Hyperpigmentation on the eyelids is a common skin concern and is usually due to genetics. It usually presents as patches of skin that are darker than the surrounding area and is normally harmless. However, it can sometimes suggest an underlying medical condition. Also, for some people it can be severe and a cosmetic skin concern. In this article, we will explore the causes of hyperpigmentation on the eyelids and how to treat it.
What Causes Hyperpigmentation on Eyelids?
Hyperpigmentation on the eyelids can appear as diffuse darkening or localised spots. This discolouration can be gradual, with patches varying in hue from light pink or brown to almost black, depending on your natural skin tone and the cause.
The skin on our eyelids is among the thinnest on the body and is highly sensitive to changes both from internal and external factors. It happens when excess production of melanin, the pigment that gives colour to our skin, leads to hyperpigmentation. This can present as spots or an overall darkening of the eyelid skin. Below are the most common causes for hyperpigmentation on the the eyelid area.
Genetics
This is the main cause of hyperpigmentation on the eyelids. Genetic factors play a pivotal role in the darkening of eyelid skin. They can dictate how much melanin the body naturally makes and its distribution. Individuals with darker skin tones, for example, possess more active melanocytes. These are the cells that make melanin. As such they are more prone to hyperpigmentation in general. In addition, if you have a family history of darker eyelids then you will be more likely to develop hyperpigmentation in this area.
Genetics also determine the response of your skin to inflammation and injury. Some people having a heightened reaction that leads to extra melanin build up as part of the healing process. This is condition is called post-inflammatory hyperpigmentation and it is common in people with skin of colour. In addition, hereditary conditions and certain genetic diseases can cause abnormalities in melanin production and distribution. These can lead to uneven pigmentation on the eyelids.
Sun Exposure
Sun exposure is a significant trigger for hyperpigmentation on eyelids. The delicate skin of the eyelids is highly susceptible to the sun’s UV rays. Also, this area is often missed during sunscreen application. The skin’s natural response to sun damage is to produce more melanin in an effort to protect it. As such chronic sun exposure without proper protection can lead to a build up of melanin. This then results in darkening of eyelid skin. However, this is not just a cosmetic concern as UV radiation can cause cell damage. This increases the risk of skin cancer and speeds up the aging process in the eyelids.
Aging
This is another key factor that can lead to hyperpigmentation on the eyelids. As we age, our skin undergoes various changes, including the slow down of cell turnover, reduction of collagen production and alteration of melanin distribution. This can cause the skin to become thin and more fragile, especially around the eyes. As such it makes it more prone to discolouration. Additionally, the cumulative effects of environmental damage over the years, like prolonged sun exposure, can exacerbate age related hyperpigmentation. Older skin also tends to retain more pigmentation after inflammation or injury.
Inflammation
In general, inflammation can play a significant role in the development of hyperpigmentation on the eyelids. When the delicate skin around the eyes becomes inflamed, it can trigger an increase in melanin production as a natural protective response. There are a variety of causes that can trigger this post inflammatory hyperpigmentation. These include allergic reactions, dermatitis, infection or even as a result of irritation from skin products. If this is chronic, then the over production of melanin can build up and lead to darkening of the eyelid skin.
Medications
Certain medications can cause darkening of the skin on the eyelids. This side effect is known as drug-induced hyperpigmentation. It occurs when a drug leads to an increase in melanin production or deposition in the skin. Medications that can cause this include antimalarials, antipsychotics, anticonvulsants, heavy metals and certain chemotherapy drugs. The eyelids are particularly vulnerable due to their thin skin, which can more readily show changes in pigmentation. Drug-induced hyperpigmentation typically fades once you discontinue the medication. However, sometimes it can persist for months or even years. In some cases it may even be permanent.
Hormonal Changes
These are also a cause of hyperpigmentation on the eyelids. Hormonal conditions like melasma are common during periods of hormonal changes like pregnancy. Melasma can also occur with the use of oral contraceptives or hormone replacement therapy. The fluctuation in hormones, especially oestrogen and progesterone, can trigger an overproduction of melanin when there is exposure to the sun. Even minor sun exposure can exacerbate this condition due to the delicate nature of the eyelid skin. While this condition may fade as hormones balance, it can persist and be hard to treat.
