Facial features of allergic disease: Allergic shiners, Dennie's lines, Allergic salute, Nasal crease, Postnasal drip

Author: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago
Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU

Allergic shiners: Dark circles under the eyes are due to swelling and discoloration from congestion of small blood vessels beneath the skin in this area. This can give the appearance of having "gone a few rounds" on the playground. The symptoms of allergic rhinitis often produce a combination of gestures and facial features (listed below), particularly in children and teenagers. Click to see illustration 1 and 2.

Dennie-Morgan lines: Young children with nasal allergies or atopic dermatitis have characteristic Dennie-Morgan lines. These are crease-like wrinkles that form under the lower eyelid folds (double skin folds). Click to see illustration.

Allergic salute: This describes the way that many children use the palm of their hand to rub and raise the tip of their nose to relieve nasal itching and congestion (and possibly to wipe away some mucus). Click to see illustration.

Nasal crease: This is a line across the bridge of the nose usually the result - particularly in children - of rubbing the nose (allergic salute) to relieve nasal congestion and itching. Click to see illustration.

Mouth breathing: Nasal congestion can result in chronic mouth breathing, associated with the development of a high, arched palate, an elevated upper lip, and an overbite. Teenagers with allergic rhinitis might end up needing braces. Click to see illustration.

Allergic (adenoidal) face (long face syndrome): Nasal allergies may promote swelling of the adenoids (lymph tissue that lines the back of the throat and extends behind the nose), resulting in a tired and droopy appearance. Click to see illustration.

Postnasal drip: Children may experience a constant postnasal drip and repeated sore throats from allergic mucus building up and being discharged into the throat. Serious nasal allergies also reduce the sense of taste and smell. Click to see illustration.


What Are Allergic Shiners? ACAAI.
Spotting an allergic child. BBC.
Illustration of endoscopy in allergic rhinitis.

Published: 02/16/2012
Updated: 04/12/2012

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