BASIC ANATOMY AND PHYSIOLOGY OF THE EYE AREA
As a person's face ages, numerous anatomical features change. These aging features can affect both young and mature individuals. Facial lines and wrinkles deepen due in part to muscle contractions in the forehead, between the eyes, and around the sides of the eyes. Furthermore, eyebrows tend to lower and the musculature in the scalp and sides of the face weaken.

The lymphatic system in the body ages as well. As the lymphatic system ages, it becomes less efficient at removing toxic fluids from the body as a whole and specifically in areas of the body that have a high capillary concentration. The technique of lymphatic body massage emphasizes techniques that help to activate the lymphatic system, assisting with the fluid transport in the body. This massage has specific applications in the face, particularly the eye area.

Collagen and elastin synthesis slows with age. The result of that retardation in the body is the appearance of lines and wrinkles, sagging, and skin that has a crêpy appearance. The advent of peptides in cosmetic science has yielded remarkable technology in managing lines and wrinkles. Recently, there have been advances in managing eye area skin, particularly whereby the delicate structure of the upper and lower eyelids can be strengthened by specific bio-peptides that help eyelid drooping and under-eye wrinkle reduction.

The underlying fat structure in the face is also an important consideration. There seems to be few options, outside of a surgical technique, that can be performed when the facial fat deposits change shape and position. Understanding the impact that these changes can have will help skin care professionals to make the right decisions with their client. Fat is distributed in the face in deposits called fat pads, as well as other types of underlying fatty tissue. As people age, these fatty areas under the skin can change shape, redistribute to other areas in the face, and/or shrink in size. If fat deposits shift, the face may experience a loss of volume under the eye and cheek and under-eye puffiness.
If fatty deposits are determined to be the cause of the under-eye puffiness, then different techniques should be used, especially compared to puffiness caused by fluid retention of a weak lymphatic system.

KEY INGREDIENTS

Moisturizers
Moisturizers are vital because the eye area is an extremely delicate structure. Keeping skin hydrated in this area helps basic biological activities, such as normal cellular rebuilding, optimize the aesthetics of the area. Hydrating the eye area also reduces fine lines and wrinkles. Clients have, more than likely, seen product claims such as, "Fine lines are reduced by 35 percent!" Much of these claims are made by simply hydrating the skin, thereby plumping it up. While this type of hydration is transient, it is still an important aspect of good eye care and aesthetics.

Sebum and Oils
One of the aspects surrounding good skin health, and the eye area in particular, is not so much the overproduction of sebum, but the lack of it. When the skin starts to age, which can happen at a fairly young age, hormone levels in the skin will change. This change can affect some people more than others. The purpose of sebum for the skin is to lubricate the skin's surface to provide skin flexibility in three dimensions.

This property is known as suppleness. When the skin starts to slow down and stop oil production, which often happens in individuals who are aging, individuals perceive that their skin is dry. The truth is that their skin may contain a fair amount of water, but not oil. As a result, the surface of the skin becomes rigid and inflexible. To resolve that problem, some products contain a class of ingredients known as esters. An example of this class is capric caprylic triglyceride. When esters are applied to the skin, the individual will immediately feel hydrated even though they are experiencing skin lubrication.

Peptides
Peptides can do many things, depending on their structure, from activating the skin to making collagen, elastin, and lipids. Peptides can also increase the turnover of skin and upregulate and downregulate skin and cell biological activities. There is a rule of thumb professionals should follow when using peptides or other active ingredients known as the three Ds: dose, depth, and delivery. Skin care professionals must put the correct dose into the skin at the correct depth and with the proper delivery mechanism.

For instance, if professionals are trying to lighten melanin banding with peptides (smooth banding around the eye area), they need to use an active ingredient that lightens the skin at a high enough dose to have an effect on the pigment. Too much of the ingredient may irritate the skin whereas too little may not be effective. Professionals also need to use the active ingredient at the correct depth for it to produce results. In regard to lightening pigment, the ingredient has to go to the epidermal dermal junction or the treatment will be unsuccessful. Some companies get the active ingredient to the site by utilizing liposomes while others use ingredients that facilitate penetration.

