other symptoms or occur after a head or facial injury. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can help reduce any potential complications including:
Anaphylaxis (life-threatening allergic reaction) due to severe allergies
Daytime sleepiness and impaired ability to carry on daily activities due to insomnia
Neurological complications, such as coma and permanent brain damage, due to serious head trauma
Spread of periorbital/orbital infection resulting in meningitis, brain abscess and possibly loss of vision and brain damage

Dermatology

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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