Periorbital hyperpigmentation (POH), is a common condition encountered in dermatology practice. It is an ill-defined entity that presents as bilateral, round or semicircular homogenous brown or dark brown pigmented macules in the periocular region. This paper discusses POH in skin of colour and explores genetic, intrinsic and external causes, as well as clinical features. Diagnosis and management of POH are also covered in detail.
Despite there being a scarcity of data regarding the incidence and prevalence and reasonable aetiological explanation for POH, this paper discusses and offers very detailed solutions for classification, genetics, causes and available treatment options.
Using a wide range of clinical studies, comparisons and papers, the authors of this paper explain the different causes of POH in skin of colour. This is followed by a wide range of treatment options. The treatments are matched to the individual causes of POH, based on clinical studies. The causative factors include genetic or heredity, excessive pigmentation, post-inflammatory hyperpigmentation secondary to atopic and allergic contact dermatitis, periorbital oedema, excessive vascularity, shadowing due to skin laxity, and tear troughs associated with ageing.
There are a number of treatment options available for periorbital hyperpigmentation. Among the available alternatives to treat dark circles are topical depigmenting agents (such as hydroquinone, kojic acid, azelaic acid, and topical retinoic acid) and physical therapies (such as chemical peels, surgical corrections, and laser therapy), most of which are tried scientifically for melasma, another common condition of hyperpigmentation that occurs on the face. The aim of POH treatment should be to identify and treat the primary cause of hyperpigmentation as well as its contributing factors.