what causes under eye puffiness in adition to aging
J Cosmet Dermatol. 2019 April; xviii(2): 530–538.
Global periorbital peel rejuvenation by a topical eye cream containing depression molecular weight heparan sulfate (LMW‐HS) and a blend of naturally derived extracts
Lora Colvan
1 Research and Evolution, SENTÉ INC, Carlsbad California,
Tina Fleck
1 Research and Evolution, SENTÉ INC, Carlsbad California,
Virginia Fifty. Vega
ane Research and Development, SENTÉ INC, Carlsbad California,
Received 2018 Sep 10; Revised 2018 Dec 4; Accustomed 2018 December ten.
Summary
Background
Maintaining a youthful advent is a priority for many people. Global eye rejuvenation is sought more frequently and at a younger age than other treatments. Major concerns around the eye area are periorbital hyperpigmentation, puffiness, and lines and wrinkles. Glycosaminoglycans (GAGs) are complex carbohydrates that attune skin health, repair and renew skin's advent. Heparan sulfate (HS) is the most biologically agile GAG, although it is too large and polar to penetrate the skin. Low Molecular Weight Heparan Sulfate (LMW‐HS) is a smaller version of HS designed for skin penetration while preserving its activeness. In this study, nosotros investigated the effects of a topical centre foam containing LMW‐HS and a blend of naturally derived extracts to address global periorbital rejuvenation.
Method
A single‐center, open‐label study including female person and male subjects (north = 15) was conducted to evaluate the efficacy and tolerability of an center foam containing LMW‐HS and a alloy of naturally derived extracts applied twice daily for 12 weeks.
Results
Improvements in the appearance of periorbital hyperpigmentation and fine and coarse wrinkles were observed every bit early on as week two with continuous improvement upward to 12 weeks. Subtract in puffiness (73%) and dark circles (93%) were reported by subjects. The test product was highly rated by subjects on performance and attributes and was well tolerated past all the subjects in this report.
Conclusion
Results demonstrated that an eye foam containing LMW‐HS and a alloy of naturally derived extracts achieved global pare rejuvenation by improving advent of periorbital hyperpigmentation, puffiness, and fine and coarse wrinkles.
Keywords: anti‐aging, dark circles, hydration, puffiness, wrinkles
i. INTRODUCTION
Glycosaminoglycans (GAGs) are large, linear, negatively charged, and the most arable heteropolysaccharides in the body. Among the 4 classes of GAGs known today, namely: chondroitin sulfate (CS)/dermatan sulfate (DS), heparin/heparan sulfate (HS), keratin sulfate (KS), and hyaluronic acid (HA), but HA is not‐sulfated nor forms part of proteoglycans. Sulfated GAGs (SuGAGs) are present on all animal cell surfaces or as components of the extracellular matrix (ECM). The SuGAG saccharide courage is sulfated in various positions, creating a smashing diverseness of potential interactions with partner proteins.1 Biologically active SuGAGs regulate numerous skin functions such equally tissue evolution, remodeling, and healing. More specifically, heparan sulfate (HS), a vital component of all animal cells,2, three interacts with a plethora of partner molecules, including growth factors (GFs), chemokines‐cytokines, ECM components, enzymes, morphogens, and pathogen‐derived molecules.4 HS facilitates self‐assembly and structural integrity of ECM components and can agree millions of distinct structural modifications, which explains why it has been called "the about information‐dumbo biopolymer in nature." 5 HS has a large diversity of regulatory functions that give it great potential every bit a corrective ingredient to restore aged‐skin homeostasis and health. Unfortunately, naturally occurring HS has limited pare penetration due to its large molecular size and high polar charge. Low Molecular Weight Heparan Sulfate (LMW‐HS) is a pharma‐class corrective ingredient that was developed to overcome peel penetration limitations while preserving its action.4 LMW‐HS is a modified grade of endogenous HS in which size (half-dozen‐12 kDa), shape, and charge were optimized. Previously, Gallo et al4 showed that an LMW‐HS‐containing facial cream triggered improvements in skin hydration, barrier function, compactness, and elasticity. Thus, the aim of this study was to evaluate the efficacy and tolerability of an eye cream containing LMW‐HS and a blend of naturally derived extracts to accomplish global periorbital rejuvenation.
