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. 2025 Mar;49(5):1526-1535.
doi: 10.1007/s00266-024-04445-9. Epub 2024 Nov 12.

Cell-Free Fat Extract with Anti-melanogenic Property Improves the Appearance of Infraorbital Dark Circles: A Preliminary Clinical Study

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Cell-Free Fat Extract with Anti-melanogenic Property Improves the Appearance of Infraorbital Dark Circles: A Preliminary Clinical Study

Bijun Kang et al. Aesthetic Plast Surg. 2025 Mar.

Abstract

Background: The formation of infraorbital dark circles involves various factors including hyperpigmentation, skin aging and laxity. This study is to investigate whether cell-free fat extract (CEFFE) inhibits melanin synthesis and improves the appearance of infraorbital dark circles.

Methods: Imaging systems analysed the melanin content in three groups of zebrafish embryos treated with 0 (CTRL), 100, and 200μg/mL of CEFFE. Eleven patients with infraorbital dark circles were enrolled and received intradermal injections of autologous CEFFE. Clinical trial assessments included subjective assessments (Global Aesthetic Improvement Scale and Likert satisfaction scale) and objective assessments (standard two-dimensional photographs, VISIA® photographs, and infraorbital skin colour measurement).

Results: In the experiment of zebrafish embryos, the melanin content of CEFFE treatment was significantly reduced. In clinical trial, 72.73% of patients considered CEFFE treatment for infraorbital dark circles to be effective, and more than half of the patients were satisfied with the treatment. In the evaluation of skin colour at the inner, middle, and outer edges of the infraorbital dark circles, there was a gradual improvement in infraorbital skin colour after each treatment and at the 3-month follow-up, with a statistically significant improvement in skin colour on the outer edge of the infraorbital dark circles (p < 0.05). Simultaneously, we observed a reduction in periocular wrinkles, with a significant difference at the 3-month follow-up (p < 0.05). The events observed included bruising, erythema, and oedema, which resolved spontaneously.

Conclusion: Our study demonstrated that CEFFE inhibits melanogenesis and is a safe and effective treatment for infraorbital dark circles.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Anti-melanogenesis; Cell-free fat extract; Hyperpigmentation; Infraorbital dark circles; Periocular wrinkles.

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Conflict of interest statement

Declarations. Conflicts of interest: The author declares no conflict of interest. Ethics Approval and Informed Consent: This study was approved by the Institutional Review and Ethics Board of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (SH9H-2019-T135-3) and registered in the Chinese Clinical Trial Registry (ChiCTR2000031313). All patients voluntarily signed informed consent forms.

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