Periorbital Hyperpigmentation

What is Periorbital Hyperpigmentation?

Hyperpigmentation is a condition where a portion of skin appears darker than other surrounding areas of skin due to excess melanin in the affected areas. Melanin is the pigment that gives colour to the skin. Sometimes hyperpigmentation can appear around the eyes (periorbital). “Peri” is a prefix from Greek meaning “around” or “surrounding”; orbit refers to the eye. Periorbital hyperpigmentation is usually benign and change in the colour of around eye area can be caused by different reasons and should be assessed by a physician.

According to the Journal Pigment International, of all individuals with periorbital darkening, only 17% of individuals had darkening that was mostly caused by melanin , about half of affected individuals had visible blood vessels in the area.

How is Periorbital Hyperpigmentation Identified?

Periorbital hyperpigmentation (POH) or perioral hyperpigmentation is identified based on visual assessment by a physician. Sometimes as a person ages, the eye area can appear more “sunken in” as fatty deposits shift and the skin texture changes. This can produce a shadowing of the eye area that should be distinguished from true pigment change.

What Causes Periorbital/Perioral Hyperpigmentation?

The same factors that cause other forms of hyperpigmentation may also contribute to Periorbital hyperpigmentation. These facial areas are exposed to UV radiation that can lead to activation of melanocytes and production of melanin. If too much melanin is deposited, persistent skin darkening may be seen.

While friction is linked to some forms of hyperpigmentation, it probably isn’t a significant factor in Periorbital hyperpigmentation. However, individuals who continuously rub the areas around the mouth or eyes can create irritation and inflammation in these areas. Those with allergies may find that the skin around the eyes becomes inflamed. Part of the body’s response to inflammation involves an increase in melanocytes and more melanin production. Usually, this discoloration has a brown appearance.

Finally, the area around the eyes is rich in tiny blood vessels. Depending on the size of these vessels and where they reside in the skin, they may give the skin a darkened appearance that tends to be blue/black or purplish hue. This so-called vascular hyperpigmentation is different than most other forms of hyperpigmentation. It is very common for vascular hyperpigmentation to occur along with melanin-based hyperpigmentation in the eye area. Swelling around the eyes-which can have a variety of causes, including allergy, illness, stress, or lack of sleep-can worsen the appearance of vascular hyperpigmentation

Is Periorbital Hyperpigmentation Dangerous?

Most cases of Periorbital hyperpigmentation and the factors that contribute to skin darkening are usually not dangerous. In fact, darkening is often attributed to natural changes that occur with skin aging. Typically, skin darkening develops over time. Sudden changes in skin colour and changes in the colour of the lip itself should be evaluated by a doctor.

Did You Know?

Patients are often bothered by hyperpigmentation around the eyes, but cosmetic colouring around the eyes dates back to ancient Egypt. There, royalty used a substance called kohl to outline the area around the eyes and enhance their appearance.