The debate has always been heated among skin care specialists and dermatologists as to the risks and benefits of scrubbing one’s countenance and body parts. The dangers of creating microscopic tears in the skin are very real, especially if a scrub contains granules with irregular edges, like crushed walnut shells or apricot pits, or if too much pressure is used with any method of exfoliation, including alcohol, witch hazel or astringent with cotton and microdermabrasion.

Washcloths vs. Scrubs vs. Astringent/Cotton vs. Buffing Pads: There are pitfalls to every method of “epidermabrasion” and skin tampering, especially on skin Black, thin, post-operative or sensitive skin.

Who’s at Risk: Sensitive and thin-skinned individuals, People of Color, post-operative skin (laser, deep dermabrasion and medical peels) and those using Magic Shave or other hair removal chemicals, Retin-A, Accutane, benzoyl peroxide, BHA (salicylic acid), glycolic acid and other AHAs and sun-sensitive skin. Because many active ingredients, medical procedures and professional treatments can cause superficial flaking and/or peeling, the temptation to speed up the process by scouring off their dead skin cells can be irresistible.

Abrading and tampering with the skin manually (scrubs, buffing pads, rubbing with a washcloth or towel, rubbing, picking, scratching, patting, using alcohol and cotton, scraping the skin while shaving, being shaved or removing shaving powders, microdermabrasion, “dermaplaning” with a blade, and/or using too much pressure for any reason) can “over-process” the skin. This allows “active” home and professional products and UV rays to penetrate into irritated skin, worsening the inflammation, which can turn mild flaking into excessive scaling and prolonged irritation which “activates” the melanocytes in the basal layer of the skin (the cells that provide your natural coloration). This situation incites a dramatic increase in pigmentation problems, especially if exposed to sunlight, rubbing, scrubbing, picking, or product overuse. Repeated manipulation, friction and skin tampering can slow down the healing process, introduce bacteria, incite secondary infection, and cause epidermal cells on and around blemishes to thicken, darken, and get larger as the body struggles to defend itself from the constant assault.

Unwelcome Results: Side effects include temporary redness, burning, excessive and prolonged scaling, increased sun-sensitivity, a thick build-up dead skin cells, severe pigmentation problems and an uneven skin tone, especially on the neck and cheeks. Symptoms can last anywhere from a few days to several months.

Warning to People of Color: Abrasion caused by overzealous manual exfoliation (scrubbing too often, scraping the skin, using too much pressure, picking, scratching, skin tampering, rubbing with a towel) by any means or method, exposure to sun and lack of adequate water intake (dehydration), can leave unsightly and hard-to-remove hyperpigmentation in its wake, especially on the neck. You can’t scrub the “black” off your neck, or someone else’s neck! And, you can’t scrub, scrape or pick off thickened dead skin cells. They just get worse.

Better Yet: Use your products exactly as directed. To combat flaking, try sulfur mask (mild, non-mechanical exfoliant that will “passively” dissolve dead skin cells. Apply a generous coat and allow it to remain on the skin for up to 10 minutes, without letting the mask dry out. It should be showered or rinsed off with warm water and gentle pressure from fingertips only. Ask us about other methods to help remove dead skin cells without trauma.

Safer Scrubs: Scrubs containing finely-ground meal (like cornmeal), papaya enzyme creams, man-made jojoba beads, fine polyethylene granules, soaps containing powdered exfoliants, and tiny marble spheres have a smooth, uniform surface, won’t tear delicate skin. However, overuse and/or applying too much pressure with the gentlest exfoliant can still cause problems!

Experienced skin care professionals can perform lactic acid peels or gentle enzymes formulated for sensitive skin if you need to exfoliate. Gentle exfoliants designed for home use on sensitive skin are safe bets and can safely boost skin-smoothing results if used as directed.

