Ann Dermatol.  2018 Oct;30(5):522-528. 10.5021/ad.2018.30.5.522.

Treatments of Infra-Orbital Dark Circles by Various Etiologies

• Park KY
• Kwon HJ
• Youn CS
• Seo SJ
• Kim MN

• KMID: 2419740
• DOI: http://doi.org/10.5021/ad.2018.30.5.522

Abstract

Dark circles refer to visible darkness of the infra-orbital areas. Dark circles are a cosmetic concern for many individuals, although not a medical concern. Moreover, clear definitions and possible causes of dark circles have not been elucidated. This study reviews the possible causes and treatment options for dark circles based on a review of the medical literature and the authors' clinical experience. Potential factors that contribute to dark circles include excessive pigmentation, shadowing due to tear troughs and infra-orbital fat herniation, shadowing due to infraorbital laxity and wrinkles, and thin, translucent skin overlying the orbicularis oculi muscle. Given the different possible causes for dark circles, therapeutic modalities must be individualized for each patient. Because various factors cause dark circles, it is useful to identify the underlying causes in order to select the appropriate treatment.

Keyword

Dark circles; Etiology; Infra-orbital darkness; Treatment options

MeSH Terms

Darkness
Humans
Pigmentation
Shadowing (Histology)
Skin
Tears

Figure

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  Fig. 1 Infraorbital darkness due to excessive pigmentation. (A) Chronic rubbing-induced postinflammatory hyperpigmentation in an atopic dermatitis patient. (B) Post-purpuric pigmentation around the eyes after two-jaw surgery. We received the patient's consent form about publishing all photographic materials.

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  Fig. 2 Infraorbital dark circles due to a deep tear trough.

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  Fig. 3 Infraorbital darkness due to fat herniation.

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  Fig. 4 Dark circles caused by wrinkles and skin laxity.

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  Fig. 5 (A, C) Dark circles due to both tear troughs and malar retraction. (B, D) Improvement in dark circles with correction of tear troughs and mid-facial depressions with hyaluronic acid filler. Dotted lines indicate the contour of the anteromedial cheek.

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  Fig. 6 Five injection zones for correction of tear troughs.

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  Fig. 7 (A) Dark circles with tear troughs and wrinkled infraorbital fat bulge. (B) Improvement using a linear tread technique with an hyaluronic acid filler.

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  Fig. 8 (A) Dark circles with thin and wrinkled infraorbital skin (B) one day after intradermal long-chain polynucleotide filler injection.

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