Why is it red or discolored under my eyes?

Discoloration under the eyes can cause pain and discomfort. Some people may also be uncomfortable with how it looks.

It can be a sign of thinning skin due to aging, or it can indicate a health condition like eczema or blepharitis, which is inflammation of the eyelids. 

If you have dark skin tones, under-eye skin may appear darker than usual, purple or gray, and if you have paler skin tones, you may experience reddening.

Why is the skin under my eyes red or discolored?

Undereye skin is thin and often sensitive to environmental factors. In fact, experts say that eyelid skin is four times thinner than the skin on the rest of the face. This is why it’s prone to discoloration and irritation and why you should consider any treatments for relief carefully. 

Contact dermatitis, an allergic reaction to something in the environment, could cause the skin in this area to change color.

Certain lotions and eye drops can lead to inflamed and irritated skin. This might occur if those products contain ingredients that your immune system interprets as dangerous.

Eczema

Eczema, or atopic dermatitis, is a lifelong inflammatory condition that can cause skin discoloration, rash, irritation, and dry, flaky skin. It can occur all over the body, including the face and under the eyes.

On darker skin tones, this discoloration can show as a darker shade than usual, purple or gray under the eyes, while on lighter skin tones, it may appear red or brown.

Doctors and healthcare professionals do not yet fully understand the exact cause of eczema.

Eczema treatment

A doctor may recommend nonsteroidal options like pimecrolimus (Elidel) or tacrolimus (Protopic) for facial eczema, particularly under the eyes.

Doctors are unlikely to recommend hydrocortisone (Cortef) for the face because the skin is thinner and more sensitive. Always check with your doctor about how much topical medication to use and for how long.

Consider using gentle soaps and non-fragranced face creams to prevent eczema symptoms from worsening.  

Blepharitis

An overgrowth of bacteria or blocked oil glands can cause inflammation and a condition called blepharitis.

When the eyelids become inflamed, they can become swollen, resulting in itchiness, irritation, flaking or scaly skin, watering eyes, and light sensitivity.

Blepharitis treatment

Gently massaging a warm compress onto the eye can help unblock oil glands and clean the eyelids. 

Cellulitis

This bacterial skin infection can cause swelling and pain in the affected area. Though it commonly affects limbs, it can also impact the eyelid.

An upper respiratory tract infection traveling through the sinuses to the eye area can cause cellulitis. Additionally, an insect bite or sting may have a similar effect.

Cellulitis treatment

According to the Centers for Disease Control and Prevention (CDC), doctors or healthcare professionals must treat cellulitis with prescribed antibiotics like cefixime (Suprax).

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Treatments

Here are some treatments that a doctor or healthcare professional may recommend for discoloration and redness under the eyes.

Antihistamines

If your discoloration is due to allergic dermatitis, over-the-counter oral antihistamines, like diphenhydramine (Benadryl) or cetirizine (Zyrtec), could help. 

Antihistamines block the histamine production in your body. Your body releases histamine when it interprets something from the environment as a threat. 

If you’re experiencing allergic contact dermatitis regularly, consider contacting a doctor or a healthcare professional to determine ways to avoid allergens or for prescription allergy medication.

Eye drops

Artificial tears, or eye drops, have lubricating properties that help relieve discomfort and moisten the eye. Studies show that eye drops containing castor oil may help to support the oil glands and improve the symptoms of blepharitis.

In addition, omega-3 fatty acids found in foods like salmon and flaxseed may help with conditions like blepharitis due to their anti-inflammatory effects.

Both studies reviewed the effects of castor oil and omega-3 fatty acids on diseases of the eye’s surface, most notably dry eyes. While eye surface diseases typically only bring redness to the eyeball, some conditions, like blepharitis, can cause undereye discoloration, so eye drops might help improve overall symptoms.

If you cannot get enough dietary fatty acids, fish oil supplements are another good source of daily omega-3 fatty acids.

Contacting a doctor

Any signs of eye infection, including discharge or undereye discoloration that progressively worsens, may require an immediate trip to a family doctor or healthcare team.

You may need oral or topical antibiotics to treat infections of the eye and surrounding area.

Summary

Inflammation and irritation under the eyes may appear differently depending on your skin tone. On paler skin tones, the area under the eye may appear red; on darker skin tones, it may appear darker, gray, or purple. This discoloration can be due to various health conditions, but the good news is that treatments are available.

It’s best to talk with a doctor or healthcare professional for advice as soon as possible.