Surely you're familiar with dark circles, infamous for cropping up after a restless night. To prevent them, there's a strong chance you slather on eye cream and go through under eye patches like it's your job. But, if all of that work is to no avail, you could be dealing with under eye hyperpigmentation, which may require robust means of treatment — likely at the hands of a board certified dermatologist or plastic surgeon.
Under eye hyperpigmentation refers to discoloration of the under eye area, particularly excess pigment that's darker (usually dark brown or tan) than the surrounding skin, says Marisa Garshick, MD, a New York City-based board certified dermatologist. Medically referred to as periorbital hyperpigmentation (POH), these darkened skin patches result from an increase in melanin production due to anything from sun exposure to genetics.
If you are underwhelmed by your current under eye treatments, it might be because you are trying to correct the wrong concern. Ahead, we break down the difference between traditional dark circles and under eye pigmentation, what causes the latter, and how you can treat it with the insight of three leading dermatologists.
What Causes Hyperpigmentation Under the Eyes?
Many factors can cause hyperpigmentation (a.k.a. pigmented dark circles) under the eye, ranging from uncontrollable factors like genetics or allergies to controllable ones like sun exposure and excessive eye rubbing. Determining what's causing your dark circles will help ensure the best course of treatment — because treating hyperpigmentation isn't one-size-fits-all.
One common cause of under eye hyperpigmentation is “sun damage over time,” Dr. Garshick says. Because the eye area is so “thin and delicate,” excess pigment “can give the overall appearance of darkness under the eyes,” she adds. The simplest way to prevent it? Double down on your sunscreen routine. We’ll use this as yet another chance to remind you that you should be using a minimum of SPF 30 every single day. While you can simply take your go-to face formula (here are some dermatologist favorites) up the lower lid, there are eye-specific formulas that are less likely to cause irritation. We’re fans of the SkinCeuticals Physical Eye UV Defense SPF 50.
But UV rays aren’t the only culprit. “What can also occur is some people can experience something known as post-inflammatory hyperpigmentation (PIH),” Dr. Garshick explains. PIH can occur any time the skin experiences inflammation or irritation. As it resolves, it heals with some discoloration. This is particularly common in individuals prone to chronic eye rubbing, skin allergies, and/or eczema around the eyes, says Joshua Zeichner, MD, a board certified dermatologist in NYC.
Who Is Most Prone to Under Eye Hyperpigmentation?
Under eye hyperpigmentation is more common in darker, melanin-rich skin tones, says Corey L. Hartman, MD, a board certified dermatologist in Birmingham, Alabama. Why? ‘If you don't have that much pigment to begin with, then you can't really have melanin dropping into the dermis, causing discoloration,” he explains. “But, if you do and those cells get damaged, it deposits into the dermis.” That's how hyperpigmentation develops.
Even so, Dr. Zeichner still deems it “very common” across all skin tones and ages. Interestingly, he observed an increase in patients concerned about under eye hyperpigmentation amid the COVID-19 pandemic. “Now that people are wearing masks and are covering the lower face, they have become fixated on the upper face,” he explains.
How Do You Distinguish Dark Circles From Hyperpigmentation?
The best way to diagnose the cause of your dark circles and develop a treatment plan is a consultation with a board certified dermatologist. But, if you're unsure about whether your dark circles are a shadow or true hyperpigmentation, Dr. Zeichner recommends the following at-home test: “Go into the bathroom or another very well-lit area with forward-facing light and a mirror. Directly facing the light, take your thumb and index finger and gently pull the skin out towards the mirror. If the pigmentation in the skin improves, then it's a shadow. If, when you pull the skin away, it remains, it is true pigmentation.”
If this test shows that your skin isn’t actually discolored, you probably aren’t dealing with hyperpigmentation. Instead, it’s probably a shadow effect creating the appearance of dark circles due to volume loss, or, because the skin under the eyes is thinner, the darkening you’re seeing may be due to your “blood vessels peeking through,” Dr. Garshick notes. This is usually the case when the dark circle “doesn't necessarily look tan or brown, but has more of a purple or blue hue,” she says.
