Causes, Prevention, and Treatment
Periocular discoloration usually means the dark circles affecting the tissues surrounding the eyes, but it is completely subjective, not fixed. Many causes such as genetics and lack of sleep lead to changes in the colors of the tissues surrounding the eyes.
Figure 1 – Commonly called dark circles these are regions of skin discolouration, typically caused by fluid buildup and poor sleep hygiene.
Why Does Periocular Discoloration Affect Facial Aesthetic?
People with periocular discoloration usually look exhausted and older. Not all dark circles are black, some circles are dark brown, blue, and sometimes purple. Some people love their periocular discoloration while others do not like them and seek to reduce their appearance and get rid of them for cosmetic purposes.
What Causes Periocular Discoloration?
Not all dark circles are dark brown. The color of your dark circles can help you in determining the best treatment options for them.
Purple Periocular Discoloration
If you have this type of under-eye circles, it means that your skin is medium-dark to dark and you have a genetic predisposition for this type of dark circles. Pigmentations can also cause this type of under-eye circles. (1)
Blue Periocular Discoloration
The most common causes of this type of under-eye circles are lack of sleep and sedentary and stressful lifestyles. In addition, if you are allergic to certain substances, your allergies can worsen the appearance of these dark circles by adding a bluish discoloration to them. (2)
Brown Periocular Discoloration
Brown dark circles are a characteristic feature of aging and genetic predispositions. When they affect fair-skinned people, their translucent skin can show the blood vessels in this sensitive area, which is cosmetically unattractive. (3)
Shadowed Periocular Discoloration
When you lose weight rapidly, a groove is created under your eyes due to the loss of the fats in this area. These grooves make your eyes sunken, which leads to the appearance of shadowed periocular discoloration. (4)
Other Risk Factors
1. Nonwhite Ethnicity
The periocular discoloration is more common in people with darker skin than others due to the changes in pigmentations and concentration of melanin. (5)
2. Genetic Predisposition
If periocular discoloration runs in your family, you will probably develop colored circles under your eyes at a certain point in your life. (6)
How To Prevent Periocular Discoloration?
Many ways can reduce and even eliminate the appearance of periocular discoloration. Please notice that what works for you may not work for others.
Get Enough Sleep
Lack of sleep and chronic fatigue are associated with the appearance of dark periocular discoloration. If you have pale skin, dark circles make you appear paler. Get 7 to 8 hours of sleep each night to get rid of these dark circles if they are due to lack of sleep and stress. (7)
Elevate Your Head
Before sleeping, put an extra pillow under your head to elevate it. This elevation reduces the appearance of puffiness due to fluid retention in the lower eyelids. Under-eye bags worsen the appearance of dark circles and make them more prominent. (8)
When the blood vessels under the eyes become dilated, they worsen the appearance of dark circles. Applying cold compresses constrict the blood vessels in the area under the eyes, which decreases the appearance of dark circles in the long run.
Reduce Sun Exposure
Use sunglasses to reduce the exposure of the area under your eyes to UV rays and sunlight.
Some high-quality over the counter moisturizers can eliminate dark circles and other periocular discolorations. The best moisturizers usually contain caffeine, aloe vera, retinol, vitamin C, and/or hyaluronic acid.
Thick slices of cucumbers can be beneficial for periocular discoloration, especially bluish. Apply the slices on your eyes for 10 minutes and rinse with water. It is recommended to repeat this treatment twice per day for the best results.
Almond Oil and vitamin E Mixture
This mixture is potent and has many healing benefits. It is recommended to apply this mixture to your face before going to sleep each night and then rinsing it with cold water in the morning for the best results. It removes dark circles and exfoliates skin pores.
Vitamin K and Caffeine Mixture
Studies show that applying a mixture of caffeine and vitamin K around the eyes can reduce the appearance of wrinkles and fine lines significantly.
Put caffeinated tea in warm water, then put them in the refrigerator for a few minutes to lower their temperature. After that, place them on your eyes for a few minutes and then rinse with water. Caffeine can reduce the appearance of fine lines and wrinkles and tighten the skin under the eyes.
Figure 2 – (a) Before and (b) after peel. Marked improvement of dark circles.
How to Treat Periocular Discoloration?
Many ways are available for treating periocular discoloration. However, you should choose the best way for your condition since not all methods work for everyone.
Your dermatologist may recommend using a skin-lightening cream containing azelaic acid, glycolic acid, or hydroquinone. Most of them are over-the-counter creams, but it is better to consult your doctor before trying any of them. (9, 10)
Periocular discoloration usually results from damaged cells by oxidative stress. Laser treatments can target these damaged cells and their darker pigments and vaporize them using heat energy. Lasers can lighten darker skin areas and stimulate the formation of new collagen. (11, 12)
Your dermatologist may recommend the use of chemical peels to lighten periocular discoloration and remove dark circles. Chemical peels usually use retinoic acid, hydroquinone, and/or glycolic acid to lighten any skin area. Some dermatologists use a combination of the previous substances such as lactic acid, salicylic acid, and resorcinol. (13)
If dark circles result from the accumulation of fat in the lower eyelid, blepharoplasty can be the solution. When the fat in the lower eyelid is removed, the shadow cast by the eyelid decreases, which decreases the appearance of dark circles. (14)
If your periocular discoloration results from volume loss under the eyes, fillers can be the best solution. They compensate for the volume loss, which will lead to the disappearance of dark circles.
The best dermal fillers for periocular discoloration are Restylane or Juvederm. They are hyaluronic acid-based fillers and can compensate for the volume loss and tighten the skin significantly. (15)
Figure 3 – Patient treated for dark circles with Volbella filler. (a) Baseline clinical picture taken before treatment, (b) after a month, and (c) after 6 months. Improvement in dark circles and tear trough deformity is seen along with sustained results up to 6 months
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