2. MATERIALS AND METHODS
All activities performed inside the scope of this study complied with recognized Skilful Clinical Practice guidelines and applicative regulatory requirements. Subjects were recruited using an IRB‐approved advertisement method. Subjects completed an Informed Consent Form (ICF) in conformance with 21 CFR Office l: "Protection of Human being Subjects," which was signed on the mean solar day of enrollment.
2.1. Subjects
Single‐centre (SENTÉ Aesthetic Clinic, Carlsbad CA), open‐characterization written report. Inclusion criteria: female and male person subjects (due north = 15), ages 35‐65, Fitzpatrick skin types II‐IV. Discipline ethnicities included Caucasian, Eastward Indian, and Hispanic. Subjects presented with at least one of the following MODERATE to SEVERE skin weather condition: fine lines and wrinkles, coarse wrinkles, nether‐centre puffiness, and/or under‐eye dark circles. Exclusion criteria: subjects who reported they were pregnant, planning a pregnancy, or nursing; individuals with active (flaring) pare diseases, such as atopic dermatitis or eczema, on the skin around the eyes; individuals who had plastic surgery or ablative laser resurfacing within i year preceding the study; individuals who had any cosmetic procedure, such equally non‐ablative laser resurfacing, neurotoxins, or dermal fillers within the last 6 months prior to enrollment; individuals who received superficial resurfacing treatment (chemic peel, microdermabrasion, micro‐needling, etc) inside the 6 weeks before enrollment; individuals with eyelash extensions.
2.two. Exam materials
All the test materials in this study were provided by SENTÉ INC (Carlsbad, CA, USA). The exam production was a cosmetic cream formulated with LMW‐HS and a proprietary blend of naturally derived extracts: Tephrosia purpurea seed excerpt (1%‐iv%), Eastward Crustaceum plankton excerpt (1%‐four%), Hieracium pilosella (one%‐3%), and Bellis perennis blossom (1%‐3%) extracts. Subjects were instructed to apply the examination production around the eye expanse twice daily (forenoon and evening) later cleansing their facial pare with the provided generic cleanser. The study elapsing was 12 weeks (August 2017‐January 2018), and subjects were evaluated at baseline and weeks 2, four, viii, and 12.
2.3. Evaluation
Subjects were evaluated at baseline and weeks 2, iv, 8, and 12. All assessments were performed after subjects washed their peel with a generic cleanser. Investigator efficacy and tolerability were evaluated at each visit past the same well‐trained personnel. Skin weather around the eyes (fine lines and wrinkles, coarse wrinkles, nether‐center puffiness, night circles, and overall skin damage) were evaluated using a ten‐signal scale (0 = none, 1‐3 = mild, 4‐six = moderate, and 7‐9 = severe). Global improvement was evaluated by the investigator using a five‐signal scale: 0 = worse, 1 = no improvement, 2 = balmy improvement (25% overall improvement), 3 = moderate improvement (50% overall improvement), and 4 = marked improvement (75% overall improvement). Skin tolerability (under‐center skin dryness and erythema) was evaluated using a ten‐point calibration (0 = none, i‐3 = mild, four‐6 = moderate, and 7‐ix = severe).
2.4. Standardized clinical photography
Digital photographs were obtained at baseline and weeks 2, 4, eight, and 12 using VISIA CR Imaging Organisation, Canfield Scientific.
2.five. Subject self‐cess
Subjects completed a self‐assessment questionnaire at weeks 2, iv, eight, and 12.
