:Periorbital dark circles

Bony structure and prominence of the orbicularis oculi muscle can contribute to infraorbital dark circles.{{cite journal | vauthors=Vrcek I, Ozgur O, Nakra T | title=Infraorbital Dark Circles: A Review of the Pathogenesis, Evaluation and Treatment | journal= Journal of Cutaneous and Aesthetic Surgery | volume=9 | issue=2 | pages=65–72 | year=2016 | doi= 10.4103/0974-2077.184046 | pmc=4924417 | pmid = 27398005 | doi-access=free }}{{cite journal | vauthors=Friedmann DP, Goldman MP | title=Dark circles: etiology and management options | journal= Clinics in Plastic Surgery | volume=42 | issue=1 | pages=33–50 | year=2015 | doi= 10.1016/j.cps.2014.08.007 | pmid = 25440739}} Skin in the lower eyelid is very thin which accentuates subdermal features.

Any condition that causes the eyes to itch can contribute to darker circles due to rubbing or scratching the skin around them. Hay fever sufferers in particular will notice under-eye "smudges" during the height of the allergy season. Atopy can lead to frequent rubbing of the eyes, leading to local inflammation and increased pigmentation.{{cite journal | vauthors=Mendiratta V, Rana S, Jassi R, Chander R | title=Study of Causative Factors and Clinical Patterns of Periorbital Pigmentation | journal= Indian Dermatology Online Journal | volume=10 | issue=3 | pages=293–295 | year=2019 | doi= 10.4103/idoj.IDOJ_158_18 | pmc=6536080 | pmid = 31149574 | doi-access=free }}

Also, dark circles from allergies are caused by superficial venous congestion{{Cite journal|last=Murdoch|first=Marshall|date=2016-11-02|title=Dark circles in the periorbital region: diagnosis and treatment options|url=https://www.magonlinelibrary.com/doi/abs/10.12968/joan.2016.5.9.431|journal=Journal of Aesthetic Nursing|volume=5|issue=9|pages=431–435|doi=10.12968/joan.2016.5.9.431|issn=2050-3717|url-access=subscription}} in the capillaries under the eyes.

Any medications that cause blood vessels to dilate can cause circles under the eyes to darken. The skin under the eyes is very delicate, any increased blood flow shows through the skin.

When cortisol is deficient the pituitary compensates by producing excess adrenocorticotropic hormone (ACTH) and melanocyte-stimulating hormone (MSH), the latter resulting in dark circles under the eyes.{{cite journal | vauthors=Slominski A, Tobin DJ, Shibahara S, Wortsman J | title=Melanin pigmentation in mammalian skin and its hormonal regulation | journal= Physiological Reviews | volume=84 | issue=4 | pages=1155–1228 | year=2004 | doi= 10.1152/physrev.00044.2003 | pmid = 15383650}}

The lack of nutrients in the diet, or the lack of a balanced diet, can contribute to the discoloration of the area under the eyes. It is believed that iron deficiency and vitamin B₁₂ deficiency can cause dark circles as well.{{Cite web|title=Why Do I Have Dark Circles Under My Eyes|url=https://www.superpharmacy.com.au/blog/why-do-i-have-dark-circles-under-my-eyes|access-date=2021-12-30|website=www.superpharmacy.com.au}} Iron deficiency is the most common type of anemia and this condition is a sign that not enough oxygen is getting to the body tissues.

The skin can also become more pale during pregnancy and menstruation (due to lack of iron), allowing the underlying veins under the eyes to become more visible.

A lack of sleep and mental fatigue can cause paleness of the skin, allowing the blood underneath the skin to become more visible and appear bluer or darker.{{Cite web|url=http://www.medicinenet.com/dark_circles_under_the_eyes/symptoms.htm|title=Dark Circles Under the Eyes|last=|first=|date=2012-06-03|website=Medicine.net|access-date=2016-04-27}}{{cite web | url=https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/causes/sym-20050624 | title=Dark circles under eyes Causes | website=Mayo Clinic }}

Dark circles are likely to become more noticeable and permanent with age. This is because as people get older, their skin loses collagen, becoming thinner and more translucent. As facial fat descends and fat volume decreases, the somewhat inflexible ligaments can result in orbital rim and facial hollowing. Photoaging has similar effects. Hemoglobin breakdown products such as hemosiderin and biliverdin can leak from the vascular contributing to pigmentation changes.

