Clinical analysis and classification of dark eye circle

Abstract Background Dark eye circle ( DEC ) is a common problem that usually lacks detailed classification in the etiology and structural variations. A newly‐developed DEC Assessment Score using Wood's lamp and ultrasonogram will provide a more precise evaluation of DEC for improving treatment results. Materials and methods Sixty‐five cases, including eight males and 57 females with a mean age of 38.9 years, were enrolled. DEC were classified into pigmented (brown), vascular (blue to purple), structural, and mixed type by Wood's lamp and ultrasonogram. A scoring system with nine parameters, including brown hue, pigmented lesions, blue/pink/purple hue, periorbital puffiness, shadow hue, infraorbital palpebral bags, infraorbital grooves, blepharoptosis, and skin type, was used for clinical evaluation. Results Pigmented, vascular, structural, and mixed types of DEC represented 5%, 14%, 3%, and 78%, respectively. Thirty‐three cases with periorbital puffiness were found to have higher “pre‐septal thickness” than those of 20 controlled cases ( P = 0.032). Fourteen patients with infraorbital palpebral bags were proved to have protruded retroseptal fat pads by ultrasonography. Conclusion Pigmentation and vascular and structural components may play important roles in DEC . Detailed classification of DEC types will access physicians in the decision of appropriate therapeutic modalities.