3. RESULTS
Under‐center pigmentation results from a combination of different colors/pigments and therefore, is developed through different mechanisms. The contribution of each of these colors/pigments (ie, cerise/pink, blue/gray, and dark-brown) to the advent of under‐eye pigmentation varies amid individuals. We investigated the efficacy of the test product to accost periorbital hyperpigmentation in subjects with moderate to astringent photodamage. Improvements in periorbital erythema were observed as early on as 2 weeks in subjects using the test product twice daily (Figure 1A,B). Further improvements (long‐term improvements) of periorbital erythema were observed at calendar week 12, suggesting no plateau consequence (Figures 1 and 2). Brown periorbital discoloration, frequently associated with an backlog of melanin, was decreased by the test product (Figure 2), significantly improving the overall appearance of the nether‐eye area (week 12). It is important to remark that different pigments/colors will exist resolved with different kinetics, as their mechanisms are diverse. Improvements in nether‐centre pigmentation reported by the clinical data were ratified by the subjects' self‐assessments in which 93% of the participants reported an improvement in the advent of dark circles (Figure 5B). Based on investigator assessments (Figure half dozenB), 53% of the subjects showed improvement in under‐middle night circles by one class or higher.
Curt and long‐term improvements in periorbital erythema. Subjects used an eye cream containing LMW‐HS and a proprietary alloy of naturally derived extracts showed a rapid reduction in redness in both upper eyelids equally well as under‐eye area as early on as 2 wks. Continuous improvements were observed at week 12. A, Female, 51 y erstwhile, Caucasian. B, Female person, 37 y onetime, Due east Indian. Standardized clinical photographs were taken at baseline, week ii, and week 12 using VISIA CR
An eye cream containing LMW‐HS and a proprietary blend of naturally derived extracts improved vascular conditions and hyperpigmentation (12 wks). Female, 50 y old, Caucasian. Standardized clinical photographs were taken at baseline and week 12
A, Example study shown using non‐standardized photography. Information technology is important to remark that clinical improvements in under‐eyes puffiness cannot be assessed using standardized photography as the endmost of the eye (a requirement for safe picture taking) results in improvements in the advent of puffiness. Female, 63 y old, Caucasian, showed improvements in under‐eye puffiness 5 min subsequently application of an eye cream containing LMW‐HS and a proprietary blend of naturally derived extracts. B, Subjects' self‐assessments and C, product performance evaluations at week 12
A, Investigator'southward Global Comeback Assessment: Overall changes in advent of fine lines and wrinkles, coarse wrinkles, under‐optics puffiness, under‐eye dark circles were evaluated at week 12. Global improvement was evaluated using a five‐point calibration (0 = worse, 1 = no comeback, ii = mild improvement [~25% overall improvement], 3 = moderate improvement [~50% overall improvement], and iv = marked improvement [~75% overall improvement]). B, Investigator's Assessment of Improvement in the appearance of under‐eye dark circles, fibroid wrinkles and fine lines at week 12. Subjects showing one course of improvement or more were included in this data
A meaning comeback in the appearance of lines and wrinkles around the eyes and on the upper eyelids (Figures 3 and four) was too observed. These changes occurred between weeks ii and 4 and are probably due to meaning improvements in pare hydration (deep and superficial hydration). The test production contains LMW‐HS, which rapidly promotes skin hydration by binding water, as well as multifunctional emollients such equally dimethicone, caprylic/capric triglyceride, Olea europaea and Helianthus Helianthus annuus seed oil unsaponifiables, among other ingredients of vegetable origin. The combination of these ingredients delivered instant and long‐term hydration while being gentle to the frail skin around the eye, minimizing potential irritation. Instant hydration was validated by the subjects' questionnaires and self‐assessments, in which 93% of the subjects stated that their pare was hydrated after the application of the examination product (Figure fiveC). Significant improvements in coarse wrinkles and under‐eye crepiness were likewise observed (Figures 3 and 4). In addition, 67% of the subjects reported improvements in coarse wrinkles (Figure 5B) at week 12 after using the examination production. Investigator'south assessment at week 12 (Effigy 6B) reported that 50% and 87% of the subjects showed improvement in the appearance of coarse wrinkles and fine lines, respectively.
