There are numerous therapeutic techniques for periorbital hyperpigmentation. In a comparative intrapatient study in which 32 patients have been enrolled, the effectiveness of combination therapy which included fractional Er: YAG laser and autologous platelet-rich plasma (PRP) has been compared to Er: YAG laser in left and right periorbital sides for hyperpigmentation treatment. 

Er:YAG laser is a flashlamp-excited system that secretes light at an imperceptible infrared wavelength of 2940 nm. The Er:YAG laser produces a pulse of 250-350 microseconds that is less than the thermal reduction time of the skin, which is 1 msec.

The right periorbital sides of patients received combination of Er: YAG laser and autologous PRP and the left side received Er: YAG laser (3 sessions with 4 weeks intervals).

The use of PRP was done in two ways which included injection and topical. Evaluation of patients was done biometric characteristics, patients and physician assessments. The satisfaction of patient’s was also assessed and the evaluation of their side effects was also done.  

Significant reduction in the melanin content in the right side of the periorbital of the patients was observed when results were obtained from mexameter. As compared to that of the left side

Also significant increase was observed in the skin lightness of the right side in compare to left.

From the visioface results it was observed that the percent change of the colour and wrinkle in right side was more than the left side. The patients and physician assessment confirmed the measured results. Combination of Er: YAG laser and PRP are significantly effective for periorbital hyperpigmentation.

Source: J Cosmet Dermatol, 2021 Feb 27