© 2010 Kathryn Khadija Leverette, Urban Skin Solutions, Inc. and urbanskin.com

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

Guide to the Management of Keratosis Pilaris

What does KP look like? This annoying skin disorder, called keratosis pilaris (KP), is characterized by thousands of hard, non-inflammatory keratin plugs that cover the hair follicles, making the skin rough and pebbled, in appearance and to the touch. And, it worsens dramatically if picked and scratched. Skin tampering invites secondary infection, enlargement of the bumps, delayed healing and unsightly discoloration. These dark, discolored sores mimic burned-out acne and can cause permanent scarring.

Does KP look different on People of Color? Yes. On many black, Hispanic, Asian and dark or olive-skinned people, KP resembles thousands of tiny blackheads and dark blemishes blanketing the skin.

What parts of the body are affected? The backs of the arms, the shoulders, the front and sides of the upper legs, the calves, the buttocks and occasionally on the cheeks of small children, though its not limited to those areas.

What causes KP? Though KP has been blamed on everything from shaving to tight jeans to dry skin, keratosis pilaris is a chronic, genetic condition caused by hyperkeratosis, the build-up of dead skin cells that cover the follicle opening.

Is there a cure for KP? No. Though KP can be controlled, the can bumps return shortly after abandoning treatment. While there is no lasting “cure”, consistent home management can keep those bumpy symptoms in check, lessening the risk of hyperpigmentation.

What can I do to treat my KP? Gentle, twice daily use of natural bristle body brush with an alpha hydroxy acid, sulfur or benzoyl acne soap or cleanser can sometimes solve the problem. Keratolytic topicals like sulfur/resorcinol lotion, benzoyl peroxide (BPO), glycolic or lactic acid gel or lotion, potent Retin-A® can all be highly effective with regular use. Since 1989 most health insurance carriers won’t cover Retin-A® prescriptions for adult patients over 26 years of age; the large amount of Retin-A® needed to keep keratosis pilaris under long-term control make its use financially prohibitive.

My KP seems to improve when I get a lot of sun. Why? Sun exposure causes mild burning and subsequent peeling (similar to BPO, Retin-A®, AHA, BHA, etc.) that temporarily exfoliates KP bumps. But, the sun also darkens bumps on People of Color and causes premature aging, the destruction of skin texture, unsightly sun spots (keratoses), sagging of the skin and skin cancer.

How do I use these exfoliating products? Since keratosis pilaris most frequently affects the non-sensitive areas of the upper arms, thighs and buttocks, topical exfoliating products may be used daily in the absence of skin irritation. Product potency and the daily application schedule should be evaluated and varied according to individual skin sensitivity of those areas and other affected body parts.

What if my KP is red in appearance? Some light-skinned KP sufferers get a non-inflamed form of “red” KP characterized by thousands of tiny rough red bumps. Others have an inflamed KP condition that resembles active acne and larger lesions, often caused by picking. Cleansers and topicals containing benzoyl peroxide (BPO) and/or sulfur, which are both anti-bacterial exfoliants, work well on all red and/or inflamed KP. Keep in mind that it bleaches fabric and must not be worn if one expects to perspire or be exposed to the sun. It works best when worn on the affected area at bedtime, followed by clean white T-shirts and/or pajamas.

What if the KP is bumpy but not inflamed? Alpha hydroxy acid (glycolic or lactic) lotions or gels (10% to 15%) can be applied sparingly once or twice day, and rubbed thoroughly into the skin until all traces have been absorbed. Unlike benzoyl peroxide, alpha hydroxy acid (AHA) won’t discolor fabric. For non-inflammatory and post-inflammatory cases, alpha hydroxy acid lotions and gels can be applied sparingly in the absence of irritation.