How to Treat Hyperpigmentation on Eyelids
The best way to treat hyperpigmentation on the eyelids is to start by finding out the cause. If the hyperpigmentation is new or sudden onset, then consult with your doctor. They can check if its due to hormonal, medicines or health problems. The initial treatment will focus on addressing the root cause of your eyelid hyperpigmentation.
If its long standing or inherited, then there are a number of topical and professional treatments that can help. However, you should approach any treatment with caution due to the sensitivity and thinness of the skin in this area.
Topical Treatments
These are the first line and often involve skin lightening products. Topical treatments for eyelid hyperpigmentation include over the counter ingredients like arbutin, kojic acid, azelaic acid, retinol and vitamin C as well as prescription options like hydroquinone and tretinoin. It’s best to see a dermatologist or other skin specialist before treating eyelid hyperpigmentation. This will ensure that you use the best products and advice to avoid irritation. Below are the best topical treatments for eyelid hyperpigmentation:
- Hydroquinone: This is a prescription only product that is effective at lightening hyperpigmentation. However, hydroquinone is not routinely used for the eyelid area due to potential irritation and the risk of ochronosis.
- Arbutin: This is a gentler alternative to hydroquinone. Arbutin can be used to lighten dark patches on the eyelids but caution is needed to reduce risk of irritation.
- Kojic Acid: This is another good over the counter option. However due to the risk of irritation and sensitivity, kojic acid must be used sparingly on the eyelids.
- Azelaic Acid: Whilst azelaic acid is milder and can help reduce pigmentation, you should only use it under medical supervision when applying to the eyelids.
- Tranexamic Acid: This is especially useful for treating melasma. Tranexamic acid creams and serums designed for facial use can be gently applied to the eyelid to treat hyperpigmentation.
- Retinoids: These promote cell turnover and can fade hyperpigmentation. You should not use them with out medical supervision on the eyelids due to the risk of severe irritation and skin damage.
- Vitamin C: This is an antioxidant that can brighten the skin. Vitamin C is safe for use around the eyes but find a product that is formulated specifically for this delicate area.
Professional Treatments
For stubborn or extensive eyelid hyperpigmentation, there are some professional treatments that can help. These usually enhance or build on the gains of topical treatments. The two main professional treatments are chemical peels and lasers. These are effective treatments but do carry some risks and side effects. You should always ensure that you have your procedure with a trained and qualified practitioner. Specifically check if they have experience in treating the eyelids.
- Chemical Peels: Mild chemical peels may be used on the eyelids to treat hyperpigmentation. Hpwever, this should only be done by a professional as there is a risk of chemical burn and scars if not done correctly.
- Laser Therapy: Q-switched lasers or intense pulsed light therapy are two examples of laser treatments that are effective for treating hyperpigmentation on the eyelids. However, this treatment needs precision for eyelid treatment. That’s why these procedures should only be done by experienced dermatologists or plastic surgeons.
Preventing Hyperpigmentation On The Eyelids
There are two key things you can do to prevent hyperpigmentation on the eyelids. The first is to be strict about sun protection as UV damage can cause or worsen eyelid hyperpigmentation. Use sunglasses and a broad-spectrum sunscreen of at least SPF30 to protect the eye area. Also be gentle with the skin around your eyes. Use non-irritating and hydrating skincare products to reduce inflammation induced hyperpigmentation.
Usually, hyperpigmentation on the eyelids is usually not harmful. However, if you notice new or changing spots, you should start by consulting with your doctor to rule out underlying health conditions as a cause. If you want to treat dark eyelid skin for cosmetic reasons, there are a number of topical and advanced options. However, it’s vital to proceed with caution and under professional guidance due to the delicate nature of sin in this area. Also remember hat treatments take weeks or months to work even with regular and consistent use. The results also vary from person to person and you may need a combination of treatments to achieve your desired outcomes.
At City Skin clinic, we are passionate about personalised skincare. Through our online skin clinic our doctors can offer a number of safe and effective treatments including Tretinoin and Hydroquinone. We treat skin conditions like acne, hyperpigmentation, melasma and skin ageing. To start your personalised skincare plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
