Name: Black Dots Under the Eyes | Causes and Treatments | Healthwords
Creator: Dr Roger Henderson
Published: 2020-10-09T13:49:38.313Z

If you are unsure of your diagnosis, you should book a routine appointment with your doctor, who will consider your symptoms and examine you. If one of the spots has changed or looks different to the others, you should book an urgent appointment in case this needs a specialist opinion.

You should seek a private dermatologist if you wish to discuss any treatment options, as the NHS does not offer treatment for this condition.

When should I see my doctor?

Black dots under the eyes can be caused by straining blood vessels. Learn more about the causes and treatments for black dots under the eyes with Healthwords.

Black Dots Under the Eyes | Causes and Treatments | Healthwords

There isn't any treatment per se, but a private dermatologist may choose to treat them surgically. This condition is more common in those of Afro-Caribbean descent and women get them more often than men. They often run in families.

These are thought to be similar to seborrhoeic keratoses, harmless brownish spots that appear anywhere on the body, but dermatosis papulosa nigra tend to appear much earlier in life. They are not contagious, and can't be passed on.

How is this condition treated?

Bio-Oil (60ml)

There are some treatments that can be used to reduce the appearance of hyperpigmentation associated with dermatosis papulosa nigra. Aside from using make-up that contains sun protection, you can use creams such as Fade Out or similar that are available from pharmacies and popular health and beauty retailers.

Fade Out cream can be applied daily, and is formulated with SPF 25 for UVB protection plus UVA protection to prevent the ageing and skin darkening effects of the sun. It contains extracts of mulberry and liquorice that penetrate deep into the skin's outer layers, working together to help reduce the production of melanin, our natural pigment. It also contains niacinamide (Vitamin B3) to help to inhibit the transfer of melanin to the upper layers, where it would become visible on the skin’s surface.

Other products such as [Bio-Oil](https://www.healthwords.ai/shop/products/bio-oil-60ml) can also be used since it is formulated especially to help improve the appearance of scars, stretch marks and uneven skin tone through regular use.

Healthwords pharmacists' top tips

Keratosis pilaris is a very common skin condition, where skin gets bumpy and red, resembling [chicken skin](https://www.healthwords.ai/article/chicken-skin-411) or goosebumps. It typically occurs on the upper outer arms and thighs, where hair follicles get blocked with pockets of keratin, a thick tough substance that helps to protect the skin. Bumps can be red, grey or flesh-coloured, and skin feels rough, dry and sometimes itchy.

This condition affects up to half of the population, running families and appearing most obviously in adolescence, with improvement usually in adulthood. It is completely harmless, but people become concerned with the appearance.

A keloid scar is an area of scar tissue that has formed from a previous trauma - this may have been a small injury, such as an insect bite or acne, or a larger and more memorable injury, such as the site of keyhole surgery or a burn.

Your body has gone into overdrive trying to repair the wound and has formed a lot of collagen. This raised shiny area will feel smooth and firm, and usually in an oval or line shape, and commonly seen on the chest, back, shoulders, neck and stomach. It often extends beyond the original wound.

You may have other such scars, or family members may also have a tendency to form keloid scars. They are more common in Afro-Caribbean and Asian skin, where scars turn dark brown or black rather than the red or pink scars on Caucasian skin. They most commonly form between the ages of 10 and 30 but can form at any age. The protrusion may shrink with time and grow paler, but will likely be lifelong. Keloid scars carry no risk in themselves, although some people are bothered by how they appear, and they may be itchy, painful or give a burning sensation.

Dr Kandi - Keloid scar

Acne vulgaris, also known as pimples, acne, spots or zits, is very common, usually starting in the teenage years and continuing up to the age of 30. About 80% of teenagers suffer some degree of acne. Mild untreated acne typically takes several years to settle but severe acne can scar the skin for life if untreated. 

It coincides with the hormonal changes of puberty, and women may suffer into adulthood with hormonal changes in their menstrual cycle. Hormones affect the amount of oil (sebum) produced by glands next to hair follicles so the skin becomes very greasy, and these follicles then become blocked and inflamed. 

Acne can cause blackheads, whiteheads or pustules, or more inflamed lesions including red and sore cysts and larger nodules, which are more likely to cause long-term scarring. Acne usually affects the face - the T-zone is typical in teenagers (forehead, nose and chin), or the muzzle distribution in early adulthood, which includes the upper lip, chin, jawline and neck. However it can also affect the back and chest. 