A cosmetic cream containing LMW‐HS and a proprietary alloy of naturally derived extracts improved lines and wrinkles around the eyes and on the upper eyelids as early as four weeks. Female, 54 y former, Caucasian. Standardized clinical photographs were taken at baseline and calendar week iv and 12
Early on and continuous improvement in the advent of fibroid wrinkles and under‐eye crepiness by an eye cream containing LMW‐HS and a proprietary blend of naturally derived extracts. A, Male, 55 y onetime, Hispanic. B, Male, 56 y quondam, Caucasian. Standardized clinical photographs were taken at baseline, calendar week 2, and week 12
Under‐eyes puffiness or mild swelling becomes more prominent as nosotros age due to intrinsic changes in the physiology and anatomy of peel. Application of the exam product resulted in a rapid decrease in under‐eye puffiness (Figure vA, not‐standardized photography from an independent instance study). Seventy‐three percent (73%) of subjects in this report reported comeback in nether‐eye puffiness (Figure 5B) at calendar week 12. Finally, Investigator's global improvements assessments of fine lines and wrinkles, coarse wrinkles, under‐center puffiness, and night circles indicated that 40% of the subjects showed mild improvements in these atmospheric condition, while 27% and 20% of the subjects showed moderate and marked improvements, respectively (Figure sixA). In improver, production satisfaction was highly graded by all the participants, as 100% of subjects agreed that the test product was easy to use, did not dry the peel, and felt soothing (Effigy 5C).
four. DISCUSSION
Skin aging, regardless of whether its origin is chronological or environmental, results in visible deterioration of the skin'southward status and loss of its functionality.vi Environmental aging, which is triggered by solar radiations (UVA, UVB, IR, and visible light), pollution, and other stressors, is characterized by lines and wrinkles, dyschromia, dry skin, leathery appearance, sallow complexion, and changes in skin tone and texture.7, 8, ix, 10, 11 Signs of aging notoriously appear earlier around the periorbital area than in other parts of the face due to a unique combination of thin pare (the eye contour has the thinnest skin of the facial area), perpetual movements (over 10 000 blinks per day in addition to 22 muscles in constant movement), decreased corporeality of subcutaneous fat, and the lack (or extremely small corporeality) of sebaceous glands. Crumbling of the center surface area commonly starts manifesting around the third decade of life. Major patient concerns fall into three categories: periorbital hyperpigmentation, puffiness, and lines and wrinkles. In this written report, we reported early and long‐term improvements in all these periorbital concerns by a cosmetic cream formulated with LMW‐HS and a proprietary blend of naturally derived extracts.
Addressing periorbital skin rejuvenation is a complex procedure that involves improvements in periorbital hyperpigmentation, under‐centre puffiness, fine lines, and coarse wrinkles (Figure 7). Equally mentioned previously, ecology and intrinsic factors are responsible for the activation of mechanisms linked to these conditions. Periorbital hyperpigmentation (dark circles effectually and under the middle and upper‐eyelid discoloration) is a frequent cosmetic problem, with no golden standard treatment option available. It affects many individuals and results in an undesired tired, stressed, and aged expect.12 Diverse causes lead to periorbital hyperpigmentation, including aging, increased peel laxity and skin thinning, tear trough depression, post‐inflammatory hyperpigmentation (PIH) secondary to atopic dermatitis or allergic contact dermatitis, and post‐inflammatory hemodynamic congestion.thirteen, 14 Interestingly, different pigments/colors (ie, brown, blue‐greyness, red‐pink, and purple) are responsible for under‐eye discoloration (Figure vii). One of the nearly common causes for under‐center hyperpigmentation is the naturally occurring thinning of the skin, which allows the visualization of vascular changes and/or muscles under the skin. Therefore, cosmetic formulations that contribute to thickening the peel around the centre may visually improve the advent of nether‐centre discoloration. Clinical studies using LMW‐HS in topical formulations have shown increases in skin compactness and elasticity, suggesting improvements in dermal wellness.4 In addition, ex vivo data suggests that multiple applications of cosmetic creams containing LMW‐HS resulted in deposit of collagens and elastin (unpublished information, non shown), further supporting a role of LMW‐HS in skin thickening.
