Q: I’m a 19-year-old male and have been wearing spectacles for about five years. Dark marks have developed on the sides of my nose where the glasses sit. Please help.
The marks could be due to one of several causes. Respecting your own suspicion that they are most likely caused through the continuous contact and pressure of the frame of your eyeglasses, this will suggest a likely diagnosis of post-inflammatory hyperpigmentation (PIH). PIH is usually seen on areas of the skin that have remained affected by acute or chronic inflammatory reactions of various nature.
However, it can also be seen as a consequence of mild but long-standing sub-clinical inflammatory reactions in the area in question. In your case, my hypothesis is that either your frame has been a bit too tight on your nose, as such causing frictional (irritant) contact dermatitis or even certain degree of allergic contact dermatitis to the material of your glasses’ frame. Over a period of time, such mildly active but persistent contact reactions can become a precursor to an underlying inflammation in the skin.
I can also suspect that such a continuous physical friction and pressure might also have traumatised the superficial delicate cutaneous blood vessels, resulting in mild bruising of your skin. In this case, the dark marks seen on the skin surface are due to the deposition of blood pigment called hemosiderin.
The other skin disorders that would need to be excluded as the differential diagnosis will be melasma, localised form of lichen planus actinicus pigmentosus, fixed drug eruption (FDE) – a rare form of allergic reactions to either of the many medications including simple analgesics, and sometime can be seen as localised dark patches on certain areas of the skin, amyloidosis, and few other rare skin conditions. Consult a dermatologist for a detailed diagnosis.
I recommend you don’t use any over-the-counter products and self treat, as it will camouflage the originality of your skin marks on clinical examination making it a more complex task to reach an accurate diagnosis for the treating dermatologist.
Dr Ikramullah Al Nasir is a specialist dermatologist and medical director of Dermacare Dubai. Got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to email@example.com.