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35. Why do some patients complain of dark circles around the eyes?

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This is a common complaint, often expressed by female patients. Patients are usually over age 50, or 20-30-year-old age groups. The common underlying mechanism is a chronic low-grade irritation-inflammation and/or increased levels of the melanocyte-stimulating hormone.

Ask the patient about:

  • Itch
  • Foreign-body, ‘scratchy’ sensations
  • Pregnancy

Management

  • Lubrication/lavage with artificial tear products
  • Cool compresses
  • Mast-cell stabilization (if allergic component suspected).

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