MELASMA AND DARK SHADOWS UNDER EYES
This can be one of the most frustrating and difficult conditions to treat. Key points to prevent discolouration are:
- All year round sun protection. Use a very high factor sunscreen preferably with reflectant properties. Reapply to the face every two hours. Wear a broad brimmed hat in summer. Only choose make up with an added sunscreen.
- Contraception containing oestrogen can make pigment worse. Switch to a non hormonal contraceptive if possible, or at least a progesterone only one.
- Pregnancy is a powerful stimulator of pigment. Expect it to get worse in pregnancy.
- Chemical peels containing glycolic acid or trichloroacetic acid can be applied by skilled clinicians however they can provoke considerable inflammation initially.
- Some patients may benefit from a Fraxel laser
- Use tretinoin gel or cream daily, long term. This drug based on vitamin A has proven effects on reducing the activity of pigment cells in the skin. It is available on prescription from on-line chemists or your GP.
- For dark under eye circles, fillers such as Restylane and Juvaderm lift the skin away from the bluish coloured deep muscles and are worth considering.
An excellent patient information leaflet is available from the British Association of Dermatologists.