What if my KP bumps are much darker than my skin tone? Sometimes, KP looks like a sprinkling of blackheads, especially on People of Color. Formulations containing alpha hydroxy acid (glycolic or lactic) formulated with lighteners and brighteners along with bleaching soaps can work wonders on KP that is a much darker brown than the surrounding skin. Hydroquinone (HQ) must be allergy patch-tested for three days prior to use unless you have used skin lighteners containing HQ without adverse reactions in the past. Body exfoliants containing AHA and formulated with hydroquinone and skin brighteners are designed specifically for use on hyperpigmented skin if direct sun is avoided and full-spectrum sunscreen is used religiously.

How do skin lighteners fade the spots caused by KP? These products work three ways. First, alpha hydroxy acid softens and exfoliates the buildup of keratin (dead skin cells) that buries the hair follicle. Next, it acts as a “vehicle” to carry skin lighteners and brighteners deeper into the follicles. Last, skin lighteners help inhibit the over-production of dark melanin coloration in the basal layer of the epidermis, but need a vehicle with a small particle size to penetrate deep enough to be effective.  Lighteners and brighteners include hydroquinone, kojic acid, mandelic acid, arbutin, bearberry extract, mulberry extract, azelaic acid, licorice root extract, l-ascorbic acid, vitamin K, lemon and lime extract, and others. These ingredients perform best when formulated with a “penetrant” (like AHAs and retinoids) that allows these melanin-suppressors to penetrate the follicle.

Can I go into the sun after the KP clears up and my spots fade? If your skin is exposed to any direct sun at all, it is important to apply full-spectrum sunscreen hourly. Try to make every effort to avoid the sun whenever possible. This is especially important if any discoloration is present, or if your skin blemishes have a tendency to over-darken. Previously hyperpigmented skin can darken faster than the surrounding skin, even after the spots have faded and the KP is under control. Keep in mind that a variety of health problems and medications can make your skin extremely sun sensitive and total sun avoidance is advisable.

What are the side effects of these treatment products? The side effects of the treatment for keratosis pilaris can include temporary dryness, mild peeling and itching and the presence of superficial darker patches of dead skin cells. These symptoms subside as the skin gets used to exfoliating lotions and gels, and if they are used exactly as directed. Overuse will worsen or prolong these symptoms.

Can scrubbing help my KP? Gentle exfoliation in the absence of irritation can help keep the KP-affected skin smooth. Excessive pressure, rough scrubbing and picking are taboo. They increase the risk of uncomfortable side effects, irritation, sun sensitivity and dark discoloration.

Are any treatments available to boost my efforts? Professional glycolic and lactic acid peels, the absence of irritation, can be useful in boosting stubborn cases.

Can I stop treatment after I clear up? No. Keratosis pilaris is a chronic genetic condition with no permanent cure. Home maintenance must be continued permanently to prevent the bumpy or symptoms from recurring.

© 2003 Kathryn Leverette, Solutions Center, Kathryn Leverette, Inc.

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

Similar problems can affect women on the chin, sideburns, neck, chest, abdomen, legs and in the bikini area from tweezing, waxing, shaving and sometimes even depilatories. The sensations experienced by the razor bump (ingrown hair) sufferer are constant itching, tingling, burning, soreness, swelling and sometimes real pain. Symptoms can be mildly annoying and localized for some, and severe and extensive for others.
Pseudofolliculitis barbae is a chronic condition that can persist as long as the individual shaves, waxes, threads, and/or tweezes. Obviously, the problem can be dealt with by just allowing the hair to grow out. As the hair grows longer, it simply pops out the follicular opening and new “bumping up” ceases because the individual has stopped shaving, waxing or tweezing. This option, however, is not always practical due to the pressure of one’s employer, lifestyle, beauty and grooming customs.

Strict grooming regulations have been historically imposed by law enforcement agencies, fire departments, parcel delivery services and the military. These and other industries have traditionally insisted on the clean shaven look, and this has caused suffering and disfigurement to thousands of black men. In recent years, consciousness has gradually increased and some rules are slowly changing. Some branches of the military, most notably the Navy, are allowing extremely bump-prone men to sport a short, neatly groomed beard.

