Undereye Pigmentation

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Periorbital pigmentation, also known as undereye pigmentation or dark circles is a very common problem these days, causing increased stress and psychological problems. It presents as brownish to purplish pigmentation in the under eye area and can be because of a number of reasons including:

  1. Genetic/Hereditary factors – Undereye pigmentation is very often inherited in the family
  2. Exogenous factors : Excessive exposure to sun light can cause sun damage and pigmentation in the undereye area similar to rest of the body. Also, increased exposure to dust and other allergic substances can cause itching and allergic contact dermatitis leading to pigmentation.
  3. Excessive vascularity : This is a major cause of undereye pigmentation. It gives a purplish hue to the undereye area and appears even on stretching the skin.
  4. Stress/fatigue or excessive strain to the eye can cause dark circles and give a tired look to the eye. Lack of sleep, excessive screen time, alcohol overuse, smoking etc are important causes of undereye pigmentation.
  5. Post inflammatory pigmentation following skin problems like allergic contact dermatitis or atopic dermatitis can lead to unwanted pigmentation. Excessive rubbing can also lead to Post inflammatory pigmentation.
  6. Tear trough : Facial structure or anatomy or loss of tissue due to ageing can lead to development of tear trough, which causes shadowing effect, thereby producing dark circles.
  7. Thin eyelid skin is another cause for undereye pigmentation
  8. Extension of pigmentation demarcation lines of the face can lead to undereye pigmentation.
  9. Others : Vitamin K deficiency or swelling in the undereye area can also lead to dark circles.
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Various options are available for the treatment of dark circles. These include:

  1. Avoidance and treatment of the causative factor : Any skin condition leading to post inflammatory pigmentation needs to be treated.
  2. Proper moisturization helps in maintaining a healthy undereye skin.
  3. Lifestyle modification : This is the most important factor for treatment of undereye pigmentation. Patients are advised to provide adequate rest to the eyes and avoid excessive stress occurring due to phone or laptop use. Proper nighttime sleep is required to provide rest to the eye. Avoid alcohol consumption and smoking to prevent excessive free radical damage to the skin.
  4. Photoprotection : Adequate sun protection with a sun screen is mandatory to stop additional damage to the skin.
  5. Topical treatments : Various formulations containing hydroquinone, kojic acid, arbutin, azeleic acid, retinoids, vitamin K and caffeine are available for the treatment of dark circles. They can be used based on the underlying cause of pigmentation.
  6. Chemical peels : Chemical peels containing glycolic acid, lactic acid, trichloroacetic acid, mandelic acid, arginine etc are available which help in reducing pigmentation in the undereye area. Multiple sessions are required to help reduce them gradually. Topical agents are added with them as priming agents as well as to enhance the action of peels.
  7. Laser treatments : Various lasers including Q switched Nd YAG lasers, Ruby lasers and alexandrite lasers are available for treatment of dark circles. These lasers are beneficial according to the cause of the pigmentation.
  8. Undereye plasma treatments – These help in increasing the collagen production in the undereye area causing reduction in sagged skin and other age related factors leading to undereye darkening.
  9. Undereye fillers – Hyaluronic acid fillers help in three dimensional correct of the periorbital area. They are helpful in correction of the tear trough. As the shadowing effect due to facial anatomy reduces, it leads to reduction in the dark circles.
  10. Surgical treatment : Blepharoplasty is helpful in reducing dark circles in patients with under eye bags which casts a shadow in the under eye area, appearing as pigmentation.

Visit your dermatologist for identifying the cause of dark circles and adequate treatment according to the underlying cause.

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