The skin directly beneath the lower eyelid, known as the infraorbital region, is uniquely delicate and often the first area to show signs of irritation or fatigue. This skin is considerably thinner than the rest of the face, making the underlying structures and blood vessels more visible. Redness in this sensitive area is a very common complaint with a broad spectrum of underlying causes, most of which are temporary and harmless.
Localized Skin Conditions
Redness that originates from a specific dermatological issue often involves a reaction where the skin barrier has been compromised or irritated. One common cause is contact dermatitis, an inflammatory reaction that occurs when the skin encounters an irritant or an allergen. This type of inflammation can be triggered by ingredients in makeup, cleansers, face creams, or even the preservatives found in some eye drops or contact lens solutions.
The resulting redness appears precisely where the offending substance has touched the skin, sometimes accompanied by stinging, itching, or scaling. Eyelid dermatitis, a form of contact dermatitis, is particularly common because the eyelid skin is so thin and sensitive. Allergic contact dermatitis may not appear immediately, sometimes developing hours or days after exposure, making it difficult to pinpoint the exact product responsible.
Atopic dermatitis, commonly known as eczema, is another frequent cause of persistent under-eye redness. This chronic condition involves a genetic predisposition that results in a compromised skin barrier, making the area prone to dryness, inflammation, and itchiness. Eczema flare-ups under the eye present as dry, red, and sometimes flaky patches. A related issue is periorbital dermatitis, characterized by clusters of small, red bumps or pustules affecting the skin around the eyes and mouth.
Environmental and Allergic Triggers
When redness is part of a broader reaction, it often points to environmental or airborne triggers rather than direct product contact. Seasonal allergies, or hay fever, are a major systemic cause, where the immune system releases histamine in response to airborne allergens like pollen, dust mites, or pet dander. This systemic allergic response causes generalized eye irritation and inflammation, frequently leading to allergic conjunctivitis.
The resulting itchiness and watery eyes often prompt mechanical irritation from frequent eye rubbing. This physical action exacerbates the inflammation and can break tiny surface capillaries, causing the delicate skin under the eye to appear visibly red and puffy. Non-allergic external irritants can also cause redness. Substances like smoke, pollution, strong fragrances, or extremely dry air can irritate the skin and mucous membranes, leading to inflammation around the eyes.
Vascular and Structural Factors
Sometimes, the redness is not due to inflammation but is instead a visible manifestation of the body’s underlying anatomy and circulation. The skin in the infraorbital region is exceptionally thin, often lacking the subcutaneous fat layer. This transparency allows the underlying network of tiny blood vessels (capillaries) to be seen more easily, which can give the area a reddish, bluish, or purplish tint, particularly in fair-skinned individuals.
The prominence of these blood vessels is influenced by lifestyle factors, such as fatigue and poor hydration. Lack of sleep and dehydration can negatively affect circulation, causing blood vessels to dilate or become congested, which increases the visibility of the blood through the thin skin layer. Minor physical trauma, such as aggressive rubbing or harsh makeup removal, can also cause slight bruising, technically called purpura, which appears as a temporary reddish discoloration beneath the surface. This type of redness is structural, related to anatomy or blood flow, rather than a pathological skin condition.
Recognizing Serious Symptoms
While most instances of under-eye redness are benign, certain accompanying symptoms suggest a deeper issue that requires prompt medical evaluation. The presence of signs associated with a spreading infection, such as significant pain, a feeling of warmth, or swelling that rapidly spreads toward the cheek or forehead, warrants immediate attention. These symptoms could indicate a serious bacterial skin infection like orbital cellulitis, which requires urgent treatment.
Any changes to vision accompanying the redness are a serious warning sign. Symptoms like sudden blurred vision, double vision, or increased sensitivity to light necessitate an immediate consultation with an eye specialist. Redness that persists for more than a week without improvement, despite avoiding known irritants, should also be examined by a healthcare professional. Consulting a dermatologist for skin issues or an ophthalmologist for symptoms affecting the eye will help ensure an accurate diagnosis and appropriate management plan.