Physiological and lifestyle factors contributing to risk and severity of peri-orbital dark circles in the Brazilian population

Abstract

Background: Peri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.

Objective: To compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.

Methods: Subjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.

Results: Family history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ΔL*and ΔE* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.

Conclusion: Although typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.

FIGURE 1

Distribution of Fitzpatrick skin types of all subjects

FIGURE 2

A-D Spectral imaging values for melanin, oxygenated blood, and dermal scattering taken from under the eye and from the cheek. M = melanin, B = blood volume, S = hemoglobin oxygen saturation and D = dermal scattering factor. The within-subject difference between readings for the under-eye area and the cheek area is indicated by ∆. The volume fraction amounts of melanin (M), the average volume fraction of whole blood (150g Hb/ liter) (B), the oxygen saturation of the blood (S) and the dermal scattering coeffi cient (D) were evaluated