Main causes and mechanisms associated with the three major crumbling concerns of the periorbital area: periorbital hyperpigmentation (dark circles and upper‐eyelid discoloration), puffiness, and lines and wrinkles. All these conditions are triggered by a variety of factors and therefore require a multi‐factorial approach
Another condition linked to periorbital discoloration is capillary leakage, which is due to inflammation, resulting in tissue aggregating/deposition of heme groups and other related pigments.15 Free‐heme groups are highly cytotoxic due to the iron atom contained in the porphyrin ring, which catalyzes an uncontrolled production of free radicals (via Fenton reaction),16 enhancing oxidative stress, necrosis, and apoptosis. Nether normal conditions, heme‐oxygenase (HO) is responsible for heme deposition into carbon monoxide (CO), iron (which is sequestrated by ferritin), and biliverdin. Chronic oxidative stress and inflammation besides promote the deposit of hemosiderin, a complex form of ferritin, denatured ferritin and other materials, and the accumulation of damaged proteins (which contributes to the blue‐gray color of under‐eye circles). Topically applied LMW‐HS has been linked to a rapid subtract in erythema and uneven pigmentation also equally decreases in edema and inflammation (unpublished data).four In addition to LMW‐HS, the test product also contains a blend of Hieracium pilosella and Bellis perennis flower extracts, which take been linked to heme‐oxygenase‐1 (HO‐1) induction contributing to the deposition of the heme grouping and preventing activation of melanocytes. Thus, Eastward. Crustaceum plankton excerpt helps to subtract vascular permeability minimizing fluid extravasation and preventing edema and puffiness.
Age‐related reduction of epidermal function results in skin dehydration that can be aggravated by environmental stressors, further compromizing barrier function and increasing trans‐epidermal water loss (TEWL) with the concomitant activation of cutaneous inflammation. Therefore, restoring skin hydration plays a fundamental part in controlling inflammation, which happens to be the principal cause of erythema and edema. As a SuGAG, LMW‐HS has the intrinsic capacity of water bounden, which, in combination with its penetration profile (reaches epidermis and papillary dermis), improves peel hydration at different levels. Congenital or acquired dermal melanocytosis is another status that can trigger the gray‐blue color of nighttime circles.17 Chronic environmental stress and inflammation actuate melanin production, and the disruption of the cyclic production of pare cortisol further affects pare homeostasis and perpetuates the inflammatory response.18 To accost cortisol imbalance, Tephrosia purpurea seed extract was added to the exam product. This extract is enriched in stachyose, ciceritol, kaempferol‐3‐O‐rutinoside, quercetin‐3‐O‐rutinoside, and patuletin‐three‐O‐rutinoside, which accept been linked to normalization of cortisol imbalance while increasing β‐endorphins production.19 Information technology is of import to note that the exam product in this study does not contain the typical active ingredients used to address periorbital hyperpigmentation, such as hydroquinone, tretinoin, kojic acrid, azelaic acrid, arbutin, growth factors, vitamin C, or sunscreen actives.twenty, 21 Although these active ingredients have been proven to be efficacious, they may trigger irritation, increasing the risk of PIH or worsening uneven skin tone atmospheric condition. Addressing periorbital discoloration is frequently washed past a combination in‐part and accept‐home skin care approach.22 Thus, it would be interesting to evaluate the potential synergistic effect of the exam product with in‐office procedures such equally pulsed light therapy, lasers, or peels.23, 24, 25
