A recent article published in Clinical and Aesthetic Dermatology reported that periorbital hyperpigmentation (POH) is a commonly encountered condition. However, scientific data on the clinical profile and pathogenesis of periorbital hyperpigmentation is scarce. Various exogenous and endogenous factors contribute to the development of POH. The etiological factors include – genetic or heredity, excessive pigmentation, post-inflammatory hyperpigmentation (PIH) secondary to atopic and allergic contact dermatitis, periorbital edema, excessive vascularity, shadowing due to skin laxity and tear trough associated with aging. 

The authors discussed alternative treatment options available for POH or dark circles as this condition is less responsive to standard therapies, owing to its multifactorial etiology and deposition of melanin in both dermis and epidermis. These include – topical phytonutrients depigmenting agents, topical retinoic acid; and physical therapies, such as chemical peels, surgical corrections and laser therapy, most of which are tried scientifically for melasma. 

This article stated that the aim of treatment should be to identify and treat the primary cause of hyperpigmentation, as well as its contributing factors. Even minor skin lightening effects can improve the quality of life of the patients, hence, topical therapies and simple techniques, such as chemical peels may be employed. 

Source: Clinical and Aesthetic Dermatology. 2016 Jan; 9(1): 49–55. Published online 2016 Jan 1.