Under eye texture/bumps/fine-lines aging me. Treatment options? (Photo)

The undereye area is one of the first to show signs of aging, due to the very thin skin in this area, only 0.3mm thick. This area may show dark circles, volume loss, crepey skin, or some combination of the above. Both PRP (platelet-rich plasma) and PRF (platelet-rich fibrin) have been shown to be helpful for treating the undereye area, improving dark circles, skin laxity, wrinkle scores and photoaging. This was highlighted by a recent systematic review and meta-analysis by Evans et al. (2021, Archives of Dermatological Research), which reviewed a total of 19 studies.
Growth factors in platelets will stimulate your the cells in the area to rejuvenate and regenerate. This could improve texture, fine lines, skin thickness and elasticity. Deeper injections of PRP should stimulate regeneration of fat cells as well.
It's difficult to tell without an in person consultation, but if there is a lot of volume loss, then you might want to discuss with your doctor about using dermal fillers. I prefer PRP because the end result will always look natural, whereas with dermal filler, the results are less predictable and sometimes lumps can form.
For good results, with PRP or PRF, concentration is very important, as this will directly affect the number of growth factors available. Both PRP or PRF could be low concentration, depending on the preparation method, and thus less effective. If the concentration is lower than baseline, the sample might be PPP, or platelet poor plasma. The only way to be sure is to test the sample. The review mentioned above by Evans concluded that PPP does not work as well as PRP or PRF. In general, single spin systems produce the lowest concentration PRP. Double spin systems produce the highest concentration, but are at risk for lower levels of purity, with higher numbers of red blood cells and white blood cells in the PRP.
For best results, multiple treatments may be required.

Hello! These problems are often genetic but there are a variety of potential causes. I would recommend RF microneedling and PRP injections. RF microneedling is amazing for any textural concerns such as bumps and fine lines/wrinkles. PRP enhances the results for microneedling and brightens dark under eyes. To maintain your results, I would start Jan Marini Luminate eye gel and repeat the microneedling and PRP as needed, usually every year. Hope that helps!-Diyanah Bani Hani, MD