Nether‐heart puffiness or balmy swelling becomes more prominent as we historic period due to intrinsic changes in the physiology and anatomy of pare. Lifestyle (eg, smoking, booze, and drug consumption) and diet (eg, salty food) are strong triggers of under‐eye puffiness, every bit are seasonal allergies and eczema. Therefore, decision-making under‐heart puffiness is a daily challenge. Periorbital edema, also as erythema can be linked to rubbing and scratching the skin around the eyes (mechanical friction) or to conditions such as mail service‐inflammatory hemodynamic congestion, inflammation (increase in capillary permeability), and impaired lymphatic circulation (Figure 7). Interestingly, crumbling results in gradual cloudburst and a decrease in density and network complexity of the lymphatic organization,26, 27 promoting water accumulation in the tissues. Furthermore, UV radiations were establish to damage cutaneous lymphatic vessels,28 contributing to the lymphatic‐dependent dysregulation of adipose volume and, therefore, facial wrinkle germination.29 We observed that the test production addressed under‐middle puffiness (Figure 5A,B), contributing to the global rejuvenation of the periorbital surface area.
Wrinkles on the face are the most dominantly recognized sign of skin crumbling. Facial sites such as the corner of the eyes (crow's feet) are specially susceptible to wrinkle formation due to constant move and skin thinning. While intrinsic crumbling plays a role in crow's anxiety formation by decreasing the thickness of the epidermis (with minimal changes in the number of jail cell layers) and dermis, ecology stressors (solar radiation and pollution) remain the predominant factors associated with coarse wrinkle formation as these stressors increase collagen degradation and decrease its product, diminish the corporeality of functional elastic fibers, and significantly change the residuum of cutaneous GAGs (Figure 7). Chronological and environmental aging trigger intense dermal and epidermal GAG remodeling, altering the ratio of abundancy of SuGAGs, which is linked to the development of solar elastosis.30 Eolith of elastotic material not simply affects the dynamics of the ECM but also increases SuGAG‐linked dysfunction by sequestrating these molecules and compromizing both their biological activity and water trapping chapters, resulting in fragile and dehydrated skin that shows signs of tiredness. In addition to these changes in the dermal level, volume loss on the adipocyte layer also contributes to wrinkle germination.31, 32
In conclusion, our clinical evaluation of an eye cream containing LMW‐HS and a proprietary blend of naturally derived extracts showed full global improvements in periorbital pare condition. This test product was highly rated by subjects for efficacy and product attributes and was well tolerated. Although results of this proof‐of‐concept clinical study were satisfactory in both efficacy and subject satisfaction, further evaluations with a larger number of subjects would be appropriate to expand this report's findings. In addition, it would exist interesting to evaluate the efficacy of this test product in combination with common in‐part procedures for periorbital heart rejuvenation, such as dermal fillers, neurotoxins, lasers, and others.
CONFLICT OF INTEREST
The authors accept no other conflict of involvement.
Notes
Colvan L, Fleck T, Vega VL. Global periorbital skin rejuvenation by a topical eye foam containing low molecular weight heparan sulfate (LMW‐HS) and a blend of naturally derived extracts. J Cosmet Dermatol. 2019;xviii:530–538. x.1111/jocd.12857 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Funding data
This report was funded in full by SENTÉ Inc. Lora Colvan, Tina Bit, and Virginia L. Vega are employees of SENTÉ INC.
