Plastic Surgeon
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'Raccoon Eyes'




People wonder about those dark rings around their eyes. If they go all the way around then they are rings . People call them 'raccoon eyes'.

If the darkness is merely beneath the eyes, and while there is no 'nick name' for such a condition that readily comes to mind, for many this too is a very disconcerting problem.

There are several causes and I will try to comment on the ones that are most frequently observed.

One of the most frequent causes is due to a brown pigment. Pigment can be of several types. In the eye lid area it is due to a stain from the hemosiderine molecule.

Hemosiderine is a major part of the red blood cell. When a red blood cell rupture the contents of the cell including the large hemosiderine molecule is dumped into the spaces around the blood vessels and tissue cells. Many have observed the colors (pigment) of a 'black and blue' spot. Hemosiderine has at is center the iron molecule. Of course most of us know what rust is. Oxidized iron. And we know what color rust is - rust color a red brown depending on the composition of the metal containing iron.

So, do we have rusted lids ?? !!

The iron pigment hangs around in the skin of the lids as it is a very large molecule and the body has a hard time getting rid of it. Also, the skin of the lids can be thin and the pigment can be seen beneath the skin as a dark and rusty and brown color.

And what causes the hemosiderine to get where we would not like to find it ?

Micro hemorrhages. Not like a gallon of blood but just a few or more blood cell breaking through the blood vessels - when there is swelling or distention of the blood vessels. As you know the body is in a constant state of fluid increase and decrease. Usually this does not cause a problem but sometimes, with extra salt, hormonal shifts, 'water retention', etc., there is swelling that causes stretching. This can be enough to cause small blood vessels to leak or rupture. A small number of red blood cells leak out. These cells dissolve spilling their contents into the tissues.

Unfortunately, swelling especially occurs under the eyes because the skin is thin and the tissues supple and loose, which allows swelling. Over time and repeated swellings, the pigment builds up and 'raccoon eyes' can develop.

Allergies can influence the development of 'raccoon eyes'. Since allergies are associated with sinus problems and general swelling of tissues, they can make the problem worse.

Fat around the eyes: what about the 'fat'. As many know, there is fat around the eyes. In some families and under certain conditions, e.g. goiter, the fat balloons or swells in the eye lid area. Fat has a rich blood supply and can cause the problem as described above with micro-hemorrhages and pigment deposition.


Sinus problems: sinus problems or nasal problems are a major cause of eyelid problems. Repeated infections inside the nose or the sinuses contribute to the problem of pigmentation. Along with infection and inflammation repeated swellings occur. This as described above, causes pigment changes.

Hereditary and pigment problems: just as poor Mr. Raccoon has rings around his eyes, some human families have rings around their eyes. This is not caused by the above hemosiderine but rather a greater number of pigment cells called melanophores

There are other causes. If you would email me at , I will consider adding your input.



Depending on the cause, treatment is tailored to the cause of the problem.

Buldging Fat: due to allergies, heredity, recurrent sinus problems, fluid retention; a lower lid blepharoplasty can be done to decrease the amount of fat etc.. Please see our main page for information on eyelid surgery. The fat is removed in part. This can improve the situation but it make take some time before the hemosiderine pigment is cleared from the tissues. Some may remain.

Allergies - get them under control as best possible. Work with your family doctor or allergist, etc.

Hereditary problems: there are products that can help to some degree and your family doctor, plastic surgeon or dermatologist can probably recommend a product.

Sinus problems: Again control is important. Undetected or under treated nasal septal or (inside the nose) problems should be treated, many times surgically.

It bothers me that so many individuals have so many problems for so long. Many times they may be helped by 'septalplasty' or other inside the nose (intra nasal) operation(s).

Many cases of 'allergies' are really due to nasal obstruction because of a crooked nasal septum. Repeated infections inside the nose or the sinuses, contribute to the problem of pigmentation, appropriate surgery can help.


More than one condition may be associated with 'raccoon eyes'. Many of these situations can be helped. The therapy should be tailored to the cause(s). I hope you have found this informative.

Dr C.


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Copyright © Donald J. Capuano M.D. 1996,2002+