Infraorbital Hyperpigmentation

Speaking about infraorbital hyperpigmentation and the therapeutic approach, Dr Uche Aniagwu, Founder, Dr Uche Tear Trough Academy, UK, brought forth an international perspective on its aetiology and treatment options as well as to look at the clinically proven topical therapeutic agents

Dr Uche started off by stating the difference between hyperpigmentation and discolouration. Hyperpigmentation is a result of the over production of melanin whereas pigmentation or discolouration is secondary to vascular permeability. The colour of skin plays a role in determining how hyperpigmentation affects the under eye area. In Asian and Black skin, there is a diffused darkening of skin, whereas in Caucasian skin, it is in freckle format and tends to follow the tear trough groove. For practitioners, it is important to diagnose hyperpigmentation correctly as it would determine the future course of action. A simple stretch test will enable this, wherein when you stretch the skin, you see no difference in the presentation of the discolouration.

Causes of infraorbital hyperpigmentation:

● Increase in dermal and epidermal melanocytosis

● Idiopathic

● Linked to family history

● Post-inflammatory

● Atopy leading to rubbing/scratching

● UV exposure

● Drugs such as Prostaglandin eye drops for glaucoma

Treatments advised by Dr Uche include targeted melanin production, topical treatments and mesotherapy injectables as well as laser and mid-deep chemical peels.

According to him, topical creams and serums are quite helpful as patients can use them at home and they are affordable, too.

He highlights the fact that since hyperpigmentation is the over production of

melanin, the logical step in its treatment is to target this production. Some ingredients that help in doing so include:

Arbutin

● Inhibits melanin production.

● 2-7 per cent concentrations.

● Plant extract.

● Concerns around rebound hyperpigmentation.

Kojic acid

●Inhibits tyrosine synthesis and is crucial for inhibiting melanin production.

●Temporary lightening.

Tretinoin

●It’s a retinoid. It also promotes collagen synthesis and inhibits melanocytosis.

Dr Uche also points out that infra-orbital hyperpigmentation is often accompanied with skin laxity or puffiness or other kinds of discolouration around the eyes. He further enlisted ingredients that will not work to treat this condition. They are as follows:

● Hyaluronic Acid Fillers

● Promote hydration and volume and impact shadows but do not work on hyperpigmentation

● Platelet Rich Plasma

● Radiofrequency

He recommends use of lasers and chemical peels. As per the typical time frames, you shall see the results within two weeks, reaching a full effect by 12 weeks.

As Dr Uche mentions: There are a host of treatments that tend to work in unison. If you are treating under eye concerns, you would normally recommend multiple methodologies including in-clinic treatments and at-home care.