REFERENCES
one. Ernst S, Langer R, Cooney CL, Sasisekharan R. Enzymatic deposition of glycosaminoglycans. Crit Rev Biochem Mol Biol. 1995;30(five):397–444. [PubMed] [Google Scholar]
2. Lin X, Wei Thousand, Shi Z, et al. Disruption of gastrulation and heparan sulfate biosynthesis in EXT1‐scarce mice. Dev Biol. 2000;224(2):299–311. [PubMed] [Google Scholar]
iii. Kitagawa H, Izumikawa T, Mizuguchi S, et al. Expression of rib‐1, a Caenorhabditis elegans homolog of the human tumor suppressor EXT genes, is indispensable for heparan sulfate synthesis and embryonic morphogenesis. J Biol Chem. 2007;282(xi):8533–8544. [PubMed] [Google Scholar]
iv. Gallo RL, Bucay VW, Shamban AT, et al. The potential role of topically applied heparan sulfate in the treatment of photodamage. J Drugs Dermatol. 2015;fourteen(seven):669–674. [PubMed] [Google Scholar]
v. Venkataraman G, Shriver Z, Raman R, Sasisekharan R. Sequencing complex polysaccharides. Scientific discipline. 1999;286(5439):537–542. [PubMed] [Google Scholar]
half dozen. Newton VL, Mcconnell JC, Hibbert SA, Graham HK, Watson RE. Skin aging: molecular pathology, dermal remodelling and the imaging revolution. G Ital Dermatol Venereol. 2015;150(half dozen):665–674. [PubMed] [Google Scholar]
7. Quan T, Qin Z, Xia Due west, Shao Y, Voorhees JJ, Fisher GJ. Matrix‐degrading metalloproteinases in photoaging. J Investig Dermatol Symp Proc. 2009;14(1):xx–24. [PMC gratuitous article] [PubMed] [Google Scholar]
viii. Schroeder P, Haendeler J, Krutmann J. The function of most infrared radiation in photoaging of the pare. Exp Gerontol. 2008;43(7):629–632. [PubMed] [Google Scholar]
ix. Rittié L, Fisher GJ. Natural and dominicus‐induced aging of human skin. Cold Spring Harb Perspect Med. 2015;5(1):a01537. [PMC free commodity] [PubMed] [Google Scholar]
10. Krutmann J, Liu W, Li L, et al. Pollution and skin: from epidemiological and mechanistic studies to clinical implications. J Dermatol Sci. 2014;76(3):163–168. [PubMed] [Google Scholar]
xi. Vierkötter A, Schikowski T, Sugiri D, Matsui MS, Krämer U, Krutmann J. MMP‐one and ‐3 promoter variants are indicative of a common susceptibility for peel and lung crumbling: results from a accomplice of elderly women (SALIA). J Invest Dermatol. 2015;135(five):1268–1274. [PubMed] [Google Scholar]
12. Giacomoni PU. Advancement in skin aging: the future cosmeceuticals. Clin Dermatol. 2008;26(four):364–366. [PubMed] [Google Scholar]
13. Roh MR, Chung KY. Infraorbital dark circles: definition, causes, and handling options. Dermatol Surg. 2009;35(eight):1163–1171. [PubMed] [Google Scholar]
fourteen. Freitag FM, Cestari TF. What causes dark circles under the eyes? J Cosmet Dermatol. 2007;6(3):211–215. [PubMed] [Google Scholar]
fifteen. Eberlin S, Del Carmen Velazquez Pereda G, de Campos Dieamant G, Nogueira C, Werka RM, de Souza Queiroz ML Effects of a Brazilian herbal compound as a cosmetic eyecare for periorbital hyperchromia ("dark circles"). J Cosmet Dermatol. 2009;8(2):127–135. [PubMed] [Google Scholar]
16. Sadrzadeh SM, Graf Eastward, Panter SS, Hallaway PE, Hemoglobin Due east. A biologic fenton reagent. J Biol Chem. 1984;259(23):14354–14356. [PubMed] [Google Scholar]
17. Watanabe S, Nakai K, Ohnishi T. Condition known as "dark rings nether the eyes" in the Japanese population is a kind of dermal melanocytosis which can be successfully treated past Q‐switched ruby laser. Dermatol Surg. 2006;32(6):785–789. [PubMed] [Google Scholar]