A mole is usually a mid or dark brown flat mark (a junctional naevus), or a dome-shaped brown or flesh-coloured bump (a dermal naevus). It should be neither itchy nor bothersome.

You may have numerous moles, and they may run in your family. They may have been present for as long as you can remember, or since birth, although new moles can appear throughout childhood and even into your 20s, especially after recent sun exposure.

Certain skin types such as those with pale skin, blue eyes and red or blond hair, and who are likely to easily burn, are likely to be more at risk of concerning changes to moles.

Actinic keratoses (or solar keratoses) are small red flakey marks on your skin in response to long-term sun damage. They appear many years after sun exposure on sun-exposed areas such as the top of forehead or crown of the head, tops of ears, forearms, hands and lower legs, and so are more common in older people. 

They feel like rough patches like sandpaper, and yellow or orange scales can appear that resemble tiny cornflakes. The surrounding skin may be pink or red, and there might other evidence of sun damage such as deep wrinkles, large freckles or brown blotches. They don't usually cause any symptoms beyond a mild itch or soreness, but some people feel self-conscious that they look unsightly.

Rosacea is a common condition that causes redness on the cheeks and across the nose, and is sometimes accompanied by more persistent red bumps, known as papules or pustules if they have a yellow centre. Its full name is actually [acne](https://www.healthwords.ai/condition/acne) rosacea. Episodes of flushing may precede a more persistent redness.

Certain triggers are thought to cause blood vessels just under the skin to widen, becoming more visible and causing redness, but the underlying cause is not well understood. It is common – affecting up to 10% of people – and typically appears in those aged 30 to 60 as well as in fair-skinned/blue-eyed people. The exact cause remains unknown, but triggers for its development include sun damage, leaky tiny blood vessels under the skin, a skin mite called \* Demodex folliculorum \*, and a family history of rosacea. It is not contagious, so you cannot catch it from someone else.

Dr Kandi - Rosacea

Hidradenitis suppurativa occurs in areas where there are sweat glands around hair follicles. It is a condition that often affects the armpits but can also affect the groin, under the breasts, and around the anus, as well other areas of the body too. It is a chronic condition that can cause both abscesses and scarring of the skin. The cause of hidradenitis suppurativa is unknown.

The symptoms are very painful lumps that range from blackheads to [boils](https://www.healthwords.ai/condition/boils-864), cysts, or channels (called sinus tracts) that contain and sometimes leak pus. As it is a long-term recurrent condition that requires ongoing management it can cause quite an impact on an individual’s everyday life and can lead to depression.

Polycystic Ovarian Syndrome (PCOS) and Acne

PCOS (polycystic ovary syndrome) is a hormonal condition that causes a range of symptoms in women of reproductive age. [Acne](https://www.healthwords.ai/condition/acne) is one related condition affecting 3 in 10 of PCOS sufferers, which on top of other PCOS-related symptoms, adds to a feeling of anguish and low self-confidence.

Dr Kandi -Acne

Sunburn is when excessive exposure to the sun damages the skin causing it to become damaged. The majority of cases can be self-treated. Sunburn is an example of a first-degree (superficial) [burn](https://www.healthwords.ai/article/burns) - the skin is red, painful and very sensitive to touch, and the damaged skin may be slightly moist from leakage of the fluid in the deeper layers of the skin.

Sunburn, caused by the UVB rays in sunlight, is common and sore at the time. But it also increases your risk of developing[ skin cancer](https://www.healthwords.ai/condition/melanoma-skin-cancer-418) later in life, so it's important to avoid this by using sun safe practices. These include adequate - sun cream SPF 30 and above, with both UVA and UVB protection, cover up with hats and clothes and avoid the sun altogether on summer days between 11 am and 3 pm.

Dr Kandi - Sunburn

Melanoma (also known as malignant melanoma) is the most serious type of [skin cancer](https://www.healthwords.ai/condition/scc-non-melanoma-skin-cancer-522) caused by sun exposure. It's serious because the cancer can spread to other organs in the body, so it needs prompt identification and treatment. You can take steps to prevent it, but also keep a watch for any moles or other skin marks that are new, changing or don't look like your other moles.

Melanoma is the 5th most common cancer in the UK, with almost 17,000 new cases each year. The number of cases has doubled in the last 30 years, and it can occur at any age.

