Infraorbital dark circles: A review of the pathogenesis, evaluation and treatment

Vrcek, Ivan; Ozgur, Omar; Nakra, Tanuj

doi:10.4103/0974-2077.184046

Cited by 68 publications

(39 citation statements)

References 50 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PDCs have a multifactorial pathogenesis, stemming from a variety of factors, both physiologic and pathologic. Reports agree that individual differences in anatomic structure, such as bony, ligamentous, subcutaneous, vascular, dermal, and epidermal architecture as well as pigmentation are the underlying cause for most PDCs 1 3 7 . Classically, PDCs have a perceived association with lack of sleep, cigarette smoking, and stress, although these associations have not been validated 8 9 .…”

Section: Introductionmentioning

confidence: 97%

“…Periocular dark circles (PDCs) are a common cosmetic complaint. PDCs contribute to an appearance of fatigue, play a role in perceived age 1 2 3 , affecting emotional well-being and overall quality of life 1 2 3 4 . While prevalence studies are scarce, the impact of PDCs is reflected in the cosmetic industry where under eye concealers comprise a large portion of the market 5 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Periocular Dark Circles: Correlates of Severity

Lim¹,

Fischer

Sung

et al. 2021

Ann Dermatol

View full text Add to dashboard Cite

Background Periocular dark circles (PDCs) are a common cosmetic complaint. Grading systems based on objective measures have been used but no standard system is in place. Objective To determine factors associated with subjective and objective PDC severity. Methods Enrolled patients (n=100) completed a questionnaire comprised of demographic variables, medical history, and self-perception of PDC. Those perceiving PDC graded dissatisfaction on a 10-point scale. Clinical severity (grades 0~4) and subtype (constitutional, post-inflammatory, vascular, shadow effects, or others) were determined. A Konica Minolta CR-400 chromameter was used to obtain colorimetry measurements (L * a * b * values). The objective average difference in darkness (ΔL * ) between the periocular region and the cheek was determined. Comparisons were made using Spearman correlation coefficients (r). Results Patient dissatisfaction correlated with both clinical severity (r=0.46, p <0.001) and the ΔL * by colorimetry (r=0.35, p =0.004). Factors associated with subjective dissatisfaction were female sex (r=0.38, p =0.002), higher Fitzpatrick skin type (r=0.42, p =0.001), fewer hours of sleep (r=−0.28, p =0.03), and use of concealer (r=0.35, p =0.004). Factors associated with objective measures were higher Fitzpatrick skin type (r=0.36, p =0.0007 and r=0.28, p =0.009, respectively), family history of PDC (r=0.34, p <0.001 and r=0.20, p =0.05), and history of eczema (r=0.45, p <0.001 and r=0.20, p =0.0504). Clinical severity grading correlated with colorimetric severity (r=0.36, p =0.0003). Conclusion Overall, subjective dissatisfaction was associated with clinical severity. However, factors associated with subjective severity did not necessarily overlap with factors associated with objective severity. These findings highlight the importance of patient-reported grading. There may be added value in incorporating a component of subjective grading into the traditionally objective PDC grading scales.

show abstract

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Periocular Dark Circles: Correlates of Severity

Lim¹,

Fischer

Sung

et al. 2021

Ann Dermatol

View full text Add to dashboard Cite

show abstract

“…In addition, the eye-lids have the thinnest skin of the face, and the bone structure and contour of the eye socket can lead to shadowing effects around the eye. 1,12,13 In view of all these various factors, dark circles are difficult to characterize and measure. While many articles detail the origins and triggers of dark circles, there are only a few that describe how to assess and characterize them.…”

Section: Introductionmentioning

confidence: 99%

<p>Identification Of Three Key Factors Contributing To The Aetiology Of Dark Circles By Clinical And Instrumental Assessments Of The Infraorbital Region</p>

Mac-Mary¹,

Solinis

Predine³

et al. 2019

CCID

View full text Add to dashboard Cite

Background: The aetiology of infraorbital dark circles is complex and multi-factorial. The aim of this research was to measure and characterize dark circles and to determine the physiological changes associated with the occurrence of this aesthetically unpleasing issue. Materials and methods: Clinical, photographic and instrumental assessments were performed on Caucasian skin to determine the most appropriate methodologies to measure dark circles, comparing different zones of the infraorbital region in subjects with and without dark circles. Exploratory studies were also carried out on African and Far East Asian skin, as well as on tracking the natural variation of dark circles over seven days in Caucasian subjects. Results: Under-eye dark circles in Caucasian subjects are characterized by significantly darker coloured skin and higher colour deviations between the dark circle region and surrounding areas of skin. Multispectral image analysis produced a higher melanin index in subjects with dark circles, suggesting hyperpigmentation in the affected area, in addition to a higher haemoglobin index. The higher haemoglobin index, combined with preliminary assessments of the vascular network by videocapillaroscopy, suggests there may be more dilated, thicker or increased numbers of capillaries in subjects with dark circles. Ultrasound analysis showed a significant difference in skin thickness between the two groups of subjects linking the appearance of dark circles to thinner skin under the eye. Many of these trends were also observed in African and Far East Asian skin. The results also showed intra-individual, intra-day and inter-day variability of dark circle intensity in subjects with Caucasian skin. Conclusion: Three key physiological factors associated with the occurrence of infraorbital dark circles are hyperpigmentation, a tendency for more dilated, thicker or increased number of capillaries and thinner skin in the under-eye area. The combination of these three factors provides a robust indication of the presence of infraorbital dark circles.

show abstract

“…Although multifactorial, the main treatment options must be directed to the most probable cause of the malignancy. After cosmetic and cosmeceuticals, one must always try with the least invasive method such as intense pulsed light or superficial peelings ( Vrcek et al, 2016 ). Permanent eyelid tattoos ( Fig.…”

Section: Miscellaneousmentioning

confidence: 99%