i am 38 years old and have puffy red bags on my cheek areas. What can i do to help it? (photo)

The doctor doing so may think they are doing you a favor.  The steroids kill fat.  This can be an absolute disaster.  The start of a train wreck.  Am I making myself clear?  Please put this option out of your mind.  No one with any level of success treating this relies on steroid injections.

You have a midcheek groove that defines the lower portion of your little cheek bag or festoon.  Artful filling of this with Restylane can make a huge difference for you.  Please note the the spa down the street cannot satisfactorily provide this service for you.  You need to find very experienced injector.  Especially ones who are not going to inject your lower eyelid with steroids.

And yes, there is no substitute for a personal consultation.  Just make sure the doctor actually examines you and speaks to you and you don't feel bullied.

     The malar bags are difficult areas to treat completely.  Filler or fat grafting can camouflage the area.  Kenneth Hughes, MD Los Angeles, CA

It looks like you have early signs of what is known as a malar bag or festoon. Injection of hyaluronic acid fillers into the cheeks can help camoflage the bag and make it much less noticeable. I always like to use Restylane for malar bags. Juvederm attracts water and can sometimes get too puffy, especially when there is already some fluid retention in this area.

Many patients also note that the bag is most prominent in the morning and gets better over the course of the day. Sleeping with your head elevated (on several pillows) may help a little, but injectable fillers are probably your best option.

From your pictures, it's difficult to discern what might be the issue under your eyes in the upper cheek area.  Sometimes fillers can be used to help even out the area and camouflage puffiness but you would need to be evaluated in person to determine if you might be a candidate for such a treatment.  

Based on the photos, you appear to have malar bags of your upper cheeks rather than true eye bags. If this is confirmed by a one-in-one consultation, there are various treatment options. Sometimes kenalog, a steroid, can be injected into the puffy areas to lessen the effect. Also injectable fillers such as Restylane placed above or below the bag can help lessen its appearance. Finally , certain lasers that tighten the skin can sometimes help. Careful consultation with your surgeon can allow you to set up a customized treatment plan.