Ep 56: Undereye Dark Circles- Causes & Treatment
Are dark eye circles genetic? If you have dark eye circles from childhood, there are two possibilities. The first is what we know as post-inflammation hyperpigmentation, which is caused by constant rubbing, due to underlying eczema. Or, you may actually have inherited especially thin skin that causes the underlying veins to appear prominent. Photoaging also causes overall skin thinning and loss of collagen. This week, Dr. Teo Wan Lin explains how they develop, as well as treatment options. Tune in to hear a dermatologist’s tips on the best cosmeceutical ingredients that help to brighten the under eye area which also provide anti-aging benefits.
Hi guys and welcome to today’s episode of Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin from TWL Specialist Skin & Laser Centre, and today’s topic is going to be about dark eye circles. We’re going to be talking about what causes dark eye circles and whether there are truly effective methods to treat this concern.
Are dark eye circles caused by genetics?
Unfortunately, the bad news is that 75% of what constitutes an individual having dark eye circles is probably related to one’s genetics. 75% is something I arbitrarily assigned as a proportion, mainly because of the experiences I’ve had addressing this problem in my patients. For example, a quick way to assess is this. If you look at your childhood photos and notice that you’ve already had dark skin under your eyes as a kid, here are two possibilities.
The causes behind your dark eye circles
The first is periorbital post inflammation hyperpigmentation, and that is commonly due to underlying eyelid eczema. The second cause is that of thin skin over the periorbital area. This increases the appearance of the underlying blood vessels of the vein specifically. In school they usually tell students that veins contain venous blood, which is dark bluish in nature as compared to oxygenated blood, which is bright red.
This is a reason why there can be an increased congested appearance around the eye area. Especially if you’re genetically prone to have thin skin around that part of your face. There is also this concern about more pigment developing as one grows older. A lot of this blood actually does leak out into the more superficial layers of skin. Because of this leakage of the pigment hemosiderin that eventually develops. This will give rise to a brownish substance that darkens the appearance of skin.
Dark eye circles and a tired appearance
Some of the psychological concerns that individuals may have with dark eye circles is giving off the impression and the appearance that one is lethargic. For example, if in a workplace setting, it could perhaps hinder a positive first impression. This is very important for individuals who are in client facing roles. Another aspect, of course, is the cosmetic acceptability. A lot of women may find that as they grow older, the darkening of the skin around their eyes is a telltale marker of age. Additionally, they may also not want to appear tired. As we know, an easy way to really perk up your face is to brighten the eyes. Studies have demonstrated that a lot of perceived radiance, even specifically referring to skin radiance, has to do with how the eyes are perceived.
Skin aging can cause darker eye circles
I think that there are important aspects that we need to understand. Firstly, as you grow older, whatever genetically determined eye circles you have will become more obvious. Because, of the thinning of the dermis due to loss of collagen and elastin. That is actually a huge component of what firms up the periorbital skin.
The second thing is the interaction with other signs of photoaging around the eye area such as fine lines and wrinkles. So, when combined with the issue of hyperpigmentation, all these things can reduce the cosmetic appearance or the perceived aesthetic value. It’s also very important to consider that if one suffers from PIH, or post inflammation hyperpigmentation, that is due to an underlying problem – dermatitis.
Especially in pediatric age groups, and even adult patients who have had undiagnosed eyelid eczema, they have this long term habit of rubbing their eyes. Whether or not they really have itchy eyes or eyelids, it’s become part of their habit. So all that increases friction around that area. It’s definitely leading to inflammation in the long term. It’s a vicious cycle, known as dermatitis. Overall, this is the leading cause of post inflammation hyperpigmentation leading to the appearance of pigmentation around the eyes and dark circles.
The CUIONS Anti-Aging Sleeping Eye Mask is made with copper nanoparticle-impregnated fabric with clinically proven anti-wrinkle properties, and can help with reducing the appearance of puffiness and dark eye circles for undereye skin health.
Sensitive skin around the eyes
A note about eyelid eczema here: the eyes are a very sensitive part of one’s facial skin. Firstly, because of the proximity to the eye area, which is clearly an important functional organ. Secondly, the skin on the eyelids is thinner than the rest of our facial skin. Similar to how the skin is on the lips is- what we call the mucosal areas. This lack of protection will only be exacerbated by eczema of the eyelids.
How to treat eyelid eczema that could be causing your dark eye circles
Treatment of eyelid eczema is also not as straightforward as general types of eczema on other parts of the face or the body. This is because the eyes are particularly sensitive to topical steroid exposure. It can lead to cataracts and glaucoma as side effects. Hence, dermatologists usually do not prescribe topical steroids to the eyelids for the treatment of eczema. Rather, we use calcineurin inhibitors for example tacrolimus, pimecrolimus. These are acceptable anti inflammatory immunomodulatory creams. When used in conjunction with a barrier restoring moisturizer, it is safe and effective for the treatment of eyelid eczema.
The use of skincare makeup such as the Dream Concealer that is formulated with a cosmeceutical base for skin healing, can effectively treat and conceal dark eye circles.
