Management of periorbital hyperpigmentation- An overview of nature based agents and alternative approaches.

Periorbital hyperpigmentation is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids and is commonly found in females belonging to the age group of 16-45 years. The data presented in this review includes studies conducted on patients with a clinical/ histological diagnosis of periorbital hyperpigmentation or melasma. Many diverse topical depigmenting agents comprising of an array of naturally obtained actives like arabinoxylans, α-arbutin, asiaticoside, azelaic acid, beta-carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, D-glucoronic acid,dihydrochalcone, dipalmitoyl-hydroxyprolene, fucoxanthin, genistein, glabridin, b-glucogallin, hyaluronic acid,lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, xymenynic acid demonstrated significant benefits in the management of periorbital hyperpigmentation. An exhaustive literature search revealed that other techniques like blepharoplasty, carboxytherapy, CaHA fillers, tear trough implant, QSRL, medicated tattoo, fat transfer, micro-needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light and radiofrequency have been evaluated and reported to be beneficial in the treatment of periorbital hyperpigmentation. The use of topical depigmenting agents is the most widely reported method in the clinical management of periorbital hyperpigmentation. Of these, α-arbutin, caffeine, cyanidin-3-glucoside, dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of periorbital hyperpigmentation. It also presents the advantages of combination products and other alternative therapies used in the management of POH. This article is protected by copyright. All rights reserved.