What is Dermatochalasis?
Dermatochalasis is a condition characterized by lax, redundant, and overhanging excess eyelid skin that develops as part of the normal aging process of the eyelids. 1
Clinical Features
Dermatochalasis presents with the following characteristics:
- Excessive, loose, and redundant eyelid skin that hangs over the eyelid margin, most commonly affecting the upper eyelids 1, 2
- May be associated with herniation of orbital fat, giving the eyelids a baggy appearance 3
- Can involve lateral hooding (excess skin on the outer eyelid) and medial orbital fat loss in more advanced cases 4
- Progressive in nature, worsening with age as skin elasticity decreases 2
Functional and Cosmetic Impact
The condition causes both functional and aesthetic problems:
- Visual field reduction when the excess skin becomes heavy enough to obstruct superior vision 1, 3
- Cosmetic concerns related to the aged, tired appearance of the eyes 2
- Graded by severity from mild to severe based on the degree of skin redundancy and functional impairment 1, 2
Pathophysiology
- Part of the normal aging process affecting the periorbital tissues 1
- Results from loss of skin elasticity and tissue laxity in the eyelid region 2
- Often accompanied by changes in orbital fat distribution, with prolapse laterally and loss medially 4
Important Distinction
Dermatochalasis should be distinguished from blepharochalasis, which is a different condition involving recurrent episodes of eyelid edema leading to skin changes 3. Dermatochalasis is specifically the age-related redundancy of eyelid skin without the inflammatory component.
Treatment Considerations
- Surgical blepharoplasty remains the traditional definitive treatment, involving excision of excess skin and repositioning of orbital fat 1, 4, 3
- Nonsurgical alternatives including radiofrequency microplasma and plasma exeresis have emerged as options for mild to moderate cases 1, 2
- Treatment is indicated when visual field compromise occurs or for cosmetic improvement 3