Darkened Purple Colour Under Eyes (Hemosiderin?) - Can I Do Juvederm?

Be careful rushing in to having fillers with your recent diagnosis of allergic rhinitis, not because of allergy of the Juvederm, but lower eyelid swelling from the allergies can be accentuated with the filler as it absorbs water.  Allergic rhinitis and or conjunctivitis can cause dark circles too.  The theory of hemosiderin has not been proven and there is no sure way to be certain as to the cause of the coloration. If the filler is injected underneath the muscle layer, you may have less issues with irritating symptoms from the allergies. There are risks with these procedures so speak with your doctor.  Lasers, such as Fraxel and V-beam can help lighten the skin coloration in few, but not all patients.

Yes it is possible to still have Juvederm injections but you must understand that the area under the eye contains a lot of superficial blood vessels.  If the vessels are transmitted by the needle you will likely get bruising, which will then cause more hemosiderin.  Seek out a dermatologist or plastic surgeon who is extremely skilled in injecting the tear trough.  Sometimes delivering the Juvederm through a blunt canula as opposed to a sharp needle will be less traumatic and less likely to worsen hemosiderin.

Ture hemosiderin staining of the tissues in the lower lids is very difficult to treat with lasers of any kind. If you have tear trough deformities a shadow effect may be contributing to your dark circles. If there is a pigment component,  Juvederm may make the pigment worse only if bruising from the injection occurs. A true tear trough deformity with lower eye bags caused by fat is best treated with a fat transopsition. This will lessen the bags and fill the defect below the lid.

Juvederm will not cause hemosiderin darkening under the eyes. Hemosiderin in very difficult to remove and most lasers will be ineffective.

Juvederm will not improve the purple color - hemosiderin deposition - in lower eyelids.  In fact, if there is bruising or bleeding associated with the injection it could make it worse.  There is no prefect answer for this problem, however, eyelid surgery - blepharoplasty or fat transposition - may help.

The only way to ascertain that the purple color is from hemosiderin would be a biopsy (a 2,5 mm punch biopsy)

However: This would be only of academic benefit and  don't think you need it.

There is a combination of factors: Hemosiderin and Melanin usually go hand in hand.

Dilatation of capillaries contributes to the darkening under the eyes.

Also, with thinning od the skin, blood in the larger underlying veins contributes to the discoloration.

Juvederm will improve the loss of thickeness and to a limited extent the discoloration.

Fractonated CO2 Resurfacing may help  a great deal, but I would use Juvederm first.