Dark Circles Causes & Treatments (Part 4) - Pigmentation & Vascular Symptoms

Continuing from our previous article we will discuss the colour changes that can be responsible for dark circles and ways to combat them.
PigmentationSome people with dark skins ( Fitzpatrick types 4 to 6 ) inherit a genetic tendency for darker pigmentation around the eyes. This of course becomes obvious from a very early age even in childhood.
TreatmentThe famous ‘touch éclat’ is the make up of choice for many women as it creates a light reflection which counteracts the dark shadow along with camouflage make-up.
Some lasers can be very effective in particular the Ruby laser. Laser skin pigmentation treatment is particularly effective on Asian and Middle Eastern patients with dark brown circles due to excess pigment.
Skin bleaching agents such as Hydroquinone, retinoic acid, azelaic acid, alfa–hydroxy acids, kojic acid and trichloroacetic acid can be used to lighten the skin. Some of these preparations can be very strong and may provoke skin reactions. They should be used under doctor’s supervision only and can only be obtained on prescription. Decades ago the accepted treatment for bleaching skin lesions included products containing mercury salts. Their use is now prohibited because of their high toxicity. Hydrogen peroxide can also bleach melanin by oxidizing it, but because it can cause skin irritations it is mainly used for bleaching hair.
VascularThe skin of the lower eyelid is the thinnest in the face so it is not surprising that it can show the underlying blood vessels which could sometimes appear as a blue/ purple tinge. This is especially obvious in pale skinned individuals (Fitzpatrick skin types 1 and 2) but other skin types can also be affected. Another factor that determines the appearance is the density and the extent to which the blood vessels are dilated. The more closely packed and the more dilated the blood vessels are the redder the skin looks. The amount of oxygen in the blood is also important. High levels of oxygen in the blood makes the skin bright red while a low level of oxygen gives the skin a bluish colouration.
TreatmentCosmetic laser surgery. Lasers are used to help improve this condition and the pulsed dye lasers are especially effective. Bruising may result therefore the patient may have one to two weeks down time. If the vessels are very large they can be surgically removed.
In conclusion dark circles having once been considered untreatable can now be dramatically improved by advancements in aesthetic techniques. The good news is that in most patients this can be achieved without surgery.