For decades, viable solutions to this universal problem eluded the medical, esthetic and drug store markets, and continue to do so, on a wide-scale basis. Most physicians have relied, unsuccessfully, on topical steroids, retinoid creams and systematic antibiotics.

Over-the-counter and mailorder systems have utilized single edge blades, weak cortisone creams, bromelain enzymes, abrasive scrubs and alcohol-based salicylic acid solutions. While these methods can help improve the condition, they rarely offer longterm relief. As a result, this all too common skin disorder presents a wide open arena for knowledgeable esthetic practitioners, who can dispense exfoliating, calming and antibacterial professional products and have the skill to release ingrown hairs safely in a clinical skin care setting.

Shaving Habits: We instruct our clients to shave in the direction of hair growth with a single edge disposable blade like the PFB Bump Fighter. Examine the shaving area and determine which areas are less “bumped up” than others. Carefully imitate the shaving method and direction you use in the clearest areas, and repeat the same process on the entire shaving area. Do not repeatedly go over the same area in a back and forth motion in an effort to get a closer shave. Unscented shaving creams, mild shaving soaps and gels containing benzoyl peroxide or alpha or beta hydroxy acids work well with single-edge disposable blades. The blade should be used no more than once or twice.

If the preferred shaving method involves an electric razor, we prefer the traditional barber’s trimmer, called a T-edger or liner, which gives a close, more precise shave that the larger clippers. An example of this compact trimmer is the Wahl, designed for black men who shave, but Oster, Andes and other trimmers work equally well. Professional disinfectant spray (Clippercide or Oster) must be used before and after shaving to disinfect and lubricate the blades.

We include wives, mothers and girlfriends in the consultation. They are often the ones who wield the sewing needles and tweezers, or observe the picking, unhooking, tweezing and other types of skin tampering habits at home. Picking and tampering with the skin of introduces secondary bacteria and leads to inflammation, delayed healing, scarring and larger, thickened dark spots. Tweezing and waxing trap recently removed hairs deep below the skin line, setting them up to become trapped again and again as they re-grow.

Avoid rotary shavers that cut beard hair at too many different angles, seriously compounding the problem. The skin should never be stretched to obtain a closer shave. When the skin bounces back, newly shaved hair will be situated, and later trapped below the skin line. The same principal applies to twin, triple and five-blade razors; the first blade stretches the skin, while the second (third, fourth and fifth) blade shaves way too close.

Depilatory creams and shaving powders should be discouraged once one of our anti-bacterial, keratolytic topicals is applied nightly in the bump prone area without irritation. Use of depilatories leads to dark hyperpigmentation of the lower face and neck, sometimes called “shadowing”, caused by chemical irritation and subsequent sun exposure. Melanin-suppressing skin lighteners should be introduced gradually in the absence of irritation and allergy. During the day, greaseless anti-inflammatory creams and oil-free full-spectrum sunscreens are vital to correcting and discouraging beard discoloration.

Electrolysis: Those with chronic “trouble spots” (often on the neck or cheeks, usually where tweezing was performed repeatedly) might want to explore the “blend method” of electrolysis for their problem areas. The electrologist should be skilled and experienced in the treatment of black, bump-prone clients with curved, often scarred, hair follicles. The curved follicle, healing process, risk of scarring and hyperpigmentation, as well as inflammatory reaction to the temporary “trauma” of electrolysis can differ radically from other races.

Laser hair removal has become increasingly popular in recent years to gradually and permanently reduce hair on the face and body. It is important that candidates do their homework to steer clear of the risks related to lasers, especially scarring and hyperpigmentation on darker skin tones.

Laser practitioners must:

(a) Use the safest, most appropriate laser for darker skin tones (the YAG Q-switched neodymium yttrium aluminum garnet laser that produces a 1064nm wavelength of laser light)

(b) Be well-trained in the use of that laser

(c) Disclose exactly what that laser can and cannot do for you

(d) Be experienced working with your ethnic skin type

(e) Be able to address pre-laser pain management, reduction of inflammation, melanin suppression (to control pigmentation), sun protection/avoidance, and be able to treat post-laser skin.

