{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:08:24Z","timestamp":1791842904181,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Skin Research and Technology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dark under\u2010eye circles or periorbital hyperpigmentation constitute a prevalent and challenging cosmetic problem with diverse etiologies and types. While modifying exacerbating habits can provide partial relief for the pigmentary and vascular factors associated with this condition, and despite the abundance of available treatment options, there is currently a lack of gold\u2010standard evidence\u2010based treatments proposed for curing this disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to assess the safety and effectiveness of carboxytherapy in treating periorbital hyperpigmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>In this 4\u2010week single\u2010arm clinical trial, 20 eligible Iranian patients with symmetric periorbital hyperpigmentation received weekly intradermal carboxytherapy. The treatment involved administering 10\u201320\u00a0mL of CO2 at a rate of 20\u00a0mL\/min and a temperature of 15\u00b0C for a duration ranging from a few seconds to 1 min. Follow\u2010up assessments were conducted 1 month after the final session. The primary outcome was defined as the changes in \u0394E or the variations in pigmentation observed between the orbital and extra\u2010orbital skin before and after the trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The patients reported satisfaction with the statistically significant reduction in hyperpigmentation achieved through carboxytherapy in the lateral (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002), middle (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001), and medial (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) regions of the periorbital area. The total response rate of the patients was estimated at 20%. Patient satisfaction exceeded \u0394E changes, with no significant linear relationship (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.084).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Carboxytherapy can be proposed as an effective and safe treatment for periorbital hyperpigmentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/srt.13651","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T08:20:49Z","timestamp":1710404449000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effectiveness, safety, and patient satisfaction of carboxytherapy as an adjunctive treatment for periorbital hyperpigmentation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3794-6206","authenticated-orcid":false,"given":"Farnoosh","family":"Seirafianpour","sequence":"first","affiliation":[{"name":"Razi Drug Research Center Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najmolsadat","family":"Atefi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) School of Medicine, Iran University of Medical Sciences (IUMS)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazila Ghoreishi","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Southern California (USC)  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad 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