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Periorbital dark circles | |
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Other names | Dark circles, infraorbital venous stasis, periorbital hyperpigmentation |
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Minor dark circles and a hint of periorbital puffiness—a combination principally suggestive of minor sleep deprivation. | |
Specialty | Sleep medicine |
Periorbital dark circles (including dark circles of the lower eyelid) are dark blemishes around the eyes. There are many causes of this symptom, including heredity and bruising. [1]
Bony structure and prominence of the orbicularis oculi muscle can contribute to infraorbital dark circles. [2] [3] Skin in the lower eyelid is very thin which accentuates subdermal features. [2]
Any condition that causes the eyes to itch can contribute to darker circles due to rubbing or scratching the skin around them. Hay fever sufferers in particular will notice under-eye "smudges" during the height of the allergy season. Atopy can lead to frequent rubbing of the eyes, leading to local inflammation and increased pigmentation. [4]
Also, dark circles from allergies are caused by superficial venous congestion [5] in the capillaries under the eyes.
Any medications that cause blood vessels to dilate can cause circles under the eyes to darken. The skin under the eyes is very delicate, any increased blood flow shows through the skin.
When cortisol is deficient the pituitary compensates by producing excess adrenocorticotropic hormone (ACTH) and melanocyte-stimulating hormone (MSH), the latter resulting in dark circles under the eyes. [6]
The lack of nutrients in the diet, or the lack of a balanced diet, can contribute to the discoloration of the area under the eyes. It is believed that iron deficiency and vitamin B12 deficiency can cause dark circles as well. [7] Iron deficiency is the most common type of anemia and this condition is a sign that not enough oxygen is getting to the body tissues.
The skin can also become more pale during pregnancy and menstruation (due to lack of iron), allowing the underlying veins under the eyes to become more visible.
A lack of sleep and mental fatigue can cause paleness of the skin, allowing the blood underneath the skin to become more visible and appear bluer or darker. [8] [9]
Dark circles are likely to become more noticeable and permanent with age. This is because as people get older, their skin loses collagen, becoming thinner and more translucent. As facial fat descends and fat volume decreases, the somewhat inflexible ligaments can result in orbital rim and facial hollowing. [2] Photoaging has similar effects. [3] Hemoglobin breakdown products such as hemosiderin and biliverdin can leak from the vascular contributing to pigmentation changes. [2]
Circles may also gradually begin to appear darker in one eye than the other as a result of some habitual facial expressions, such as an uneven smile.[ citation needed ]
Sunlight causes the skin to produce more melanin, the pigment that darkens skin. [10]
Periorbital hyperpigmentation occurs when more melanin produced around the eyes than is usual, giving them a darker color. [11]
At one time, hydroquinone solution was often mixed in an oil-free moisturizer that acted like a skin bleach. However the use of hydroquinone for skin whitening has been banned in European countries due to health concerns. In 2006, the United States Food and Drug Administration revoked its approval of hydroquinone for over the counter preparations warning that it may cause cancer or have many other detrimental effects. [12]
The use of hydroquinone skin-whitening products may be toxic, harmful or lethal for humans. [12]
Modern treatments include topical creams that are marketed for the condition. Various ingredients have been researched, developed and included in these creams. For example, recently, chemical compounds called alpha hydroxy acids (AHAs) have been added as a beneficial ingredient to creams for dark circles. [13] Specialist treatments including laser and intense pulsed light skin surgery can also be used. [14] Low-level laser therapy, autologous fat transplantation and hyaluronic acid fillers are also alternative treatment options. [15]
In addition, many skin care ingredients can help in the form of eye creams. Caffeine is a potent vasoconstrictor that has been proven to improve the look of dark circles [16] by constricting, or tightening, the dilated vessels under eyes. Vitamin C can help brighten hyperpigmentation as well as thicken the dermal layer of skin which conceals dark circles. [17]
Melanin is a family of biomolecules organized as oligomers or polymers, which among other functions provide the pigments of many organisms. Melanin pigments are produced in a specialized group of cells known as melanocytes.
Melanocytes are melanin-producing neural crest-derived cells located in the bottom layer of the skin's epidermis, the middle layer of the eye, the inner ear, vaginal epithelium, meninges, bones, and heart found in many mammals and birds. Melanin is a dark pigment primarily responsible for skin color. Once synthesized, melanin is contained in special organelles called melanosomes which can be transported to nearby keratinocytes to induce pigmentation. Thus darker skin tones have more melanosomes present than lighter skin tones. Functionally, melanin serves as protection against UV radiation. Melanocytes also have a role in the immune system.
Vitiligo is a chronic autoimmune disorder that causes patches of skin to lose pigment or color. The cause of vitiligo is unknown, but it may be related to immune system changes, genetic factors, stress, or sun exposure. Treatment options include topical medications, light therapy, surgery and cosmetics. The condition can show up on any skin type as a light peachy color and can appear on any place on the body in all sizes. The spots on the skin known as vitiligo are also able to “change” as spots lose and regain pigment; they will stay in relatively the same areas but can move over time and some big patches can move through the years but never disappear overnight.
Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.
Laser hair removal is the process of hair removal by means of exposure to pulses of laser light that destroy the hair follicle. It had been performed experimentally for about twenty years before becoming commercially available in 1995–1996. One of the first published articles describing laser hair removal was authored by the group at Massachusetts General Hospital in 1998. Laser hair removal is widely practiced in clinics, and even in homes using devices designed and priced for consumer self-treatment. Many reviews of laser hair removal methods, safety, and efficacy have been published in the dermatology literature.
Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.
Hypopigmentation is characterized specifically as an area of skin becoming lighter than the baseline skin color, but not completely devoid of pigment. This is not to be confused with depigmentation, which is characterized as the absence of all pigment. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin. Some common genetic causes include mutations in the tyrosinase gene or OCA2 gene. As melanin pigments tend to be in the skin, eye, and hair, these are the commonly affected areas in those with hypopigmentation.
Melasma is a tan or dark skin discoloration. Melasma is thought to be caused by sun exposure, genetic predisposition, hormone changes, and skin irritation. Although it can affect anyone, it is particularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy medications.
Ochronosis is a syndrome caused by the accumulation of homogentisic acid in connective tissues. The condition was named after the yellowish (ocher-like) discoloration of the tissue seen on microscopic examination. Macroscopically, though, the affected tissues appear bluish-grey because of a light-scattering phenomenon known as the Tyndall effect. The condition is most often associated with alkaptonuria, but can occur from exogenous administration of phenol complexes such as hydroquinone. It was first described by Rudolf Virchow in 1865.
Azelaic acid (AzA) is an organic compound with the formula HOOC(CH2)7COOH. This saturated dicarboxylic acid exists as a white powder. It is found in wheat, rye, and barley. It is a precursor to diverse industrial products including polymers and plasticizers, as well as being a component of a number of hair and skin conditioners. AzA inhibits tyrosinase.
Liver spots are blemishes on the skin associated with aging and exposure to ultraviolet radiation from the sun. They range in color from light brown to red or black and are located in areas most often exposed to the sun, particularly the hands, face, shoulders, arms and forehead, and the scalp if bald.
Skin whitening, also known as skin lightening and skin bleaching, is the practice of using chemical substances in an attempt to lighten the skin or provide an even skin color by reducing the melanin concentration in the skin. Several chemicals have been shown to be effective in skin whitening, while some have proven to be toxic or have questionable safety profiles. This includes mercury compounds which may cause neurological problems and kidney problems.
beta-Arbutin, also known as β-arbutin or by its International Nomenclature of Cosmetic Ingredients (INCI) name, arbutin, is a glycosylated derivative of hydroquinone. β-Arbutin is naturally present in the leaves and bark of a variety of plants, notably the bearberry plant, Arctostaphylos uva-ursi. Utilized as a biosynthetic active ingredient in topical treatments for skin lightening, β-arbutin is aimed at addressing hyperpigmentation issues. Its mechanism of action involves inhibiting the activity of tyrosinase, an essential enzyme for melanin synthesis in the human skin, thereby leading to a reduction in hyperpigmentation. It is important to distinguish β-arbutin from its structurally similar stereoisomer, α-arbutin, which exhibits similar effects in clinical applications.
Pigmentation disorders are disturbances of human skin color. There may be a loss or reduction, which may be related to loss of melanocytes or the inability of melanocytes to produce melanin or transport melanosomes correctly.
Periorbital hyperpigmentation, also known as hereditary dark circles, is characterized by darker skin around the eyes caused by the presence of additional melanin. It is an extremely common hereditary human characteristic and is frequently found on individuals with dark skin. Periorbital hyperpigmentation is most prevalent within the 16–25 age group.
Postinflammatory hypopigmentation is a cutaneous condition characterized by decreased pigment in the skin following inflammation of the skin.
Oral pigmentation is asymptomatic and does not usually cause any alteration to the texture or thickness of the affected area. The colour can be uniform or speckled and can appear solitary or as multiple lesions. Depending on the site, depth, and quantity of pigment, the appearance can vary considerably.
Glyceryl octyl ascorbic acid (GO-VC) is an amphipathic derivative of vitamin C consisting of two ether linkages: a 1-octyl at position 2 and a glycerin at position 3. The chemical name is 2-glyceryl-3-octyl ascorbic acid. The isomer in which these two groups are swapped is also known.
Postinflammatory hyperpigmentation (PIH) is a skin condition characterized by the darkening of the skin (hyperpigmentation) following an inflammatory injury, such as acne, dermatitis, infectious disease, or trauma. Less frequently, it may occur as a complication of a medical procedure performed on the skin. It is a common cause of skin discoloration and can affect individuals of all skin types.
alpha-Arbutin, or α-arbutin, is a glycosylated hydroquinone, and an anomer of the naturally occurring arbutin. α-Arbutin is used in the cosmetic and pharmaceutical industries for its skin lightening effects, treatment of hyperpigmentation, and as a safer alternative to hydroquinone.