18. Altemus K, Rao B, Dhabhar FS, Ding W, Granstein RD. Stress‐induced changes in peel barrier function in healthy women. J. Invest Dermatol. 2001;117(two):309–317. [PubMed] [Google Scholar]
19. Hubert J, Chollet S, Purson Southward, et al. Exploiting the complementarity betwixt dereplication and computer‐assisted structure elucidation for the chemical profiling of natural corrective ingredients: tephrosia purpurea every bit a case study. J Nat Prod. 2015;78(7):1609–1617. [PubMed] [Google Scholar]
xx. Sarkar R, Ranjan R, Garg S, Garg VK, Sonthalia S, Bansal S. Periorbital Hyperpigmentation: A Comprehensive Review. J Clin Aesthet Dermatol. 2016;9(1):49–55. [PMC costless commodity] [PubMed] [Google Scholar]
21. Bucay VW, 24-hour interval D. Adjunctive skin care of the brow and periorbital region. Clin Plast Surg. 2013;forty(i):225–236. [PubMed] [Google Scholar]
22. Woodhall KE, Goldman MP, Gold MH, Biron J. Benefits of using a hydroquinone/tretinoin skin care system in patients undergoing intense pulsed light therapy for photorejuvenation: a placebo‐controlled study. J Drugs Dermatol. 2009;8(9):862–867. [PubMed] [Google Scholar]
23. Vavouli C, Katsambas A, Gregoriou Due south, et al. Chemic peeling with trichloroacetic acrid and lactic acid for infraorbital night circles. J Cosmet Dermatol. 2013;12(3):204–209. [PubMed] [Google Scholar]
24. Momosawa A, Kurita Thou, Ozaki M, et al. Combined therapy using Q‐switched red laser and bleaching treatment with tretinoin and hydroquinone for periorbital pare hyperpigmentation in Asians. Plast Reconstr Surg. 2008;121(i):282–288. [PubMed] [Google Scholar]
25. Alster TS, Bellew SG. Improvement of dermatochalasis and periorbital rhytides with a loftier‐energy pulsed CO2 laser: a retrospective study. Dermatol Surg. 2004;30(iv Pt 1):483–487; word 487. [PubMed] [Google Scholar]
26. Ryan T. The ageing of the blood supply and the lymphatic drainage of the peel. Micron. 2004;35(3):161–171. [PubMed] [Google Scholar]
27. Karaman Southward, Buschle D, Luciani P, Leroux JC, Detmar Chiliad, Proulx ST. Reject of lymphatic vessel density and office in murine pare during aging. Angiogenesis. 2015;18(4):489–498. [PubMed] [Google Scholar]
28. Kajiya K, Kunstfeld R, Detmar Thousand, Chung JH. Reduction of lymphatic vessels in photodamaged human skin. J Dermatol Sci. 2007;47(3):241–243. [PMC free commodity] [PubMed] [Google Scholar]
29. Pessa JE, Nguyen H, John GB, Scherer PE. The anatomical ground for wrinkles. Aesthet Surg J. 2014;34(2):227–234. [PubMed] [Google Scholar]
30. Werth BB, Bashir M, Chang L, Werth VP. Ultraviolet irradiation induces the accumulation of chondroitin sulfate, but not other glycosaminoglycans, in human skin. PLoS 1. 2011;6(8):e14830. [PMC free article] [PubMed] [Google Scholar]
31. Kahn DM, Shaw RB. Overview of electric current thoughts on facial volume and aging. Facial Plast Surg. 2010;26(five):350–355. [PubMed] [Google Scholar]
32. Jacono AA, Ransom ER. Anatomic predictors of unsatisfactory outcomes in surgical rejuvenation of the midface. JAMA Facial Plast Surg. 2013;15(ii):101–109. [PubMed] [Google Scholar]
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850077/
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