Classification and characteristics of periorbital hyperpigmentation

Abstract

Introduction: Periorbital hyperpigmentation (POH) is among the commonest esthetic and dermatological complaints. Despite its frequency, there are inadequate information detailing its incidence and prevalence. This subsequently leads to lack of comprehensive POH classification and stratification of impact on an individual's general well-being. Malaysia, a multiracial country with an expansive expatriate population, provides a unique opportunity to identify demographics of POH and subsequently attempts to group this esthetic and dermatological entity. Objective: This study aims to develop a new and clinically relevant POH classification system and to measure impact on quality of life of POH individuals. Methods: One hundred patients with POH were enrolled, of which all underwent clinical assessment by a clinician. Objective assessment with mexameter and digital analysis were performed. All recruited patients also completed a questionnaire based on dermatology life quality index (DLQI). Results: Assessments noted the commonest type of POH among the subjects was vascular (51%) with the least being pigmentary (6%). The location of POH majority involved both the upper and lower eyelids (65%). DLQI scoring shows that a majority (58%) did not disrupt their quality of life. Conclusion: Vascular type POH was the frequent most form observed, and involvement tends to occur on both eyelids. A majority of noted that POH does not affect they QOL, but the due consideration must be given in those whom are moderately and minimally affected. A thorough and comprehensive holistic approach is required in managing POH despite its focal presentation as it does affect a patient's quality of life.

Establishment of visual assessment for the severity of dark circles in Chinese Han women

“…Besides, the mixed type, which is a combination of vascular and pigmented type, is also common among woman consumers 10 . This type is frequent in Chinese population only secondary to vascular type 8 . Considering its multifactorial etiology and high prevalence, we are making effort to explore further the characteristics of mixed type of dark circle with larger sample size in order to optimize this visual assessment scale.…”

“…They also complained of dissatisfaction with their facial appearance, fatigue, and insomnia. Lack of sleep was reported to be the major factor to dark circle in Asian population 8 . Besides, stress or anxious, emotional liability, and aging can play a significant role in developing dark circles 8,9 .…”

“…It is reported the distribution of dark circle types varied among countries. Among Chinese population, vascular type with lighter skin (type I‐IV) is more frequent compared with other Asian population 4,8 . Pigmented type is another common type owing to excessive pigmentation under eyes in Asian population.…”

“…It presents irregular patches of brownish or gray pigmentation on the eyelids as a result of color transmission of gray or blue‐gray melanocytoses through the dermis 4,6 . Structural type of dark circle especially with tear trough is prevalent throughout 3 races in Asia, including Chinese, Malays, and Indians but less occurred among Chinese population 8 . It is caused by shadowing which could be either tear trough or caused by skin laxity, puffy, or the overlying pseudoherniation of the infraorbital fat 1,11 .…”

Periorbital Hyperpigmentation—Dark Circles under the Eyes; Treatment Suggestions and Combining Procedures

“…In a Korean study of 100 patients with POH, vascular-type (35%) and mixed-type (54%) dominated [13]. A Malaysian study identified the vascular type as the major one (51%), while the pigmentary type was the least common with 6% [14]. A study from India reported constitutional (51.5%) and post-inflammatory (22.5%) POH types as the commonest [8].…”