©2010 Kathryn Khadija Leverette, Urban Skin Solutions, Inc. and urbanskin.com

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

Of all the skin disorders that affect the darker races, hyperpigmentation is the chief complaint. Skin problems, medications and medical conditions can lead to skin discoloration, including acne, razor bumps, shaving irritation, hormonal melasma, chemical irritation, eczema, friction, electrolysis, allergic reactions, abrasive scrubs, scrubbing, product overuse, prescription medications, hormones, dehydration, obesity, auto-immune disease, chicken pox, sunburn, waxing, electrolysis, insect bites, picking, wiping the eyes, rubbing, tampering with the skin by any means, trauma, tweezing, surgical procedures, lasers and microdermabrasion.

Hormonal and post-inflammatory hyperpigmentation on all races and skin types can be improved dramatically with light skin peels, conservative use of topical alpha hydroxy acids and retinoids in formulations containing  melanin-suppressing skin brighteners, sun avoidance and diligent use of non-clogging, full-spectrum sunblock suited to skin type. The key to controlling hyperpigmentation includes taking a medical history, addressing the lifestyle issues that cause or worsen the problem, corrective skin care, skin brightening peels and follow-up care to monitor product overuse, sunblock under-use and sun exposure.

Hormones, pregnancy, unchecked acne flare-ups, sun exposure, allergic reactions, over-scrubbing and/or overuse of homecare products, eczema, allergic reactions, and getting inappropriate professional procedures are only a few of the many factors that can make or break any dark spot lightening program. The cause of the skin problem, and the factors that worsen it, must be addressed before pigmentation problems can be improved or overcome. If you have acne, razor bumps, “rashy” skin, tamper with your skin, fail to follow instructions, have serious underlying medical problems, take sun-sensitizing medications or are overweight, these issues must be factored in to the plan of action.

Kojic acid dipalmitate, licorice root, bearberry extract, arbutin, mulberry extract, azelaic acid and ascorbic acid work especially well when formulated together in “cocktails”. Like hydroquinone (HQ), they can be combined pore-penetrating ingredients, including retinoids, glycolic acid, lactic acid and dimethyl isosorbide, that act as “vehicles” to carry active lighteners to the deeper target tissues. Used exactly as directed, there is a low incidence of irritation or allergic reaction.

It is important to discuss past hydroquinone usage and subsequent reactions, daily sun exposure, use of sunblocking products  and the need for sun avoidance. Passive sun exposure, like riding in a car, waiting for the bus, working in the sun, gardening and outdoor sports poses the greatest risk. Many people mistakenly feel that they don’t need sun protection for intermittent  sun exposure or because they have a darker skin tone.

Tips for Success

Lose weight. Dark pigmentation is easier to address if you lose weight.

Learn about and then address the exact cause of your discoloration, including acne, razor bumps, shaving irritation, sun exposure, failure to apply and reapply sunscreen, insect bites,  tweezing, picking, scratching, over-scrubbing, over-applying products, heaters, weight gain, friction, medications, dehydration, health issues, hormones, etc.

Avoid the sun, and never skip sunblock. Use a product that contains a UVA block, like zinc oxide or titanium dioxide. Apply a generous amount and reapply often. Don’t forget to include your neck, chest and hands.

Reapply sunblock often, especially when driving, walking, golfing, running, swimming, gardening, outdoor work, doing double days in training camp, etc.

Get your car windows tinted to the legal limit. Keep the sunroof closed.

Don’t try to rush things! If your skin gets irritated, you may be overusing your active lightners, by applying them too thick or too often.

Get professional treatments every two to four weeks in the absence of irritation. Exfoliation and brightening procedures boost your efforts.

