Classification and characteristics of periorbital hyperpigmentation

A Cluster Validity Index-Based Objective Criteria for Aesthetic Evaluation of Periorbital Treatment

Purpose

Dark circles and pigmentation around the eyes are common reasons people see dermatologists. An effective assessment of the severity of infraorbital color and texture differences is critical for determining appropriate treatment. Evaluation of the visual severity of cases is mostly based on visual inspection. Treatment efficiency is often measured using patient questionnaires in many cases. The subjectivity of assessments may lead to a prolonged healing process, misdiagnosis, and excessive use of drugs or chemicals.

Patients and Methods

In this study, a computer-aided objective evaluation approach was proposed for grading periorbital facial rejuvenation. This approach is based on the analysis of numerical features extracted from different facial regions in digital images. Healing was objectively graded by evaluating data clusters formed using the extracted features. Accordingly, an increase in the visual similarity between paired facial regions is accepted as an indicator of healing, which directly affects the form of data clusters. An intracluster validity index was measured to evaluate the clusters as dense and well separated. A total of 144 facial regions were extracted and examined, and the automatically calculated grades were compared with expert evaluations.

Results

The cosmetic effects of the experimental drug were evaluated during the experiments, and expert grades were accepted as the ground truth. The results show that the proposed automated grading approach can evaluate rejuvenation with an accuracy of up to 0.91 accuracy in the upper orbital region.

Conclusion

This study concluded that the proposed data-clustering-based approach is promising and can be functional without any special instruments.

Effect of Rice (Oryza sativa L.) Ceramides Supplementation on Improving Skin Barrier Functions and Depigmentation: An Open-Label Prospective Study

Ceramides plays a crucial role in maintaining skin barrier function. Although foregoing evidence supported beneficial effects of topical ceramides for restoration of the skin barrier, studies on oral ceramides are extremely scarce, with most published data collected from in vivo and in vitro models. Thus, this study aimed to evaluate the efficacy of rice ceramides (RC) supplementation to improve skin barrier function and as a depigmenting agent through comprehensive clinical assessments. This study investigated the beneficial effects of orally administered RC supplementation in 50 voluntary participants. Skin hydration, firmness and elasticity, transepidermal water loss (TEWL), melanin index (MI), erythema index (EI), sebum production, pH, and wrinkle severity were assessed at baseline and during monthly follow-up visits. RC supplementation was found to significantly (p < 0.01) improve skin hydration, sebum production, firmness and elasticity, and wrinkle severity for three assessed areas, namely the left cheek, dorsal neck, and right inner forearm. Additionally, RC significantly (p < 0.01) reduced the rates of TEWL, levels of MI and EI. Analyses of data indicated that participants at older age were more responsive towards the effect of RC supplementation. Our findings suggest that RC supplementation can effectively improve skin barrier function, reduce wrinkle severity, and reduce pigmentation.

Establishment of visual assessment for the severity of dark circles in Chinese Han women

Objective

To establish a visual assessment scale for the severity of dark circles' pigmented and vascular type in Chinese women.

Materials and method

A total of 269 healthy Chinese women from Shanghai with different degrees of dark circles', both pigmented and vascular types, were evaluated by visual assessment. Photographs of their dark circles were analyzed by image analysis.

Results

The visual assessment evaluation on classification and severity showed a favorable agreement between the successive measured results. Significant differences from very slight to severe dark circles for pigmented type and vascular type were observed. The severity level by visual assessment was significantly positively correlated with ΔE values while negatively correlated with ΔL values (P < .01) in both pigmented and vascular types. Besides, Δa values of vascular type were significantly positively correlated with the ΔE values for dark circles' vascular type. Values between ΔE and ΔL also showed a significant negative correlation (P < .01).

Conclusion

The five‐point visual assessment scale for dark circles of vascular and pigmented types was verified and proved to have good repeatability. The image analysis's objective result proved significant and consistent with the visual assessment and color parameters. This scale could be a useful and effective tool in diagnosing dark circles' severity.

Periorbital Hyperpigmentation—Dark Circles under the Eyes; Treatment Suggestions and Combining Procedures

Periorbital hyperpigmentation (POH) is a frequent concern among both young and adult patients. The etiology is multifactorial with a genetic background. Prevalence is higher in darker skin types. It has been estimated as high as 30% in a recent Indian study. Females are often more disappointed by POH than males. Treatment has to consider underlying pathologies and patients’ needs. We present our treatment algorithm for POH. In this study, 74 patients with POH, 64 females (86.5%) and 10 males (13.3%), were treated. Of these, 39 patients (53%) had a family history of POH. The age range of patients was 18−57 years (average: 36.1 years). In case of tear trough deformity, soft tissue augmentation was used by injection of hyaluronic acid gel, calcium hydroxylapatite, or autologous fat. Blepharoplasty with partial fat pad resection or repositioning via arcus marginalis release was used to correct severe orbital fat herniation and excess of the lower lid skin. Melanin hyperpigmentation of the skin was improved by sessions of Q-switched 1064 and 532 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. Small vessels (capillaries and veins) were targeted by a 1064 nm long-pulsed Nd-YAG laser. Sessions of intense pulsed light (IPL) or CO2 fractional laser were employed to improve skin texture and fine lines. Topical hyaluronic acid-based formulations may be used as adjuvant self-treatment by patients. For pigmented and mixed-type POH, ultraviolet light protection is recommended as a maintenance treatment. By the use of various technologies, treatment can be individually tailored.