Physiological and lifestyle factors contributing to risk and severity of peri-orbital dark circles in the Brazilian population

Abstract

BACKGROUNDPeri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.OBJECTIVETo compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.METHODSSubjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.RESULTSFamily history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ∆L*and ∆E* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.CONCLUSIONAlthough typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.

Association between clinical characteristics, quality of life, and sleep quality in patients with periorbital hyperchromia

“…Only 25% of the individuals presented comorbidities regardless of whether or not they were associated with POH. Family history is one of the risk factors related to POH, and 73% of the patients presented other cases in relatives of first and second degree

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“…In addition, some factors related to life habits may also contribute to the development of POH, among them the stress. In the sample, most of the patients reported stress …”

“…Periorbital hyperchromia or periorbital hyperpigmentation, popularly known as dark circles, is a fairly common condition and a frequent reason for dermatological medical consultation . It is defined as brownish pigmentation, from light to dark, mainly involving the lower eyelids .…”

“…POH has a multifactorial etiology . It is estimated that several exogenous and endogenous factors are involved, the main mechanisms being melanin deposition, hemosiderotic pigment deposition caused by vascular ectasia and anatomical changes . Popularly, one of the possible associated causes is lack of sleep, but few studies have evaluated whether or not this hypothesis is appropriate.…”

Anin vivomodel for postinflammatory hyperpigmentation: an analysis of histological, spectroscopic, colorimetric and clinical traits

“…HSI measurements were used to determine melanin concentration 11,12 and data was normalized against adjacent normal skin. Table 2 shows the measured melanin content in acne-induced PIH and TCA-induced PIH along with that in adjacent normal skin.…”