Periorbital hyperpigmentation (POH) is an everyday dermatological condition that features a dark periorbital area beneath the lower eyelids and remains popular among females aged 16 to 45 years.

The present review included data from the studies conducted on patients with a clinical/histological POH or melasma diagnosis. 

• Many myriad topical depigmenting agents containing an array of naturally obtained actives like hyaluronic acid, lactic acid, lycopene, niacinamide, arabinoxylans, α-arbutin, retinol, asiaticoside, beta-carotene, azelaic acid, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, fucoxanthin, genistein, glabridin, b-glucogallin, d-glucoronic acid, dihydrochalcone, dipalmitoyl-hydroxyprolene, pycnogenol, salidroside and xymenynic acid have shown usefulness in managing POH. 
• A comprehensive literature search showed that other techniques like Q-switched ruby laser, blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, nitrogen plasma skin regeneration, medicated tattoo, fat transfer, micro-needling, chemical peels, intense pulsed light, and radiofrequency have also reported being beneficial in treating POH. 
• Topical depigmenting agents are the popularly reported method in the clinical management of POH. Of these, α-arbutin, caffeine, cyanidin-3-glucoside and dihydrochalcone exhibit noteworthy benefits. 
• Crossbreed products containing a combination of actives have been proven superior to single active-containing products. 
• Several topical actives have a role in the modulation of melanin and tyrosinase biosynthesis pathways concerning the complex pathophysiology of POH. 

Source: Sawant O, Khan T. Management of periorbital hyperpigmentation: an overview of nature-based agents and alternative approaches. Dermatol Ther. 2020;33(4):e13717.