Allergy, Nose & Sinus

Your Dark Undereye Circles May Be Caused by Nasal Allergies

February 1, 2020
dark eye circles

Allergic shiners appear as dark circles under the eyes, with dark and shadowy pigments that resemble bruises or “black eyes”. Also known as allergic facies and periorbital venous congestion, they occur when congestion in the sinus cavities cause vascular congestion in the veins under the eyes. When these small blood vessels are blocked and blood drainage is restricted, the blood pools and causes swollen veins, creating the appearance of dark circles.


Accompanying symptoms include itchy throat, runny nose, sinus pressure, watery eyes and coughing – which can be mistaken for flu, cold, and sinus infections. However, allergic shiners occur due to nasal congestion that is caused by allergic rhinitis, or allergies. Let’s take a closer look at this condition.



How are they different than black eyes


Black Eyes


Allergic shiners can have the appearance of blue or purple-coloured tint under the eyes, and they are caused by blood vessels around and under the eyes that have difficulty draining blood from facial veins. As such, the blood vessel swells and results in discolouration in the undereye.


On the other hand, black eyes are caused by impact or trauma, and there is actually bleeding under the skin due to damaged capillaries or veins. Both types are highly visible as the skin under the eye area is very thin.



Diagnosis of allergies


Nasal allergy occurs when the immune system mistakenly identifies a harmless substance, known as allergens, as something harmful. This will trigger an allergic reaction, and histamine is released as part of the immune system response. This histamine reaction leads to allergy symptoms like runny or stuffy nose, and sneezing.


Common allergens that cause allergic shiners include pollen, mold and fungus, and dust mites. Doctors will use various methods to diagnose allergies, including conducting a clinical history, blood tests, skin prick tests to test for specific allergens and nose scope (nasoendoscopy).


In a skin prick test, different droplets of allergens are placed on the forearm and a very small needle is used to prick the other part of the skin, allowing the allergen to enter. A naseoendoscopy procedure involves the use of a thin, flexible scope with a camera on one end (nasoendscope) that is inserted through the nasal cavity to look inside the nose, the throat (pharynx) and the voicebox (larynx).



How can it be treated




If you frequently suffer from nasal congestion, it is recommended to visit an ENT specialist in Singapore so you can receive the appropriate treatment and relieve your symptoms. It is also important to seek medical help when there are other serious symptoms present such as high fever, green nasal discharge with pain in sinus area, and occurs with another condition like sleep apnoea or asthma.


The aim of the treatment is to reduce congestion in the nasal and sinus cavities, hence releasing any blockage that prevents blood from flowing freely. Treatment options include nasal steroid sprays and oral antihistamines. In suitable patients with allergic rhinitis, sublingual immunotherapy may be recommended which involves spraying the allergen under the tongue to build tolerance to the allergen and reduce the allergic symptoms. If these treatments do not work, ENT specialists may suggest a sinus surgery to be carried out to open the pathways of the sinuses and clear blockages. 



Medically reviewed by Dr Gan Eng Cern


When Should You See an ENT Specialist in Singapore?

  • Any ear, nose or throat symptoms that you are troubled with or concerned about
  • Persistent blocked nose with mouth breathing or snoring

Dr Gan Eng Cern

Dr Gan Eng Cern is a distinguished ENT doctor with fellowship training. In addition to his clinical practice as an ear, nose and throat specialist in Singapore, Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.


  • 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
  • 2016 – Best Educator Award (Eastern Health Alliance)
  • 2016 – “Wow” Award (Patient Compliment)
  • 2014 – Eastern Health Alliance Caring Award – Silver
  • 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
  • 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
  • 2007 – Singhealth Best Doctor Award


  • MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
  • MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
  • MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
  • FAMS – Fellow of the Academy of Medicine Singapore

Why Choose Dr Gan Eng Cern


Reliable & Reputable ENT Expert

Experienced and patient ENT Specialist who has your best interests at heart. We aim to provide you with accessible and specialized care for any ENT condition in a comfortable setting.


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Our friendly staff will assist you to the best of our ability and we are happy to accept most insurance providers and assist with E-filing with relevant insurance providers or Medisave.


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Our ENT Specialist, Dr Gan Eng Cern, will be able to diagnose and offer personalised treatments for your specific ENT condition. You can expect a high level of ENT care in a spacious setting with in-house minor surgical, endoscopy, allergy testing and microscopy services.


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There are various financial options available for you to ensure that you are able to receive the most optimal treatment and care. Our ENT clinic staff will be able to assist you with your medical insurance claims and work with your chosen healthcare organization to minimize the hassle and paperwork required. In some cases, you may be able to utilise the funds in your Medisave account to defray part of the costs of your treatment. As our clinic is accredited by the Medisave board, we are able to process your claims from your Medisave for certain clinic procedures.

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