Periorbital hyperpigmentation (POH), commonly referred to as dark circles, is a prevalent dermatological concern that brings many individuals to dermatologists’ clinics. While POH is generally benign, its impact on self-esteem and quality of life is significant. It predominantly affects females aged 16–25 and is most often seen under the lower eyelids.
Causes of Dark Circles
The causes of POH are multifactorial, including:
- Genetic predisposition
- Sleep deprivation
- Post-inflammatory hyperpigmentation caused by conditions like atopic dermatitis, allergic contact dermatitis, and lichen planus pigmentosus
- Tear trough depression
- Chronic sun exposure
- Frequent eye rubbing

When no specific cause is identified, the condition is termed physiologic periorbital hyperpigmentation .

Treatment Approaches
Effective management of POH focuses on identifying and addressing contributing factors, patient education, and aesthetic treatments as needed. Key treatments include:

1. Topical Agents :
Products containing ingredients like hydroquinone, kojic acid, azelaic acid, arbutin, and vitamin C are commonly used to lighten pigmentation.

2. Sun Protection :
Broad-spectrum sunscreens and UV-coated sunglasses are essential for prevention and treatment.

3. Chemical Peels :
Specific peels can help reduce pigmentation in the under-eye area.

4. Laser Treatments :
Lasers like Q-switched ruby, Q-switched alexandrite, and Nd:YAG are effective for targeting pigmentation and vascular components. The Q-switched Nd:YAG laser, in particular, has shown promising results.

5. Platelet-Rich Plasma (PRP) :
PRP therapy stimulates fibroblasts, helping to reduce pigmentation and improve skin texture.

6. Mesotherapy :
This technique involves delivering skin-beneficial ingredients to the under-eye area and has emerged as a promising option for treating dark circles.

By addressing the underlying causes and employing appropriate treatments, individuals with POH can achieve noticeable improvements, restoring confidence and enhancing their overall quality of life.


Authored by

Dr MOHAMED SALAHUDEEN
Specialist – Dermatology
Aster Medical Centre – C ring
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