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

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello, thank you for your question.From the picture you provided, I can see one small milia under the outer corner of your eye, but under the inner corner it looks like you have prominent (and visible) sebaceous glands. Unfortunately, there isn’t a lot that can be done to completely remedy it. You could try using an eye cream that contains retinol (not tretinoin) — as it would be specifically formulated for the delicate skin in that area. I would recommend consulting with a board certified dermatologist or experienced skin care provider that has background in treating that area with microneedling/co2 laser/etc, but keep in mind that it might just be part of your anatomy. Best of luck!

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

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

Hi there,

You can do light cautery for the little bumps under your eye. It also appears that you need some volume restoration as well. Seek an expert injector for your filler as Resytlane is best in this area and see a dermatologist regarding your bumps.

Best of luck!