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What is Causing Your Clients’ Eye Issues?

Contact Author Terri A. Wojak November 2014 issue of Skin Inc. magazine
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What is Causing Your Clients’ Eye Issues?

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Many clients have caught on to how important playing up their eyes can be—after all, the eyes are known as the focal point of the face. There are several methods that can be used to esthetically enhance the eye area, including medical procedures, esthetic treatments and home care. Throughout history, almond-shaped eyes, with the outside corner sitting slightly higher than the inside corner, have consistently been an idealized form of beauty. Eyes are also perceived to be more inviting when they are symmetrical and open.

Unfortunately, the eyes are often the first area to show signs of aging due to the difference in skin structure. The skin surrounding the eyes is much thinner at approximately 0.5–1 mm compared to other areas of the face, such as the chin, which is, on average, 2.5–3 mm.1 The thinner skin around the eyes not only provides less support, but it also makes imperfections—including dark circles, puffiness, fine lines and wrinkles—more noticeable.

With the influx of products and treatments available for the eye area, it can be hard to decipher which are effective and which are simply fads. It is unfortunate that cosmetic retailers and some skin care providers inadvertently sell eye creams promising to reduce bags under the eyes or lighten dark circles, without first considering the condition’s cause. The best way to build a clientele is through earning their respect by providing realistic expectations and results.

Prevention

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To preserve a youthful appearance, protection is key—especially in the eye area. It is well known that diligent sun protection and a healthy lifestyle are the best ways to avoid prematurely aging skin. However, when dealing with sun protection, the eyes are rarely discussed. There are several products available for the eyes to repair damage, reduce dark circles and refine lines, but they rarely contain sunscreen. This is likely due to the high incidence of sensitivities around the eyes—many chemical sunscreens can cause irritation in sensitive skin. If there is not a specialized eye-protection product in the line used in your skin care facility, a simple formula containing zinc oxide tends to be the best option.

The use of UVA and UVB protective sunglasses should also be recommended for optimal protection. Those clients who experience visual sensitivity to sunlight tend to wear sunglasses on a regular basis, and typically have a more youthful appearance.

Preventing the signs of aging around the eyes is also accomplished through the use of topical products. The difference in structure and function of this skin is the reason that there are products made specifically for the eyes. The eye area has minimal sebaceous glands compared to skin on other areas of the face, therefore more moisture should be applied topically to keep this skin soft and supple, helping prevent the appearance of aging. When choosing products to protect the eye area, the use of antioxidants should also be incorporated, because these will protect against further damage. Ingredients, such as epigallocatechin gallate (EGCG) from green tea, and vitamin C and E are commonly used. Hyaluronic acid, ceramides and peptides should also be incorporated to support the health of the skin.

Fine lines and wrinkles

Once fine lines and wrinkles around the eyes— commonly known as crow’s-feet—have set in, more advanced topical products can be added to a skin care regimen. Products containing peptides that protect and trigger the production of matrix proteins, collagen and elastin are often chosen, due to their remarkable results and reduced possibility of irritation associated with their use. Neuropeptides, such as acetyl hexapeptide-3, are commonly used in eye products due to their ability to slow down muscle contraction throughout time.

Products containing growth factors are also becoming more frequently used for the eye area. There are several types of growth factors, including human, animal and synthetic, that are meant to stimulate matrix proteins in order to thicken and repair damaged skin. Some newer eye products are made with a combination of peptides, growth factors and antioxidants to complement each other.

Mild retinoids may also be recommended to address fine lines on the outer perimeter of the eyes in order to stimulate cell turnover. When retinoids are used, it is important to recommend a sunscreen if there is any chance of sun exposure. With many great product lines available, it is important to do research and choose products carefully. Skin care professionals must be well-educated on ingredients and their functions, especially on the science behind the product line they are recommending to clients.

Equipment-based treatments. Equipment-based treatments, such as microcurrent and light-emitting diode (LED), are helpful in reducing lines around the eye area. Microcurrent is known for its ability to retrain muscles using specific movements. Clients often say they see the most improvement with lifting the eye when receiving microcurrent. LED works by simulating circulation and increasing the metabolism of cells, including fibroblasts, resulting in smoother skin. Amber LED is also known to provide great results, especially in the reduction of crow’s-feet. Multiple treatments should be expected with microcurrent and LED—these are not one-time solutions and maintenance with topical products is necessary to maintain results.

Clients with deeper set lines who want to speed up the process can be referred to a medical office for more aggressive treatments. Two of the more commonly used devices for the eye area are radiofrequency and microfocused ultrasound. Each of these modalities are used for skin-tightening by heating and contracting the skin, resulting in collagen production. Neurotoxins also have the ability to reduce the appearance of crow’s-feet around the eyes by temporarily disrupting muscle contraction in the area. Neurotoxins can also open the eyes with specific injection points beneath the tail of the brow to provide a more awake and inviting appearance, offering twice the benefit for its use in the eye area. Each client is different and will experience different results per treatment. Some realize great benefits from the use of products alone; others may need to seek medical treatment before results are seen.

