Causes of Dark Circles Under the Eyes?

• Allergies such as hay fever can often result in dark under the eye circles as the allergens responsible for the hay fever results in inflammation of the eye lining, often experienced as itching, as well as inflammation of the skin around the eye. Nasal congestion that often occurs during the bout of an allergy and further contributes to the inflammation which leads to dark circle formation under the eye. This occurs due to the dilation of blood capillaries from the nose to the eyes.
• Hereditary. Fair skinned individuals with naturally deep seated eyes are often prone to developing dark circles under the eye as they get older. Dark eye circles can also develop due to genetic factors.
• Thinning of the skin around the eye occurs due to the loss of collagen and fat deposition  around the eye area as a result of ageing. Blood vessels become more distinct due to the decreased amounts of collagen and fat giving the appearance of dark eye circles. The development of puffy eyelids or hollows under the eyes occur due to the natural process of ageing
• Lack of sleep. Disturbances in the normal sleep cycle can result in the skin looking pale with development of circles under the eyes appearing darker in colour. A lack of sleep can also contribute to tired looking eyes that can often give the appearance of puffiness.
• Sun damage. The excessive amounts of sun exposure can cause the body to produce large amounts of melanin (pigment cells) to protect the skin against the harmful effects of the sun’s rays. This results in the weakening of skin tissue under the eyes contributing to dark eye circles.
• Lifestyle. The consumption of alcohol, caffeinated drinks and smoking results in the accumulation of toxins  in the body. This build up can often lead to the development of dark circles under the eye area.
• Dehydration. The decrease intake of water with the combination of alcohol and caffeinated beverages can lead to dehydration resulting in the appearance of dark circles under the eyes.
• Fluid retention in the body are commonly due to illness, excessive dieting, increased amounts of salt intake, smoking, medication, disorder’s of the heart, thyroid, kidney and liver. The above results in the dilation of the blood capillaries causing the eyes to appear engorged with dark circles under the eyes.

Treatment of Dark Circles

• Increase the amount of water intake to help detox the body of the accumulated toxins. The daily recommended allowance of water intake is approximately 6 to8 glasses.
• Decrease or eliminate the consumption of alcoholic and caffeinated beverages to prevent dehydration.
• The use of a sunscreen would help prevent the weakening of the skin’s tissue around the eyes.
• Laser therapy and chemical peels can decrease the discoloration around the eye area.
• Hollows that develop under the eye due to aging can be corrected with collagen injections.
• Decrease smoking and salt intake, and increase sleep and vitamin intake which will help minimise the appearance of dark circles under the eye.

Picture of Severe Spider Veins & Varicose Veins

Telangiectasia is a condition commonly referred to as spider veins, where thin dilated blood vessels connected to larger blood vessels are visible at the skin’s surface. These veins appear in clusters of bluish-purple or red zones and are often shaped in a ’spider’s web’, hence the name spider veins. Although this condition can affect a small percentage of males it is mostly common in females. Unlike varicose veins, spider veins do not bulge or extend above the surface of the skin.

Causes of Spider Veins

The common causes responsible for the onset or aggravation of spider veins (telangiectasia) are :

• An insufficiency in the circulation of the venous system causes the vein valves to weaken resulting in pooling of blood (congestion). This eventually leads to the development of spider veins.
• Genetic factors play a role in the weak development of the vein wall resulting in the formation of spider veins. These veins can cause an increase the blood pressure of the surrounding superficial veins.
• Excessive exposure to the sun can trigger the development of spider veins especially in lighter skinned individuals.
• Hormonally induced conditions or medication that cause hormonal fluctuations such as pregnancy or menopause can cause the vein wall to ’soften’ increasing the incidence of spider veins. The blood volume also rises during pregnancy which increases the blood pressure in the venous system. This may result in the development of spider veins.
• Conditions such as obesity with an excessive amount of body fat and less connective tissue support around the veins may lead to spider veins.
• Individuals, in jobs that require extended periods of standing or sitting without regular intervals of leg movement, are more susceptible to spider veins
• Aggravating factors such as aggressive skin treatments or an increased intake of alcohol may be at risk of developing spider veins

Management of Spider Veins

• Certain cosmetics, like foundation, can be used to camouflage the appearance of spider veins
• Regular physical activity aids, in cases of hypertension (high blood pressure), obesity and poor circulation, may assist with reducing the extent of spider vein proliferation.
• The use of flat shoes and support hose can reduce or decrease the occurrence of spider veins in person’s with venous insufficiency of the leg or varicose veins.
• Avoid excessive consumption of alcohol
• In occupations that require extended periods of sitting or standing, it is advisable to exercise the legs with short episodes of walking.
• Decreased sun exposure, especially in persons with sun sensitivity of skin, and the use of sunscreens help in the management of spider veins.

