摘要

Objectives: The aim of this study is to propose a combination approach of various old treatments used to treat infraorbital dark circles and skin laxity to achieve considerable improvement without any significant side effects and improved patient satisfaction. Introduction: Infraorbital area is a minefield of complex anatomy and pathophysiology. Dark circles, although not a medical term, refers to the darkening of the infraorbital area contributing to constant aged and tired appearance in an individual. Although, dark circles have variable number of causes which includes thin undereye skin, hyperpigmentation secondary to genetic and dermatological causes such as atopic dermatitis, infraorbital fat herniation, tear trough deformity and increased skin laxity in this area, making it one of the most challenging areas to treat for a physician. Infraorbital skin laxity Materials / method: We treated 15 Asian - Pakistani patients, Fitz Patrick skin type IV and V aged between 25 and 55 years. We first used a Q-switched 1064nm Nd-Yag laser with low fluence ranging between 1.0J to 1.5J for the infraorbital area. We then combined patient’s PRF with intradermal long chain polynucleotide in a 10cc syringe with 32-gauge needle. The cocktail was injected intradermally with a serial puncture technique in 15 points with 0.05cc infiltration on each point. Results: All the subjects experienced post procedure mild swelling which resolved spontaneously over next 48 hours. All subjects noticed considerable improvement starting after one week post procedure lasting up to 3 months Conclusion: Low fluence Q-switched 1064 Nd-Yag laser is a safe and effective way to reduce pigmentation. Polynucleotides on the other hand helps to restore normal physiology of the skin by regeneration of autologous components like glycosaminoglycans. PN has shown to increase skin elasticity by increasing fibroblast activity which is synergistic with effects exerted by PRF. It also contains significantly higher levels of growth factors which are known to improve pigmentation and skin laxity in individuals.A combination treatment shows significantly favorable and long term sustainable natural outcomes.