Dark circles under eyes or periocular hyperpigmentation is a common cosmetic concern, especially in females.
Causes of Dark Circles:
The two common causes for dark circles are,
Other than the above, the pigmentary demarcation line can occur due to thin and lax skin, pronounced tear trough, post-inflammatory hyperpigmentation due to continuous rubbing of eyes in allergic conjunctivitis and atopic dermatitis and lack of adequate sleep, stress, etc.
Three different conditions contributing to dark circles are,
Aim of Dark Circle Treatment:
Chemical Peeling for Dark Circles:
Chemical peels act through exfoliation, abrasion and shedding of the superficial skin cells followed by remodeling without scarring. The most frequently used peels for dark circles are Arginine and Lactic acid peels. Argipeel is one of the readily available combination peels for dark circles. It contains Arginine (20%), Lactic acid (20%), Aloe vera (1%) and Allantoin (0.5%).
Other peels like Glycolic acid (15 to 20%) with Kojic acid also give good results. Counseling and post peel maintenance are very important in treating dark circles with a chemical peel. We may not get much satisfactory results as per the expectation of the patient, but combination of treatment modalities and lifestyle modification gives good results.
LASER Treatment for Dark Circles:
Q-switched ruby laser (QSRL) and ablative CO2 laser resurfacing can be used, but chance of post-inflammatory hyperpigmentation (PIH) is much more with a laser. Q-switched ruby laser and topical bleaching agents with Retinoic acid and Hydroquinone are considered effective for dark circles with low incidence of PIH.
Dark circles are a complex and challenging skin condition for both the dermatologist and the patient. The management is always a cocktail of treatments with consideration that shadowing and vascular effect are dealt with separately depending on the causes of dark circles.
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