Get follow-up evaluations often and get product potency, sun protection and lifestyle issues reevaluated regularly.

Get refills before you run out or you may have to start over.

Do not use scented products on any sun-exposed body parts, even with sunscreen.

Wear 100% UV protective sunglasses at all times.

Do not scrub your skin if you start to peel or flake. Don’t use washcloths, buffing pads or abrasive scrubs.

Follow directions. Apply your active products a. exactly as directed, b. in small amounts, massaged into the skin, and c. in the total absence of irritation.
Avoid the entire mouth area and smile lines every other day. Avoid these and other sensitive areas for a few days if they become darkened, too dry or irritated.

Never attempt to ‘dot’ lighteners onto the spots only.

Never apply too thick to darker area. This will cause light halos around the spots and irritation and darkening of the spot itself.

© 2010 Kathryn Khadija Leverette, Urban Skin Solutions, Inc. and urbanskin.com

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

Genetic fat deposits under the eyes can appear in youth and gradually worsen with age. Under-eye fat can cause severe dark circles, especially just below the fat deposits, because they put pressure on those tissues. A safe, effective surgical procedure called transconjunctival blepharoplasty addresses excess fat through an incision placed inside the lower eyelid. It avoids the external incision, leaves no visible scar, and can be performed as early as the late teens or early twenties. Ask us for a referral to a board certified cosmetic surgeon.

Lack of sleep: Chronic lack of sleep, sleep disorders, frequent air travel, crossing time zones, graveyard-shift jobs and interrupted daytime sleep can lead to physical stress, causing dark circles, puffy eyes and other skin issues, including acne flare-ups. Time management before bed, consistent bedtime routines, improved sleep habits and getting seven uninterrupted hours of sleep on a consistent basis will help improve these all-too-common skin problems.

Dehydration: Inadequate water intake causes dehydration and water retention, which can lead to dark circles, puffy eyes, bloating, low energy, dry skin and scalp, shedding hair and a darker, uneven skin tone. Coffee, tea, high sodium intake, sports and energy drinks, alcohol, medications, hard water, indoor heat, smoking and secondhand smoke all significantly increase the body’s need to re-hydrate with water. Rule of thumb: Drink enough water to equal half your weight in ounces. For every dehydrating beverage and salty meal, drink extra water. Double your water intake if you must take antibiotics, diuretics, antidepressants, medication for sleep, allergies, sinus or colds, high blood pressure or diabetes, or any medication known to cause dry mouth.

Pressure-lowering eye drops and eyelash enhancing products can cause dark pigmentation on the eyelids and darken the color of the eye itself. Use exactly as directed and wear sunglasses.

Medication: Hormones, birth control pills and devices, antibiotics, antihistamines, diuretics, blood pressure  and oral anti-diabetic drugs, antidepressants, painkillers, Accutane® and other drugs can cause severe sun sensitivity that leads to skin darkening. Skin lighteners, retinoids and other products can cause photo-sensitivity. Overuse of retinoids and anti-aging eye creams also cause irritation and temporary darkening. Longterm use of fluorinated steroid creams for itching in the eye area may lead to discoloration, thinning of the skin, swelling and broken capillaries.

Chemical irritation: Acne medications like benzoyl peroxide (BPO) cause temporary darkening and swelling when applied too close to the eyes. Moisturizers applied simultaneously with BPO can cause them to migrate together, darkening the skin in the eye area and diluting BPO’s action elsewhere. Cleansers that contain BPO, salicylic acid, alpha hydroxy acids, fragrances and drying lathering agents shouldn’t be rinsed over the eyes. Bathing in hard water can dramatically dry out and darken the skin tone.

