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Dr. Gellner: Parents are often concern about dark circles under their children's eyes. They think it's a sign of something dangerous and often ask pediatricians for blood tests to look for a cause. Is this something to worry about or not?

Common Causes for Dark Bags under Eyes

Dr. Gellner: I hear all the time from parents that they're concerned that the dark circles under their children's eyes are because their children have anemia or a vitamin deficiency and they want me to run lab tests. And my response to that is no. Why not? Because those aren't the causes of dark circles. Dark circles under the eyes in children are also usually not from lack of sleep. So what are the most common reasons for those panda eyes? Nasal congestion and genetics.

Dark circles under the eyes are often caused by veins around the eyes getting larger and darker if the nose is blocked. Kids often have nasal congestion if they have colds or allergies. It can also be caused by large adenoids. These are lymph nodes that sit above the tonsils and behind the nose. Kids with large adenoids are mouth breathers and loud snorers.

If you have dark circles under your eyes, there is a good chance your kids will too. Some people genetically have thinner skin under their eyes. If your child has fair skin, they can also appear to have dark circles under their eyes, due to the veins being seen under the skin.

When to See a Professional

So when should you be concerned about dark circles under eyes? Rare cancers such as neuroblastomas can cause very dark circles under the eyes, actually even around the eyes. It almost looks like your child has two black eyes from being punched. Any time the cause of dark circles under the eyes might be something more serious, your child will have other, more concerning symptoms that will help your child's pediatrician determine if further testing is needed.

updated: February 19, 2021
originally published: February 26, 2018