Treatment of Spider Veins

There are two types of treatments that are commonly used in treating spider veins. These treatments include the invasive yet effective sclerotherapy, and non-invasive laser treatment.

Sclerotherapy

Sclerotherapy is a highly effective invasive treatment requiring several sessions. An irritant solution such as concentrated saline or a specialized detergent solution is injected directly into the spider veins causing pain that last for a few minutes. The solution damages the wall of the vein resulting in swelling and constriction of the blood supply. The spider vein becomes a scar tissue and disappears over a period of days to weeks. The side effects of sclerotherapy include skin sores, bruising and discoloration around the treated skin.

Laser treatment

Laser treatment is a non-invasive procedure that uses an intense pulsed light to heat the surface of the skin. The laser is focused on individual vessels causing the wall of the spider veins to ’seal’ (cauterization) minimizing the damage to the surrounding tissue. Since the veins appear red, pink and sometimes bluish-purple they tend to absorb more of the laser than the surrounding normal skin. When the light of the laser is absorbed the spider veins shrink without damaging the normal skin. The side effects of laser treatment includes redness, swelling, and discoloration of the skin. These effects usually subside after a few weeks.

Skin lighteners (bleaching or whitening creams) are a commonly used cosmetic product among men and women looking for a lighter skin complexion (‘fair skin’) for aesthetic purposes. Cultural misconceptions and personal beliefs about the appeal of a lighter skin complexion have made these creams, soaps and lotions a popular beauty product in Asia and Africa among darker skinned ethnic groups. A lack of appropriate regulation in many developing countries allows for these products to be sold over-the-counter although it contains pharmacologically active and toxic compounds like hydroquinones, corticosteroids and mercury.

Natural Skin Pigmentation

Melanin is a brown pigment produced by the melanocytes (melanin forming cells) in the deeper layers of the skin. The function of melanin is to absorb harmful ultraviolet (UV) rays from the sun and protects the skin from diseases such as cancer. The distribution of melanin differs among  individuals and is influenced by genetics (familial and racial). Hormonal disturbances such as pregnancy or menopause may cause conditions such as melasma, where the skin may appear hyperpigmented (dark patches) in certain areas. In these cases, the use of skin lighteners may assist to ‘even out’ pigmentation and blend these areas with the natural skin tone.

The effect of skin lighteners differs among individuals as it is dependent on:

1. The individual skin type (dry, dehydrated or oily).
2. The condition being treated (sun damage, pigmentation in pregnancy, damage from cosmetic products such as steroid creams).
3. The concentration or strength of the active ingredients.
4. The period of time during which the skin lightener was used.

Ingredients in Skin Lightening, Whitening & Bleaching Products

Hydroquinones (often misspelled as ‘hydroquinine’) is by far the most common ingredient in these skin lightening products. The bleaching effect of hydroquinones has been widely known for many decades and has been banned as a cosmetic product in many developed countries. Pharmaceutical applications include the treatment of certain hyperpigmentation disorders, like melasma, damage caused by skin sun sensitivity or photodermatosis, blemishes, freckles and age spots. Other common ingredients in cosmetic skin lightening products include hydrocortisone (’steroid cream’) and mercury, both of which have a host of side effects if used over long periods of time.

Hydroquinone

Although hydroquinone is widely used in skin bleaching cosmetic products in Africa and Asia, it is banned in Europe due to its side effects. Hydroquinone is a toxic chemical that is also used in the processing of photographs and the manufacture of rubber and hair dyes. The side effects of hydroquinone include:

• Thinning of the skin which affects the collagen fibers.
• Due to the damage of collagen fibres pre-mature wrinkling can develop.
• Hydroquinone can cause irritation to the skin as it is an unstable ingredient.
• Blistering or cracking of the skin can often result with long term use.
• Prolonged use of hydroquinone can cause grey or bluish black pigmentation.
• Impaired wound healing which can result in recurrent or chronic skin infections.
• Hydroquinone can cause cancer as it inhibits the production of melanin thereby ‘robbing’ the skin of its natural UV protection capabilities.

