title: Physiological and lifestyle factors contributing to risk and severity of peri-orbital dark circles in the Brazilian population.
abstract: BACKGROUND
  Peri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.
  
  
  OBJECTIVE
  To compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.
  
  
  METHODS
  Subjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.
  
  
  RESULTS
  Family history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ΔL*and ΔE* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.
  
  
  CONCLUSIONS
  Although typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.
authors.affiliation: Estee Lauder Companies, New York, US.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Matsui
authors.affiliation: Medcin Instituto da Pele, Osasco, SP, BR.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Schalka
authors.affiliation: Estee Lauder Companies, New York, US.
authors.forename: Garrett
authors.initials: G
authors.lastname: Vanderover
authors.affiliation: Estee Lauder Companies, New York, US.
authors.forename: Christina G
authors.initials: CG
authors.lastname: Fthenakis
authors.affiliation: Estee Lauder Companies, New York, US.
authors.forename: J
authors.initials: J
authors.lastname: Christopher
authors.affiliation: Medcin Instituto da Pele, Osasco, SP, BR.
authors.forename: Patricia Camarano Pinto
authors.initials: PC
authors.lastname: Bombarda
authors.affiliation: Medcin Instituto da Pele, Osasco, SP, BR.
authors.forename: Juliana Regina
authors.initials: JR
authors.lastname: Bueno
authors.affiliation: Medcin Instituto da Pele, Osasco, SP, BR.
authors.forename: Bianca Lenci Inácio
authors.initials: BL
authors.lastname: Viscomi
authors.affiliation: Medcin Instituto da Pele, Osasco, SP, BR.
authors.forename: Mário Sérgio
authors.initials: MS
authors.lastname: Bombarda Júnior
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001938:Brazil; D005128:Eye Diseases / Q000209:etiology* / Q000503:physiopathology; D005148:Facial Dermatoses / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology* / Q000503:physiopathology; D008019:Life Style; D008543:Melanins / Q000032:analysis; D008875:Middle Aged; D009915:Orbit; D010100:Oxygen / Q000097:blood; D012307:Risk Factors; D012720:Severity of Illness Index; D012867:Skin / Q000503:physiopathology; D013053:Spectrophotometry; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D008543:Melanins; D010100:Oxygen