How to Treat Hyperpigmentation Under the Eyes
Now that you know what causes pigmentation under the eyes to develop, it’s time to talk about how to treat it. As we mentioned, your go-to eye cream or patches may not do the trick, as most are formulated to address puffiness, crepey skin, or blue-tinted circles. But that’s not to say there aren’t both at-home and in-office treatment options.
Skincare Ingredients That Address Under Eye Pigmentation
When shopping for over-the-counter eye treatments to target hyperpigmentation, brightening and lightening ingredients are the name of the game. With that in mind, Dr. Zeichner recommends looking for products with vitamin C, which “helps block the production of abnormal pigment,” and retinol, “which enhances cell turnover and therefore helps the skin shed cells that are darkly pigmented.” Dr. Gatrshick is a fan of kojic acid, licorice root, and niacinamide, while Dr. Hartman recommends hydroquinone, cysteamine, and tranexamic acid.
These are all powerhouse pigmentation-fighting actives, but they can do more harm than good if not used properly. Dr. Hartman warns ingredients that can be very effective in treating the under eye area can also be irritating (and said irritation can lead to PIH). That's why it's important to use an under eye specific formula, and not “the same thing you're using on the rest of your face.” The skin of the face has oil glands, "which can help withstand the side effects of some of active ingredients.” The under eye area – you guessed it – does not have sebaceous glands.
Whenever you start a new product, keep in mind that patience is necessary and consistency is key. It’s important to know that OTC formulations aren’t for everyone and offer “limited benefits in severe cases” that require in-office intervention, Dr. Zeichner cautions. For most, a multi-modal approach will be needed. Consider this analogy: “Think of an in-office treatment like getting a personal trainer, and think of your eye creams as going to the gym every day,” he says. “It's important to do both for the best outcomes.” That leads us to…
In-Office Treatments for Under Eye Pigmentation
If hard-working skincare isn’t enough, your dermatologist or plastic surgeon may recommend one (or more!) of the following courses of treatments.
- Under Eye Filler: If volume loss is part of the reason for your dark circles, Dr. Hartman recommends under eye filler, which helps reduce shadowing. Those commonly used in this area are hyaluronic acid-based products like Juvéderm® and Restylane®.
- Chemical Peels: Dr. Garshick explains that chemical peels can make great strides in improving discoloration. Certain types, such as a TCA peel or glycolic peel, can be specially designed for the eye area. “While you can see benefits from just one peel, the more you do, often the better the result,” the pro says, noting that you’ll want to wait “three to six weeks in between treatments.” She emphasizes that it is “especially important to go to someone you trust to minimize any potential side effects and ensure a proper concentration is used.”
- Platelet-Rich Plasma (PRP): Like dermal fillers, injections of blood-derived PRP can increase volume under the eye area, and it's also been shown to improve the appearance of dark circles. Alternatively, the combination of microneedling with PRP in the under eye area can help with both “skin quality as well as hyperpigmentation,” Dr. Garshick says. It's a good choice for those experiencing texture conditions like crepiness, she adds.
- Laser Treatments: Lasers reduce hyperpigmentation by “targeting a specific pigment in the skin and destroying it,” Dr. Zeichner says. Depending on your needs, your provider may recommend anything from intense pulse light (IPL) to fractional lasers. Know that, “after a laser, [the hyperpigmentation] may look worse before it looks better because it needs to heal from the treatment,” he shares. It varies by laser, but the healing process usually takes one to two weeks. “In some cases, multiple laser treatments may be necessary to achieve optimal results – especially in more severe cases,” Dr. Zeichner notes.
Keep in mind that many patients require more than one treatment modality to see results, Dr. Hartman says. For example, “if you have volume loss and hyperpigmentation in the skin, I could give you fade cream or do laser,” he shares. “But, until you correct the volume, you're still going to have a shadow.”
Several factors can contribute to under eye hyperpigmentation, so the best course of action is to consult your dermatologist or plastic surgeon for a personalized treatment plan. We get it: Scooping up a new skincare product is exciting, but consulting with a professional will take all of the guesswork — and stress — out of the process.
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