An SCC (squamous cell carcinoma) is usually a firm pink or red lump and typically occurs in sun-exposed areas like the face, ears, forearms and hands, shoulder, upper chest and back. It might feel tender to press, it may develop a solid horny lump sticking up and it can sometimes ulcerate, giving a wet appearance. This grows slowly over weeks, months or even years.

It usually occurs in people aged over 50, in response to years of [sun damage](https://www.healthwords.ai/article/sunburn-526). While skin cancers all develop in response to sun damage, and similar risk factors make some more susceptible than others, there are different types of skin cancer. [Melanoma](https://www.healthwords.ai/condition/melanoma-skin-cancer-418) is the most well-known, but actually the less common. This is where a new mole appears or an existing [mole changes](https://www.healthwords.ai/condition/moles). SCC is a different process and doesn't usually start as a mole.

Symptoms of dry eyes may include:

1. **Dryness**: A sensation of dryness or grittiness in the eyes is a hallmark symptom of dry eyes. This can be accompanied by a feeling of irritation or discomfort.

2. **Redness**: The eyes may appear red or bloodshot, particularly when they become irritated due to dryness.

3. **Burning or stinging**: Some individuals with dry eyes may experience a burning or stinging sensation in the eyes, especially in environments with low humidity or when exposed to irritants such as smoke or wind.

4. **Blurry vision**: Dry eyes can cause temporary fluctuations in vision, leading to blurry or fluctuating vision, particularly during activities that require prolonged visual concentration, such as reading or using a computer.

5. **Sensitivity to light**: Dry eyes may increase sensitivity to light, making it uncomfortable to be in brightly lit environments.

6. **Watery eyes**: Paradoxically, some people with dry eyes may experience excessive tearing as the eyes attempt to compensate for the lack of adequate lubrication.

Several factors can contribute to the development of dry eyes, including:

- **Ageing**: Dry eyes are more common as people age, as tear production tends to decrease with age.
- **Environmental factors**: Exposure to dry or windy climates, air conditioning, heating, and smoke can exacerbate dry eye symptoms.
- **Medical conditions**: Certain medical conditions, such as autoimmune diseases (e.g., Sjögren's syndrome, rheumatoid arthritis), hormonal changes (e.g., menopause), and eyelid abnormalities, can increase the risk of dry eyes.
- **Medications**: Certain medications, including antihistamines, decongestants, antidepressants, and hormonal therapies, can reduce tear production or affect tear composition, leading to dry eyes.
- **Prolonged screen time**: Extended use of digital devices can contribute to dry eyes due to reduced blinking and increased tear evaporation.
- **Contact lens wear**: Contact lens use can exacerbate dry eye symptoms, particularly if lenses are worn for extended periods or if proper hygiene practices are not followed.

Dr Kandi - Dry Eyes

Milia (Milk Spots): Causes and Treatments

Milia is the condition describing tiny pearly-white bumps on the skin under the eyes. These are little cysts (or sacs) containing a hard semi-solid protein called keratin.

There may be one, two, or a few, and they usually cause no symptoms except that people become self-conscious about their appearance. They are entirely harmless, they need no treatment, and most disappear within a few months (although new ones may form in time).

## What causes milia?

In adults, these may form in response to recent [sunburn](https://www.healthwords.ai/article/sunburn-526) or from skin damage such as from a [burn](https://www.healthwords.ai/article/burns) or unusual skin conditions. They appear in up to half of newborn babies, appearing around the eyes, nose and across the cheeks and clearing up a short while later.

Dr Kandi - Milia

Vitiligo occurs when pigment (melanin) is lost from areas of skin, leaving behind white patches. The patches can grow in size and merge. These patches may be a little itchy but are not otherwise bothersome.

The main complaint is the appearance of these patches, and the loss to self-confidence that comes with it. This requires specialist attention to treat, with the aim of stopping new patches forming, and if it's caught early enough, there's the possibility of reversing white areas to allow pigment to gradually come back. For this reason, it's important to see your doctor.

Dr Kandi - Vitiligo

Polycystic Ovarian Syndrome (PCOS) and Excess Hair

Hirsutism is the medical term for more hair than women would expect on the face and body. It can be one of the signs of [PCOS](https://www.healthwords.ai/condition/polycystic-ovarian-syndrome-pcos) (polycystic ovary syndrome). For some, it can be embarrassingly unsightly, as it can be dark, thick, coarse and difficult to get rid of. It’s also more likely to be in areas associated with males, such as the cheeks, neck, chin and chest.

