14, 15 The aim of this work was to assess different techniques to discriminate between subjects with and without dark circles, to measure and quantify dark circles across different ethnic skin tones, to assess their episodic nature and to determine the physiological changes associated with their occurrence. While many articles detail the origins and triggers of dark circles, there are only a few that describe how to assess and characterize them. In view of all these various factors, dark circles are difficult to characterize and measure. In addition, the eye-lids have the thinnest skin of the face, and the bone structure and contour of the eye socket can lead to shadowing effects around the eye. 7 – 11 The anatomy of the eye area is complex and can also be a contributory factor, for example, there is minimal infraorbital subcutaneous fat and the area is prone to blood stasis and oedema. Certain medicines, such as non-steroidal anti-inflammatory drugs and chemotherapy drugs, are also suspected to trigger the occurrence of dark circles. 2 – 7ĭark circles are most often associated with tiredness, sleep deprivation and fatigue however, there are numerous other extrinsic and lifestyle-related triggers, including illness/infections, atopy and allergies, stress, hormonal changes, chronic irritation of the eye area, eye strain, exposure to UV light, dehydration, poor nutrition, vitamin deficiency, excessive alcohol consumption and smoking. However, extrinsic and lifestyle factors also play a crucial role. The colour of the palpebral skin is strongly associated with intrinsic factors, such as an individual’s ethnic origin and genetics, including the amount and quality of melanin pigment in the skin.
Visually, dark circles are characterized by differences in colour between the palpebral and surrounding areas of facial skin.
1 Their aetiology is complex and multi-factorial, and there are numerous intrinsic and extrinsic factors associated with their occurrence. Infraorbital dark circles are generally not a cause of medical concern however, they are aesthetically unpleasing for many individuals, particularly for women, and can occur across all age brackets.
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