Moving on to other types of cosmeceuticals for the treatment of eyelid eczema. I think we have to pay attention to the depigmenting creams that are in circulation in the cosmetic industry. These are, whether or not it is an illegal cosmeceutical, or if it is banned, but is still available in certain online stores, for example, hydroquinone, will not be safe for use under the eye area. Depigmentation, which is the effect of these tyrosinase inhibitors, is not going to treat any of the above causes of eyelid hyperpigmentation.
Skincare ingredients that help to reduce the appearance of dark eye circles
With this, I want to zoom in on an active ingredient known as niacinamide, also known as nicotinamide. This can be safely and effectively incorporated into eye creams for a brightening effect for the undereye area. Especially for those who suffer from dark circles hyperpigmentation due to other causes. It is a specific form of vitamin B3. Additionally, as you may have heard, niacinamide is actually a powerhouse active ingredient for brightening and hydration. Our bodies do not produce Niacinamide. So, in order to reap its benefits, you should be applying it on your skin.
The undereye area is particularly tricky because there are elements of it both being a mucosal area where the skin is thinner than the rest of facial skin. Additionally, it’s also exactly where the eyes are. This ocular location is relevant because any product applied around the eye area, even not into the eyes, can cause irritation. You may have experienced it before with certain eye creams or facial creams. You apply it around or close to the eye area. Then you may feel burning stinging in your eyes, you may even start to tear up. This is a reason why you sometimes see the label of thalmic or ophthalmologically tested. It’s not exactly very meaningful. However, at least you know that it is going to be more tolerable than other products which have not been evaluated for this purpose.
This 2% Niacinamide prescriptive cream is custom compounded by Dr.TWL Pharmacy as an effective cream for dark spot lightening. Effective for under eye treatment, niacinamide is also a gentle ingredient suitable for use on the delicate undereye area
A lot of skincare ingredients we know can help with hyperpigmentation. For example, retinols, glycolic acids, BHAs. However, these are not suitable for application around this delicate undereye area. I want to talk about the specific suitability of niacinamide for this purpose because of its additional anti-inflammatory properties. The 2% concentration which we use in the Elixir V eye cream is an effective concentration. This is particularly beneficial since a lot of hyperpigmentation could be due to inflammation.
For individuals with eczema or dermatitis, it is a gentle yet effective active ingredient. It is particularly useful in addressing photoaging concerns such as superficial wrinkles and increase in laxity of the skin. Because it is actually a powerful antioxidant that can also address the signs of photoaging. Besides, it is a moisturizer on its own. This is beneficial for those who have eczema that is causing hyperpigmentation due to recurrent inflammation. It also is relevant that is ultraviolet protective because we know that UV rays activate melanin formation.
On a health-based level, is interesting to note that niacinamide actually can reduce the level of immune suppression caused by environmental damage, which is one of the major factors involved in skin aging.
How does niacinamide work?
I think that is important now to focus on how it actually works. We find from scientific studies conducted on niacinamide, that the number of melanosomes, which are the pigment carrying cells transferred within the skin, actually had a reduction of about 35 to 68% when niacinamide was used on areas of hyperpigmentation. There was also an observation of an increase in skin lightening after just a month of use. So for the delicate under eye area 2% niacinamide is a very important active ingredient with definite brightening properties without skin irritation. That’s how tolerable it is.
It’s also important to note that the Dr.TWL Elixir-V eye cream is formulated in a very potent emollient-based phytoceramide. Plant derived ceramides can help to maintain the skin barrier. As we know, the skin of the under eye area is particularly thin and delicate. So if you have a good eye cream that has brightening functions, but it isn’t repairing the skin barrier that’s also of no use because you’re going to have a vicious cycle of chronic inflammation.
Finally, another tip that I have is a combination of botanical antioxidants in the formula. Centella asiatica, or CICA is relevant because it can reduce the amount of hyperpigmentation present. It’s got the ability to inhibit the activity of melanocytes. Peptides, for example, are a suitable alternative to stimulate collagen production. This is as opposed to retinols, which have been purported to be used in eye creams as well for anti-wrinkle effect.
Choosing a good eye cream formula
The Elixir-V Eyes is formulated with potent botanical antioxidants such as the trademark LARECEA™ Extract for regeneration, Phytoceramides for skin barrier repair, Niacinamide for brightening, and potent oligopeptides for lifting and repair.
If you are using a retinol eye cream, one that is good formulation that incorporates emollient benefits would be ideal. Brassica oleracea is a category of plants, that refers to the broccoli, kale, cauliflower group of plants, we call that a genus. These have very remarkable abilities to mediate inflammation, and as we know, their antioxidant capacity plays a huge role in terms of fighting photoaging. Larecea, which is the trademarked active component in our skincare is essentially a mix of this brassica oleracea extract that is structurally very similar to vitamin U, methionine, and it has been incorporated into the eye cream as well.
Well that’s it for this week’s dermatology flash briefing. I hope you have a great week ahead and until the next episode.