Circles may also gradually begin to appear darker in one eye than the other as a result of some habitual facial expressions, such as an uneven smile.{{citation needed|date=February 2010}}

Sunlight causes the skin to produce more melanin, the pigment that darkens skin.{{Cite web|url=https://www.mayoclinic.org/symptoms/dark-circles-under-eyes/basics/definition/sym-20050624|title=Dark circles under eyes Causes|website=Mayo Clinic|language=en|access-date=2019-06-03}}

{{Main article|Periorbital hyperpigmentation}}

Periorbital hyperpigmentation occurs when more melanin produced around the eyes than is usual, giving them a darker color.{{Cite journal|last1=Mac-Mary|first1=Sophie|last2=Zornoza Solinis|first2=Itziar|last3=Predine|first3=Océane|last4=Sainthillier|first4=Jean-Marie|last5=Sladen|first5=Christelle|last6=Bell|first6=Mike|last7=O’Mahony|first7=Mark|date=2019-12-18|title=Identification Of Three Key Factors Contributing To The Aetiology Of Dark Circles By Clinical And Instrumental Assessments Of The Infraorbital Region|journal=Clinical, Cosmetic and Investigational Dermatology|volume=12|pages=919–929|doi=10.2147/CCID.S217956|issn=1178-7015|pmc=6927230|pmid=31908515 |doi-access=free }}

At one time, hydroquinone solution was often mixed in an oil-free moisturizer that acted like a skin bleach. However, the use of hydroquinone for skin whitening has been banned in European countries due to health concerns. In 2006, the United States Food and Drug Administration revoked its approval of hydroquinone for over the counter preparations, warning that it may cause cancer or have many other detrimental effects.{{Cite journal |last=Research |first=Center for Drug Evaluation and |date=May 10, 2022 |title=FDA works to protect consumers from potentially harmful OTC skin lightening products |url=https://www.fda.gov/drugs/drug-safety-and-availability/fda-works-protect-consumers-potentially-harmful-otc-skin-lightening-products |journal=FDA |language=en}} The use of hydroquinone skin-whitening products may be toxic, harmful, or lethal for humans.

Modern treatments include topical creams that are marketed for the condition. Various ingredients have been researched, developed and included in these creams. Specialist treatments including laser and intense pulsed light skin surgery can also be used.{{cite web|url=http://www.docshop.com/education/dermatology/skin-flaws/undereye-circles|title=Undereye Circles|access-date=2016-06-29}} Low-level laser therapy, autologous fat transplantation and hyaluronic acid fillers are also alternative treatment options.{{cite journal |last1=Alsaad |first1=SM |last2=Mikhail |first2=M |title=Periocular hyperpigmentation: a review of etiology and current treatment options. |journal=Journal of Drugs in Dermatology |date=February 2013 |volume=12 |issue=2 |pages=154–7 |pmid=23377386}}

In addition, many skin care ingredients can help in the form of eye creams. Caffeine is a potent vasoconstrictor that has been proven to improve the look of dark circles{{Cite journal|last1=Ohshima|first1=Hiroshi|last2=Mizukoshi|first2=Koji|last3=Oyobikawa|first3=Midori|last4=Matsumoto|first4=Katsuo|last5=Takiwaki|first5=Hirotsugu|last6=Kanto|first6=Hiromi|last7=Itoh|first7=Masatoshi|date=2009|title=Effects of vitamin C on dark circles of the lower eyelids: quantitative evaluation using image analysis and echogram|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0846.2009.00356.x|journal=Skin Research and Technology|language=en|volume=15|issue=2|pages=214–217|doi=10.1111/j.1600-0846.2009.00356.x|pmid=19626722|s2cid=22914681|issn=1600-0846|url-access=subscription}} by constricting, or tightening, the dilated vessels under eyes. Vitamin C can help brighten hyperpigmentation as well as thicken the dermal layer of skin which conceals dark circles.{{Cite journal|last1=Ohshima|first1=Hiroshi|last2=Mizukoshi|first2=Koji|last3=Oyobikawa|first3=Midori|last4=Matsumoto|first4=Katsuo|last5=Takiwaki|first5=Hirotsugu|last6=Kanto|first6=Hiromi|last7=Itoh|first7=Masatoshi|date=2009|title=Effects of vitamin C on dark circles of the lower eyelids: quantitative evaluation using image analysis and echogram|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0846.2009.00356.x|journal=Skin Research and Technology|language=en|volume=15|issue=2|pages=214–217|doi=10.1111/j.1600-0846.2009.00356.x|pmid=19626722|s2cid=22914681|issn=1600-0846|url-access=subscription}}

• Periorbital puffiness

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Category:Eye diseases

Category:Symptoms

Category:Periorbital conditions