Hexapeptide-8 and pentapeptide-18 are known to slow down muscle fibers from exerting repetitive contraction and creating lines and wrinkles. The correct technique for using products that contain these ingredients is, first, the three Ds, and secondly, the fact that they should be used immediately after cleansing to avoid being trapped in the surface of the skin due to other product application. Getting these ingredients to penetrate deeply into the skin is extremely important so that they may perform as intended.

Hesperidin methyl chalcone is an example of an ingredient that can reduce under-eye darkness and puffiness when used at the proper dose, depth, and delivery level. If it is used in the right formulation with the right aesthetic technique, this ingredient can have an excellent result. The technique that should be used with hesperidin methyl chalcone is effleurage.

Botanicals
There are thousands of botanical extracts available to choose from to lighten and brighten the skin and reduce wrinkles, puffiness, and darkness under the eye. With botanical-based products, it is important to look at the product's ingredient list. If the botanical ingredients are some of the last ingredients on the ingredient list, the product will probably not be effective because the dose will be too low.

PRESERVATIVES, FRAGRANCES, AND SULFATES
Professionals should keep an eye out for the type of preservatives utilized in their products as some of these ingredients may irritate the eye area over time; this reaction is known as a sensitization reaction in skin. In general, it is not good practice to have fragrances in eye products for similar reasons. It is also suggested that clients and professionals avoid sulfates in eye products.

The following chart is a short guide that explains the basic challenges professionals see in the eye area and their root causes:

Under-Eye Darkness

Melanin banding (natural pigmentation patterning)
Hemoglobin deposits under the eye
Sun damage
Thin skin, which allows blood vessels to become visible

Fine Lines, Sagging, and Wrinkles

Muscle contraction
Loss of volume (fat)
Collagen and elastin loss

Puffiness

Water accumulation in the capillaries
Fat accumulation
Fat pad migration

Under-eye darkness can be one of the most difficult conditions to treat as it can have more than one cause.

Melanin-banding patterns (natural pigmentation) occurs in most Fitzpatrick III and higher individuals and gets darker with age. It appears as a smooth, dark area both below and above the eye. It often appears with a darker area around the chin as well in these individuals.

Note that the pigmentation is smooth around the eye. If the pigmentation is in a spotted pattern, then the condition is sun damage and is not from a natural patterning and can be treated for more permanent results. Natural pigmentation patterning will always return if it is not consistently treated.

Hemoglobin deposits under the eye are quite difficult to manage unless they are treated properly. This condition occurs as clients age and the capillaries under the eye tend to weaken and leak fluid. The blood can pool in the under-eye area and cause a darkening, which often has the appearance of being at an angle between the eye and nose.

Sun damage is quite often apparent on the face as a whole, but can be concentrated across the bridge of the nose and under or over the eye area.

In some clients, the eye area vascularity is closer to the surface of the skin or the skin is thinner than normal and, therefore, the underlying blood becomes visible; it appears as darkening. It can also appear, at times, to be bluish in nature.

Fine lines, sagging, and wrinkles in the eye area are also due to numerous factors. Lines around the outside of the eyes, on the forehead, or between the eyes are caused by muscles contracting while smiling, frowning, or any movement that causes the skin to move in some form. These wrinkles are often referred to as crow's feet or periorbital wrinkles.

While potent medical grade topical serums and lotions can soften these lines, the most effective treatment is a neuromuscular inhibitor, like Xeomin® or BOTOX®. These treatments slow the muscle contraction rates, reducing lines.