Mercury

Mercury which is the second common ingredient used in skin lighteners is derived from mercury chloride and is a carcinogen. The side effect of mercury includes:

• An increased risk of cancer as the skin has no protection from the sun.
• Damage of the skin connective tissue.
• A rough blotchy skin with a spotty appearance.
• Mercury poisoning as it accumulates in the skin cells and enters the blood stream.
• Dryness of the skin as moisture is depleted from the skin cells.
• Ulceration of the skin.

Corticosteroid or Hydrocortisone

Steroids which is another widely used ingredient used in skin lighteners and is an effective but dangerous compound. Fortunately, the use of corticosteroids in cosmetic products is being restricted in many countries due to its classification as a pharmaceutical. The side effects of long term topical corticosteroid use includes :

• Thinning of the skin
• Appearance of pale and dark ‘lines’ similar to stretch marks
• The skin may become prone to bacterial and fungal infections, dermatitis and systemic conditions like Cushing’s syndrome could occur.
• Pre-existing conditions like eczema and acne may ease with ’steroid’ use but will often return and aggravate over time or once the cream is discontinued.

What is folliculitis?

Folliculitis is a common condition involving the hair follicle. The hair in the follicle which normally grows in an upward direction curves and re-enters the skins surface resulting in the appearance of small white pimples or clusters of red bumps around the hair follicle. Bearded areas (sycosis barbae) on the facial skin are often infected with the bacteria Staphylococcus aureus , resulting in pain, swelling and redness of the skin.

Folliculitis Picture from Dartmouth College

Folliculitis is commonly referred to as an ‘ingrown hair’ and can occur anywhere on the body except areas that do not have hair follicles such as the palms of hand or soles of the feet. Follicular pustules or pimples occur in and around the hair follicle area. This condition affects individuals of all age groups but is common in people suffering with diabetes mellitus,  HIV, cancer or individuals on chemotherapy treatment. Ingrown hair is also more prevalent amongst individuals with curly or wavy hair due to the stiff structure of the hair composition which may be based on ethnic or genetic traits. The ingrown hairs are easily removed but the development of pimples may still persist.

Causes of Folliculitis

• Irritation of the hair shaft or follicle opening in the skin.
• Friction on the shaved area which is often caused by tight clothing.
• Excessive perspiration is often a common irritant to the hair follicle.
• Injury to the skin caused by cuts and nicks during shaving, leaves the skin susceptible to bacteria.
• Close or frequent shaving can result in irritation of the skin.
• Bacterial infection (staph skin infection) through skin abrasions results in folliculitis.

Preventing Folliculitis

• The use of an electric shaver may be a better option than the razor as it is more hygienic.
• If the use of the razor is essential, a new blade should be used for every shave.
• Avoid repetitive shaving over the same area to prevent the occurrence of cuts and knicks.
• Shave in the direction of the hair growth to minimize the occurrence of ingrown hair.
• Do not shave over skin that appears dry or irritated.
• Avoid the use of tight clothing for 2 to 3 days after shaving.
• Daily or frequent shaving should be avoided.
• Exfoliation of the skin can help to keep the area clean preventing the spread of bacteria.

Treatment and Management of Folliculitis

• Hydrocortisone creams are effective alleviating dry itchy skin.
• The application of an antibiotic ointment will sterilize the area preventing the spread of bacteria.
• Topical anesthetic ointments aids in the relief of pain and soreness of the ingrown hair.
• Oral antibiotics may be administered for bacterial skin infections.
• A warm moist towel should be applied twice a day to the affected area to keep the hair soft.
• Permanent hair removal such as electrolysis can aid in the prevention of ingrown hairs and pimples.
• If the condition does not rectify itself or becomes a recurrent chronic condition, seek medical advice.
• Avoid squeezing ingrown hair pimples that occur to prevent possible scarring.