Xanthelasma are fat deposits around the eyes, usually found near the inner corner of the eye and the inner upper eyelid. They tend to look slightly paler than the person's skin tone, and the lumps can vary in size. They are harmless themselves but can represent a [high level of cholesterol](https://www.healthwords.ai/condition/high-cholesterol) (a type of fat) in the body, although this is not always the case. Higher levels of cholesterol in the body can increase your risk of heart problems.

They do not need to be removed from around the eyes but can be removed privately for cosmetic reasons by a variety of methods from excision of the lumps to laser, chemical or freezing.

We have all grown more aware of the dangers of sun exposure in recent years, with the threat of sun damage altering our appearance and the risk of [skin cancer](https://www.healthwords.ai/condition/melanoma-skin-cancer-418). There are different types of skin cancer, but there are some rules of thumb to follow for any [mole](https://www.healthwords.ai/condition/moles), whether it’s new or existing. Let's take you through when to be concerned.

Chicken skin, also known as [keratosis pilaris](https://www.healthwords.ai/condition/keratosis-pilaris), is a very common skin condition, where the skin gets bumpy and red, resembling chicken skin or goosebumps. 

It typically occurs on the upper outer arms and thighs, where hair follicles get blocked with pockets of keratin, a thick tough substance that helps to protect the skin. Bumps are usually red, brown or flesh-coloured, and the skin will feel rough, dry and sometimes itchy. 

This condition affects up to half of the population, running in families and appearing most prominently in adolescence, with improvement usually in adulthood. It is completely harmless, but people become concerned with its appearance. 

A sebaceous cyst is an umbrella term for epidermoid and pilar cysts. It means a fluid-filled sac or lump and either originates from skin cells (epidermoid) or from a hair follicle (pilar). Sebaceous cysts are not harmful and can slowly get bigger over time or can disappear without any treatment. They are non-cancerous, so they will not cause harm or spread to any other part of your body, and they do not usually require treatment.

They appear as round, mobile lumps that can feel bouncy and can at times release a white or yellow paste-like substance from the inside of it if there is a break in the lining of the cyst and it is squeezed. 

**We do not recommend squeezing cysts as they can cause inflammation or even infection**. 

Sebaceous cysts are not painful unless they become inflamed or infected.

Glaucoma is a condition where there is damage to the optic nerve. This nerve sits at the back of your eye and transports the images your eyes see to your brain for processing. Glaucoma can threaten your vision, either by direct damage to the optic nerve, or by an increase in pressure in the fluid filling the eye, and thereby squeezing the optic nerve. It can ultimately lead to a loss of vision, so it's important it's detected and treated early. 

There are two usual types of glaucoma, based on whether pressure increases slowly or quickly. Chronic open-angle glaucoma - the most common type - is where pressure inside the eye builds slowly, so the loss of vision occurs gradually. You might not even notice changes early on, but you're most likely to lose vision in the outer edges of your vision (the periphery) first. It's often picked up on a routine check-up with your optician, where they check eye pressure by blowing a puff of air on your eyeball. This type of glaucoma usually affects both eyes and is painless.  Among white Europeans, about 1 in 50 people over 40 years of age and 1 in 10 people over 75 years of age have chronic open-angle glaucoma. 

Acute angle glaucoma is much less common. Pressure builds rapidly inside the eye and threatens vision if not treated urgently. You might feel severe pain in or around your eye or in the head, the eye may feel tight or full, lights may appear to have halos around them and you might complain of blurred vision. You may even feel unwell and be vomiting. This is an emergency and you should seek medical attention urgently. 

Other possible types of glaucoma include secondary glaucoma – caused by an eye injury or inflammation of the middle layer of the eye – and congenital glaucoma which is rare but present at birth.

An ectropion happens when the lower eyelid sags away from your eye, leaving the inner surface of the eyelid exposed. It can happen in one eye or both eyes. When the lower eyelid droops away from the eye, it can affect the ability of teardrops to drain properly. This can cause the eye to water excessively, as well as feel dry and gritty. The eyes can also become red, sore, and inflamed and this makes the eye more vulnerable to infections such as conjunctivitis.    In severe untreated cases, it's possible to develop a corneal ulcer (a sore on the eye's surface) that could affect your vision. But this is rare. An ectropion is different from an entropion, which is where the eyelid turns inwards, towards the eye.

