I have very dark lines outside the corner of my eyes. Treatment options? (photo)

Question

Hello, I have very dark lines outside the corners of both my eyes. What can I do to get rid of them? I hate them so much it's killed my confidence. When I speak to people face to face I get very self conscious about them. Any help would be appreciated.

Jonathan Kulbersh, MD · Answer

Thank you for your question. This discoloration appears to be a pigmentation issue, which can be addressed with a non-surgical rejuvenation treatment like microneedling with PRP. Microneedling is a collagen induction therapy that stimulates collagen production in the body through the creation of micro-channels in the skin. The platelet-rich plasma (PRP) comes from your own blood and is rich in growth factors that promote cell renewal for a refreshing appearance. You can have this procedure as a stand-alone treatment or in combination with injectable dermal fillers that can add subtle volume to smooth the contour underneath the eyes. Make sure you work with a board-certified plastic surgeon that can assess you in person and customize a treatment to your precise needs for the best possible outcome.

Jason Emer, MD · Answer

Thank you for your question, There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Mark Kearns, MBChB, BSc, FRACGP · Answer

The darker colour in the picture does indeed appear to be more due to pigmentation than any signs of ageing like volume loss. As such you really just want to get a good concealer and it really will get your confidence back - even for guys! - just head to your local department store and ask for some advice.

Deborah Kessler Hudak, MD, MHA · Answer

Hello! By your picture, I see three items contributing to that: (1) there is more pigment in your skin there than normally seen, (2) you have some mild hollowing of the tissue there, and (3) you have some mild upper lid heaviness, adding a visor-like shade to the tissue below.  For (1), skin-lightening creams (like Melanage Cream with Arbutase, Azelaic acid cream/Azelex, or HydroQuinone Cream 4%-7%, would help  Alternatively, the vampire facial using PRP is know to significantly reduce hyperpigmentation, improve skin texture and tone.  For a sunscreen in that area, I recommend a powder brush-on such as ColorScience has. For (2), I recommend a filler or volumizer applied near the outer corner of your eyesocket bone.  this will help pull that lid skin forward so it is not "in the shadows" as much For (3), I would simply suggest a small amount (~ 2-3 units only, each side) of a neurotoxin (Botox, Jeauveux, Xeomin, or concentrated Dysport) to the orbicularis muscle that is just under the skin of the outer 1/4 of the brow...injecting immediately under the brow.  
I hope that helps!  Have a great week!

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