]]> http://www.skincare21.net/folliculitis-treatment-of-ingrown-hair-pimples.htm/feed 1 http://www.skincare21.net/melasma-chloasma-dark-skin-discoloration-treatment.htm http://www.skincare21.net/melasma-chloasma-dark-skin-discoloration-treatment.htm#comments Mon, 27 Jul 2009 18:09:02 +0000 Dr. John http://www.skincare21.net/?p=174 Melasma is a hyperpigmentation (dark skin discoloration) disorder that is characterized with dark brown symmetric patches on the surface of the skin, primarily affecting the face. Melanin is a brown pigment produced by melanocytes, the pigment producing cells of our skin. Based on racial and environmental differences, the melanin concentration differs from person to person although certain medical conditions, drugs and topical applications (creams, gels, ointments) can also change skin pigmentation.

Causes of Melasma

Hyperpigmentation is the increased melanin production causing a characteristic dark discoloration of the skin. The increased melanin (pigment) production is often an indication of hormone imbalances in the body and therefore melasma is commonly found in women who are pregnant or on hormone replacement therapy (HRT).

Pregnancy causes an over stimulation of melanocytes (pigment cells) resulting in pigmentation occurring on the nipples, lower abdomen and face areas. Exposure of light on the skin can further aggravate the condition. The pigmented patches usually disappear after the birth of the baby or the cessation of the hormone therapy but in some cases it may remain as a permanent blemish.

Treatment for Melasma

Treatment for melasma does not have a 100% success rate as the as pigmentation can fade into the normal skin tone giving the appearance of a ‘cure’. There are preventative measures and treatment that can aid in the management of melasma.

• Treatment with 2% to 4% hydroquinone in a cream base may decrease pigmentation but may aggravate or cause dermatitis of the skin.
• Topical 0.1% tretinoin sequentially used with hydroquinone will enhance the effect in the treatment of melasma.
• Hydroquinone is contra-indicated in individuals with liver or kidney conditions, open cuts and bruises and severely sun burn skin. Individuals who have allergies, sensitive skin or are on certain type of medication need to use hydroquinone with caution especially if the treatment is long term.
• Long term application of hydroquinone can cause local ochronosis and hydroquinone creams should only be prescribed by your dermatologist. A skin assessment will first be conducted before you dermatologist will decide upon the most appropriate course of treatment.
• For the maximum bleaching effect from the use of hydroquinone applications, avoid excessive sun exposure. Light and sun sensitivity of the skin may be noticed after starting a hydroquinone cream.
• A sunscreen with a sun protection factor (SPF) of 15 to 30 should be used to prevent the aggravation of melasma. Avoid daily use of sunscreen creams with an SPF greater than 30.
• Small patches of melasma can be camouflaged with cosmetic creams that do not wipe off (stay-fast formulation) although these should only be used when other treatment is not successful.
• The use of corticosteroid creams are another common approach to treating early stages of melasma. Hydrocortisone applications are never recommended as it causes thinning of the skin and the condition often returns worse that the original state once the hydrocortisone is discontinued.

The cosmetic industry is constantly marketing new and more effective treatments for melasma, often promoting products that have not undergone clinical trials. From whitening creams (skin bleaches) to ascorbic acid (vitamin C) applications and vitamin A creams, melasma should be treated by a professional rather than risking your skin with overpriced, over-the-counter products.

Predisposing Conditions

Sun sensitivity of the skin is present in conditions such as:

Polymorphic Light Eruptions

This is a form of dermatosis of the skin that affects more women than men. Lesions of papules, plaques and vesicles are usually present on the sun exposed areas of the skin. These lesions appear to be more common in the spring and summer seasons and occurs approximately 24 hours after the skin has been exposed to the strong sunlight.

Actinis Reticuloid/Chronic Actinic Dermatitis

This is a rare condition affecting middle aged or elderly men. The area of the skin that is exposed to the sun becomes sensitive to light although the exact cause of this skin disease is not known. Thick plaques of dermatitis begin to develop when exposed to sunlight.

Solar Urticaria and Actinic Prurigo

Solar urticaria, similar to hives, is a rare condition that occurs on the sun exposed areas of the skin. The formation of wheals and skin itching occurs after the skin has been exposed to the sun. Actinic prurigo is a skin condition that begins in the early years of childhood with the development of papules and excoriations on sun exposed areas of the skin.