Dark circles

Another key concern for the eye area is the appearance of dark circles. Dark circles can appear for several reasons—mainly hyperpigmentation; vascularity—blood-pooling; and shadowing—hollowing.

Dark circles caused by hyperpigmentation are often genetically inherited, especially in darker skin types. Other causes of hyperpigmentation include inflammation from sun exposure and post-inflammatory hyperpigmentation (PIH). PIH can be caused by frequent rubbing of the eyes, using harsh products, and excessive tugging or pulling on the area around the eyes. Dark circles caused by hyperpigmentation are often treated with products containing skin-lightening ingredients as a first step. This helps control the melanin and prepare the skin if more aggressive treatments are needed. Chemical peels are known to lighten the area around the eyes, but should only be performed under medical supervision when treating inside the infraorbital rim. Physicians may also recommend resurfacing laser treatments to rapidly remove pigment from the outer layers of skin.

Dark circles due to vascularity can also be caused by several underlying triggers. Pooled blood from the leakage of small capillaries beneath the thin skin around the eye area is common and shows up as a dark purple color. This can be genetic, caused by poor circulation or lack of sleep, or triggered by allergies. Pooled blood and excessive capillaries are more noticeable due to the eye area’s thinner skin. Furthermore, as skin ages, it loses fat that may have once concealed these vessels.

When dark circles from vascular lesions are suspected, products rich in vitamin K oxide help by breaking up the small pools of blood. This is not surprising, because the leaking vessels have similarities to bruising, for which vitamin K oxide is also recommended. Vitamin K-rich foods—green, leafy vegetables—may also help combat less severe circles. Vitamin K naturally strengthens blood vessel walls, which prevents leakage, minimizes inflammation and promotes optimal blood circulation. Vitamin C may also help to strengthen vessel walls and products, such as peptides and growth factors, can help lighten the area by thickening the overlying skin.

One not-so-obvious cause of dark circles is from shadows that can occur due to hollowing under the eyes. A major contributing factor to aged skin is the loss of subcutaneous fat, which is even more apparent beneath the eyes. Medical professionals can reduce the shadow with the use of soft tissue fillers; this is a technique that requires much skill and is typically done by an injection specialist. Fillers often last at least nine months, making them a good option for those who are not ready for a surgical procedure. If a client is not ready for a medical procedure, the use of products with optical diffusers or camouflage makeup is the next best thing. Highlighting the shadowed areas and contouring the area around the hollow can make a big difference. The cause of dark circles must be observed carefully to avoid giving clients false hope that a treatment can surely address their concerns.

Under-eye bags

Moderate-to-severe puffiness or bags under the eyes are most commonly caused by excess fat. When a collection of fat is the cause, surgery is the only option for resolution. This is yet another reason that the eyes should be analyzed thoroughly, instead of giving false hope that a topical treatment—or simply getting a good night’s sleep—may work. Yes, mild swelling can be caused by allergies, lack of sleep or water retention, and these conditions can be improved with the use of topical products that contain ingredients known to stimulate circulation, including caffeine and niacinamide.

Another recommendation is to teach clients to lightly massage the area on a regular basis or use cool compresses as a temporary solution. Regardless of the severity, swelling under the eyes should be examined by a physician before a product or treatment regimen is suggested.

Allergies. One underlying cause of both bags and dark circles under the eyes during allergy season is the histamine response that an allergen causes the body to elicit. Although responses may vary, the most common manifestations include excess edema on or around the site at which the allergen has entered. For many, seasonal allergies invade the body through the respiratory system, which is located near the facial sinus cavities. When the elicited edema sets in, the pressure can cause capillaries to enlarge and burst, which is why on a day with a high allergen count, a person may look like they have not slept. If allergens are the suspected culprit, an antihistamine may be recommended to diminish the edema.

Get to the root of the problem

Clients are often concerned with the skin around their eyes and for good reason—the eyes are typically the focus of the face. Too often, the first thought is to recommend a treatment or product before getting to the root of the problem. It is the job of a skin care professional to discuss the clients’ concerns and conduct a thorough consultation to uncover possible underlying causes, which will allow them to make the best recommendation for each individual. There are several great tools available to treat imperfections around the eyes when the cause is taken into consideration.

REFERENCES

1. K Hoffmann, M Stuüker, et. al., Twenty Mhz B-scan sonography for visualization and skin thickness measurement of human skin, J Eur Acad Dermatol Venereol 3 3 302–313 (1994)

Terri+A.+WojakTerri A. Wojak, licensed esthetician of 20 years, is an authority on skin care in a medical setting, education and business. She is director and educator at True U Esthetics in Chicago, the co-author of Mastering Medical Esthetics (True, 2009) and author of Aesthetics Exposed: Mastering Skin Care In A Medical Setting and Beyond (Alluredbooks, 2014). She is also a member of the 2014–2015 Skin Inc. Editorial Advisory Board.

 

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