Periorbital Hyperpigmentation is Easy to Diagnose But It Is Not Easy to Cure

So much importance is put on the appearance of our skin and how aesthetically pleasing it appears to both ourselves and others. Often there is a perception regarding a person`s age and fatigue based on the appearance of the skin around the eye area. If the reason for having this appearance is because of POH then people with the condition might develop low self esteem which could affect their confidence and general contentment. It is not easy to cover up with make-up so the condition will be for the most time visible. Periobital hyperpigmentation is discolouration under the eyes and at times on the lid itself. The discolouration can be caused by many different conditions, one being constricted blood vessels in the orbital area. This can cause hyperpigmentation. While discolouration around the eye area can appear in all skin types. POH is often more common in darker skin colours and in aged people. Excessive pigmentation can also be due to postinflammatory hyperpigmentation secondary to atopic and allergic contact dermatitis and other skin conditions. It may also be drug induced, such as in the case of fixed drug eruptions and erythema dyschromium perstans. Periorbital hyperpigmentation may also be caused by rubbing and scratching of skin around the eyes and by accumulation of fluid due to allergies. POH usually progresses over time so early intervention and treatments are important to help control the condition. Histological characteristics of periorbital hyperpigmentation suggest that it can be both epidermal and dermal.

When we look at the etiology of POH there are so many possible causes:

• Genetics
• Inadequate sleep
• Post-inflammatory hyperpigmentation following atopic dermatitis
• Allergic contact dermatitis
• Lichen planus pigmentosus
• Erythema dyschromicum perstans
• Tear-trough depression
• Periorbital edema.

Clinically, POH is characterised by light-to dark-coloured, brownish-black pigmentation surrounding the eyelids.
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Yours in skin,

Gay Wardle