Contact dermatitis with symptoms that include itching, irritation, fine bumps and darkening can be caused by eye pressure and lash enhancing medications, contaminated mascara and eye pencils, frosted eye shadows, D&C red dyes, scented skin, hair and laundry products, contact lens solutions, and by sensitivities to chemical sunscreens, skin lighteners, acne ingredients, alcohol or other cosmetic chemicals. Switch to matte eye shadows and fragrance-free products. Avoid make-up that contains red dyes. Replace mascara every three months and never share. Patch-test products that might be causing problems.

Metal eyeglass frames containing nickel can cause dermatitis around the eyes and on the brows, nose and temples. Those sensitive to metal alloys should choose Gucci-type plastic frames that are large enough to completely cover the eye area.

Out-of-control chronic allergies cause puffiness and dark circles. ‘Allergic shiners’ afflict both adults and children and run in families. Swelling, tearing, wiping, rubbing, blotting, scratching the eye area and failure to wear sunglasses and address the allergens that trigger allergy attacks are contributing factors. Old school antihistamines like Benedryl® cause dehydration, sun-sensitivity and drowsiness. Non-drowsy medications like loratadine (Claritin®) and fexofenadine (Allegra®) are better, but can still cause dehydration. Allergy symptoms and itchy puffy eyes improve dramatically when a saline sinus rinse like NeilMed® is used consistently two to three times a day. Eliminate cow’s milk, cheese and dairy products, which are known to trigger nasal congestion and increase mucus production. For more information, see: http://www.notmilk.com/kradjian.html

Explore and remove all irritants that trigger allergies, like dust, mold, pollen, dust mites, pet dander, fragrances, etc. Use a vacuum with a HEPA filter, stick to fragrance-free skin, hair, laundry and household products, sleep on fragrance-free bed linens, keep filters and air ducts clean, bathe pets often and use dander-remover. Wear a dust mask when you clean the house and work in the yard. Keep your car’s ventilation system on “circulate”, not “intake” from the outside to keep dust, pollen and particulate pollutant from getting into your eyes, nose and lungs.

Wiping and rubbing: Tearing, rubbing, wiping and scratching causes darkening because of friction and irritation from tearing. Remove eye make-up gently with a non-drying fragrance-free product. Pat dry after cleansing; never rub with a towel. Keep irritating cleansers, fragrances and chemical sunscreens away from the eyes. Avoid incense, secondhand smoke, wind and fans. Use caution with contact lenses, which make eyes more vulnerable to irritation and infection from debris, dust, pollutants and rubbing. Replace lenses often and keep them clean. Wear UV-protective sunglasses, even on overcast days. At night, wear lightly-tinted sunglasses to protect the eyes from wind-borne debris, dust and pollutants.

Thyroid disease: Sun-sensitivity, darkening, puffiness, fluid retention and bulging in the orbital eye area, constant tearing, disturbed sleep cycles and delayed healing are symptoms that accompany Graves’ disease. Rubbing and wiping the eyes and not wearing sunglasses intensify the darkening.

Auto-immune diseases like lupus, rheumatoid arthritis, sarcoidosis, schleroderma, diabetes, thyroid disease, vitiligo and many others increase sun-sensitivity, as can the medications often associated with treatment. Diligent sun avoidance, protecting sensitive skin from the sun with hats and physical sunscreen and wearing sunglasses are crucial to avoid skin darkening and severe reactions to the sun. Prolonged, unprotected sun exposure can also trigger an auto-immune response.

Obesity and sudden weight gain: Fat cells boost the body’s production of estrogens, which leads to sun-sensitivity and skin-darkening. The darkening can extend from the orbital eye area out onto the outer cheeks, face and neck. Drugs often associated with obesity including water pills, oral anti-diabetic drugs and blood pressure medications, dramatically increase sun-sensitivity. Sun avoidance, daily sunscreen and sunglasses will help slow down the darkening. Plan to get back to pre-medication weight. Cut back on salt, eliminate high sodium foods and dairy, increase water intake, reduce fat, simple carbs and sweets, and exercise regularly. These lifestyle changes will reduce weight and water retention, and improve blood pressure, general health, skin tone and self-esteem.