Xailin night is an eye ointment for the treatment of [dry eye](https://www.healthwords.ai/symptom/dry-eyes) conditions, corneal erosion and to lubricate the eyes before or after eye surgery. It contains paraffin and wool alcohols (lanolin) which all serve to lubricate and protect water loss from the eyes. This, in turn, relieves symptoms of dry eyes and forms a protective barrier on the surface of the eye.

[Psoriasis](https://www.healthwords.ai/condition/psoriasis) is a long-term condition that causes thickened patches to appear on the skin. It can only affect the scalp, or you might have other patches on your body. It can be intensely itchy and in a mild form, may cause red patches, usually at the back of the head and extending to the neck or behind the ears. In a more severe form, thickened plaque may cause temporary loss of hair, and this requires stronger and more prolonged treatment.

Preventing Insect Bites whilst Travelling

Preventing insect bites whilst travelling is always at the front of peoples minds, especially when travelling to far flung corners of the earth. But what is the best way to do it? Are certain products better than others? In this article Healthwords’s expert travel pharmacists will explain everything you need to know to get you fully informed and put your mind at ease!

The reality is that some mosquitoes carry severe diseases, and so rather than the annoyance whilst on holiday in Ibiza – it may be a medical imperative that you do everything to avoid receiving a bite. Because different mosquitoes carry different diseases, and they all fly at different times of day, in some areas it may be necessary to use insect repellents day and night. Insect repellents have been around for nearly a century and the most effective of these is the product DEET (the active ingredient in most common repellant products). Other products include picaridin and oil of lemon eucalyptus.

Dr Kim -Insect Bites & Stings

Cradle cap, a type of seborrhoeic dermatitis, is a skin condition common in babies. It usually occurs in their first six weeks. It causes yellow scaly patches on the scalp or face that can appear oily. A red rash can emerge under the scales or in folds of skin such as the groin area. 

In most cases this gets better on its own over two to eight weeks. It is not harmful to your baby and should not cause them discomfort or to be unwell. 

Adults do not get cradle cap, but they may suffer other forms of seborrhoeic dermatitis, such as dandruff or a red flaky rash over their nose and cheeks.

Blepharitis is a common and treatable inflammation of the inner rim of the eyelid, usually affecting both eyes. There may be irritation, itching, burning, excessive tears and crusty debris or skin flakes around the eyelashes.

You may also have redness around the eyes and missing eyelashes. Common causes are bacterial eyelid infections, meibomian gland dysfunction, dry eyes, fungal eyelid infections and parasites. Blepharitis can be a recurrent or chronic problem, and patients often have other associated skin conditions such as rosacea and dandruff. Blepharitis is not contagious.

Whether you've spent months growing your beard, or are just starting your beard journey – here at Healthwords we believe in looking after your health AND your facial hair. In this article we'll discuss our best beard maintenance tips, and how to care for that wonderful tuft of hair.

Dr Roger Henderson

Chief Content Officer

If you have dark brown or black lumps, tiny in size and multiple in number, sitting on the cheekbones and under the eyes, it’s likely you have dermatosis papulosa nigra. Despite the grand title, these are completely harmless.

These usually feel smooth and soft and are each only 1 to 5mm wide, and you may have a few or many, of differing sizes. They appear from the teenage years onwards and don't usually cause any symptoms, but some find them unsightly, especially with their prominence on the face.

Black dots under the eyes

Doctor’s advice

How is this condition treated?

Healthwords pharmacists' top tips

Pharmacist recommended products

When should I see my doctor?

Related topics

Keratosis pilaris

Keloid scar

Acne

Moles

Actinic Keratoses

Rosacea

Hidradenitis Suppurativa

Polycystic Ovarian Syndrome (PCOS) and Acne

Sunburn

Melanoma (Skin Cancer)

SCC (Non-Melanoma Skin Cancer)

Dry Eyes

Milia (Milk Spots): Causes and Treatments

Vitiligo

Polycystic Ovarian Syndrome (PCOS) and Excess Hair

Xanthelasma

Moles: When to worry

Chicken Skin

Sebaceous Cyst

Glaucoma

Ectropion (Eyelid)

Xailin Night Eye Ointment

Scalp Psoriasis

Preventing Insect Bites whilst Travelling

Cradle Cap

Blepharitis

Keeping your beard in tip top condition