Periorbital hyperpigmentation (POH) holds esthetic concern for patients. The conditions etiology includes pigmentary, structural, vascular and mixed causes.

The present study systematically reviewed the current literature for the treatment of POH by searching PubMed with relevant keywords.

The study observed:

• Inclusion of 39 studies. 
• Lasers, topical creams and serums, fillers, chemical peels, carboxytherapy, plasma-rich platelet injections, blepharoplasty and normobaric oxygen are the effective treatments for POH.

The study highlighted:

• Soft tissue fillers and autologous fat grafting are the most effective means for treating dark circles resulting from volume loss. 
• Blepharoplasty surgery is most useful when excessive skin laxity is the underlying cause. 
• Various topical creams and chemical peels can effectively treat pigment-based POH, while lasers are mild to moderately beneficial for both vascular and pigment types. 
• Given the scarcity of high-quality evidence backing these results, it is essential to interpret recommendations selectively. 
• It would be helpful to conduct additional randomized clinical trials on POH.

Source: Michelle L, Pouldar Foulad D, Ekelem C, et al. Treatments of periorbital hyperpigmentation: a systematic review. Dermatol Surg. 2021;47(1):70-4.