Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation

Periorbital hyperpigmentation is a complex condition with multiple underlying causes, such as pigmented, vascular, structural, and mixed factors. The multifaceted nature of the disease presents significant challenges and complexities in its treatment, making it a difficult condition to address effectively. These options include topical cosmetics that can improve the appearance of the affected areas and various chemical treatments. Additionally, fillers are available to enhance volume and smoothen texture, while surgical methods can be employed in more severe cases. Despite these advancements, treating periorbital hyperpigmentation remains challenging. Nowadays, lasers have proven to be highly effective tools in the treatment of a wide range of pigmented diseases. However, there are many types of lasers, and the lack of corresponding guidelines makes the treatment of periorbital hyperpigmentation difficult. Here, we present a protocol describing the use of a 1064-nm picosecond Nd:YAG laser with a microlens array for treating periorbital hyperpigmentation. We discuss optimal energy settings, treatment endpoints, and other side effects while enhancing treatment effectiveness. This approach provides a basis for clinicians to screen and treat patients with eyelids dark circles, ensuring efficacy and safety.