Wrinkles form in other areas of the face, such as the cheeks and lower face. Most of these wrinkles are caused by collagen and elastin loss due to aging. Sagging is an issue that affects the upper eyelid area more prominently. The eyelid droops and gravity overcomes the elastic nature of the eyelid. The treatments for sagging include medical-grade collagen and elastin boosters and lighteners.

Another anatomical feature to consider is underlying fat in the face. As an individual ages, the fat pads in the face tend to move and change shape and size. This movement can lead to "hollows" in the cheeks and the loss of fat in the eye area, which can give a gaunt look to a face. Improvement in this area can come in two ways: a filler that is injected into the face to fill the void and a topical product that can improve the tone and texture of the face, giving it a more uniform appearance.

Puffiness under the eyes is generally caused by water accumulation under the eye or fat agglomeration. In the case of water accumulation, the capillary structure under the eye weakens with age. This weakening allows the capillaries to leak fluid into the under-eye area. This fluid would normally be removed via the lymphatic system, but, as people age, the lymphatic system become less productive, so the fluid tends to remain in place and the fluid builds up and produces puffiness.

Proper effleurage technique can help clients remove the fluid buildup and lessen under-eye puffiness. The proper technique includes lubricating the skin with the proper product, then rubbing in a counter-clockwise motion under the eye from inside to outside several times. This motion should be repeated up to five times; the professional will feel a warmth on the tip of their finger. They have now activated the lymphatic system by bringing blood supply into the area. Clients can mimic this movement at night with light-to-medium pressure after their daily cleansing routine. Train the client to do this same movement every other night and the puffiness will be reduced rapidly with the correct eye serum. The tapping technique does not activate the lymphatic system as efficiently; it is also highly preferred to work from the inside to the outside of the eye area since this is the same flow that the lymphatic system is naturally following.

If puffiness is apparent, fat pads can be somewhat minimized with this same technique since they will flatten with the effleurage movement alone. The only way to truly make an impact on fat pad involvement is to have a blepharoplasty, which is upper or lower eyelid surgery.

CASE STUDY
This client exhibited multiple challenges in the eye area, including puffiness, dark circles, and sun damage.
The first step in the process of improving this client's eye area is to diagnose the challenges presented. In this case, the majority of the puffiness is due to water accumulation. One way to determine the cause of the puffiness is to lightly touch the orbital rim and examine if it feels lumpy or like a cushion. It is common to feel both, but in this case, the predominant sensation was a soft cushion, which indicates that water is present under the skin.

The dark circle under the eye appears to be darker than the surrounding skin, but, upon close examination, it is simply a reflection of the puffiness under the eye. In this case, removing the water from under the eye will also remove the darkness.

The pigmentation near the eye area is spotty and not a smooth brown area, indicating sun damage.

This client was put on a variety of products, including an eye cream that contained active ingredients that would seal the capillaries and stop the leaking into the under-eye area, as well as peptides that stimulate wrinkle correction; a skin lightener that included a DNA repair enzyme to correct the sun damage; and a lotion that contained a hydrator and an anti-inflammatory to calm the area.

The client was also taught how to perform effleurage on her eye area and was instructed to perform it every other night. That movement facilitated her improvement quite a bit. By correctly diagnosing the conditions that are present and applying the correct topical products, quite an improvement can be achieved.

The chart on page 64 can serve as a starting point to correct eye area challenges that professionals may encounter. It will help skin care professionals to understand not only what and how to treat this complex area of the face, but also what not to treat. Clients should always be reminded to wear sunscreen, especially around the eye area!

Robert Manzo's patented and proprietary cosmetic chemistry and product formulations are the result of over 25 years in the skin care development profession. He has conducted clinical research and developed specialized skin care products and techniques in Europe, the US, South America, and Asia, affording him an expansive knowledge base to achieve personalized solutions for Skinprint's clients. He has published articles on skin chemistry and the role of anti-bacterial and anti-inflammatory ingredients on skin, and is a standing member of the Society of Cosmetic Chemists and the American Chemical Society. skinprint.com