Treatment & Management

• The individual should wear protective clothing such as a sun hat or a long sleeve shirt on sunny days to protect the skin against sunlight, especially when outdoors.
• Avoid sunlight as far as possible to prevent any further development of lesions.
• Topical preparations of ointments or lotions containing local anaesthetics of benzocaine and other sensitizing preparations should be avoided.
• A course of systemic corticosteroids will decrease any discomfort although this offers only short term relief.
• An oral preparation of hydroxychloroquine reduces and suppresses the skins sensitivity to light.
• Sun block creams or sunscreens should be worn daily on sun exposed areas of the skin and applied many times in a day, especially after swimming.
• PUVA is effective in the treatment of polymorphous light eruptions and should be used on the sun exposed areas of the skin.

With regards to sunscreens, the main preventative agent in photodermatosis, it is important to monitor the sun protection factor (SPF) of your sunscreen. In most cases an application with SPF 15 to 30  may be suitable and higher SPF creams should be avoided as they may cause contact dermatitis. Rather combine your sunscreen with other sun protecting or reducing measures instead of choosing high SPF creams.

Following exposure to sun light, the epidermis increases its production of melanin to provide natural protection against sun exposure. This is seen as darkening of the skin or a tanning effect. Individual skin reacts differently when exposed to the sun making the comparison of light and sun sensitivity differ from person to person as the amount of melanin produced differs in each individual. While this hyperpigmentation may offer some natural protection against the skin, the cause of the light or sun sensitivity should nevertheless be treated.

Ultraviolet (UV) rays from sunlight can causes degeneration of the elastic fibres of the dermis (deeper layers of the skin) and thickening of the epidermis (outer layer of the skin. This thickening of the epidermis is usually caused by an increase rate of cell division due to heat and light.

While exposure to sunlight causes the condition, hot environments, certain skin diseases and drugs may make the skin more sensitive to sunlight.

Causes of Sun & Light Sensitivity of the Skin

Many factors may result in skin sensitivity to sunlight. These include :

Genetic Disorders

This genetic disorder has a family history of sensitivity of the skin to sun exposure. These disorders include genetic diseases such as Bloom’s syndrome which has instability in the chromosomal structure and a defect in the repair of the DNA molecules. This causes a reaction in the skin when it is exposed to the light.

Porphyrias

Porphyria is a rare metabolic disorder that due to an enzyme deficiency which leads to an accumulation of breakdown products of metabolism in the blood, urine and faeces. An accumulation of these metabolites can cause toxicity to the nervous system resulting in the skin’s sensitivity to the sun felt as burning and itching.

Pellagra

Pellagra is a condition due to a deficiency of nicotinic acid in the diet. This can cause light sensitivity of the areas of the skin exposed to the sun and diarrhoea may also be noticed after sun exposure.

Polymorphous Light Eruptions

This condition is caused by the skin’s reaction to sunlight and lesions such as papules, plaques and erythema multiforme appear on the affected area. It is sometimes referred to as a ‘heat rash’.

Drug Induced Sun Sensitivity

A condition that causes the skin to react when exposed to the sun due to the intake of certain drugs. Many drugs such as ACE inhibitors, tetracycline, thiazides and phenothiazines can cause eruptions of blisters, eczema, pigmentation and excessive sunburn on the light exposed areas of the skin. These reactions are caused either by the medication dosage or an allergic mechanism to the drug.

Topical Chemicals

Chemicals that have contact on the skin such as coal tar and plant derived psoralen can cause sun sensitivity of the skin. Coal tar which is used in the treatment of the skin condition called psoriasis vulgaris leaves the skin sensitive to sunlight. The plant derived psoralens found in carrots, fennel, and parsnips results in the light sensitivity of the sun exposed areas of the skin although the psoralen drug is used in the treatment of psoriasis. In both cases the skin appears with reactions of redness and eruptions of blisters.

Photodermatosis should not be confused with general skin irritation caused by the sun. Within 20  minutes of direct exposure to strong  sunlight, most skin types will show signs of inflammation, like reddening of the skin accompanied by a burning sensation. Treatment for photodermatosis should be undertaken by a dermatologist after the cause of the light and sun sensitivity is identified.