Sun exposure: Wear sunscreen and protective eyewear during even short episodes of sun exposure, including overcast days. The sun’s long UVA rays can penetrate clouds and windshields and cause dark circles, brown discoloration, skin cancer and premature aging, even on overcast days. Sunglasses must be large enough to cover the entire orbital eye area.

Hormones: Pregnancy, hormonal imbalances and changes, hormone-containing medications and birth control devices, perimenopause and menopause can all cause sun-sensitivity, skin discoloration, dark circles, fluctuations in weight, mood swings and acne flare-ups.

Smoking: Cigarettes, cigars, clove cigarettes, blunts, weed and even limited exposure to secondhand smoke and incense can cause dark circles, especially on olive and deeper skin tones. Only a couple of cigarettes and small amounts of secondhand smoke can cause darkening on the eye area, lips and gums, along with the other well-known dangers of smoking. Now, we have one more valid reason to quit smoking and call an immediate halt to secondhand smoke exposure.

Help with darkening: Active skin brightening “cocktails” can contain mild glycolic or lactic acid (fruit acid exfoliators that act as “vehicles” to deeper tissues), dimethyl isosorbide (gentle, penetrating vehicle), retinoids (deep-penetrating active vitamin A derivatives), hydroquinone (FDA-approved skin lightening ingredient), l-ascorbate (stable, absorbable form of vitamin C), and the following melanin-suppressing brighteners: kojic acid dipalmitate, alpha arbutin, azelaic acid, vitamin K, mulberry, bearberry and licorice root extracts, niacinamide, mandelic acid and citrus extracts.

Corrective products formulated to address darkening in the orbital eye area contain just enough fruit acid or retinoid to help active melanin-suppressing brighteners penetrate better. They also gently exfoliate and repair delicate under-eye skin, which helps reduce fine lines and improve elasticity and texture. Ceramides and moisture-building factors help hydrate delicate eye-area skin, which lacks sebaceous (oil-producing) activity and tends to dry out first. Wean onto active eye care products, starting every-other-night (if not using BPO). Apply sparingly and massage gently until all traces have vanished into the skin. Overuse can cause dryness, temporary darkening of the epidermal cells, flaking, itching and redness. Avoid direct sun when possible, apply and reapply full-spectrum sunscreen and wear UV-protective sunglasses religiously.

Help with puffiness:

1. Sleep at least seven hours, with your upper body slightly elevated.
2. Decrease salt intake and eliminate processed foods, take-out foods, dairy products, salty snacks, sports drinks and soups.
3. Increase water intake dramatically and reduce intake of alcoholic beverages and caffeine. Eliminate soft drinks, sports and energy drinks, tomato juice and all dairy.
4. Control allergies and stick to all needed lifestyle changes, including controlling exposure to dust, smoke, allergens, pollutants and fragrances.
5. Avoid scented skin care, hair care, household and laundry products.
6. Lose weight, quit smoking and wear sunglasses.
7. See an endocrinologist about diabetes, thyroid issues or if eyes are bulging and watery.
8. Consult a board-certified cosmetic surgeon about under-eye fat removal.

Help with loose, sagging skin around the eye:

1. Start with prevention, since sagging skin usually requires plastic surgery.
2. Avoid direct sun and wear sunscreen and sunglasses.
3. Keep weight stable. Frequent weight fluctuations contribute to sagging skin.
4. Don’t smoke or allow any secondhand smoke exposure.
5. Control allergies and their triggers so you don’t have to rub your eyes.
6. Use active skin care products consistently, including peptides, vitamin C serum, sunscreen and sunglasses during the day and gentle AHA and/or retinoid serums at night.
7. Consult a board-certified cosmetic surgeon about solutions for skin laxity.

© 2000, 2001, 2002, 2007 Kathryn Khadija Leverette and Urban Skin Solutions, Inc.

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.