Melasma darker after having Juvederm done in tear troughs. What's best way to get rid of it?

Question

October 13th l had the Juvederm done in tear troughs, l did swell and bruise,l know thats normal.2 weeks later l still looked the same and was seeing some darker spots under both eyes that were impossible to cover up.l went back to the lady that did the injections, she said it was bruising and said give it 3 weeks,so l did.3 wks later it still looked the same, l went to different doctor for 2nd opinion l was told its melasma and bbl would help,had it done,but l still see discoloration..help!!

Jason Emer, MD · Answer

This is difficult to answer without pictures.  For melasma, we currently use clear + brilliant with bleaching and microneedling/prp and getting amazing results. I suggest you see an expert. You will need lifelong treatment, sun protection, skin care. But these treatments can give you improvement and then help you maintain. Best , Dr. Emer.

Hardik Soni, MD · Answer

Juvederm is not recommend for the tear trough area because the skin is very thin. What you are probably experiencing is called the Tyndall Effect. This can happened when filler is placed superficially. I recommend having the filler dissolved with hyaluronidase, and replaced with Restylane. Please make sure you are seeing an expert injector.

Marla M. Klein, MD · Answer

A picture of your face with a close up for under the eyes would be very helpful.  Darkness afterwards can be due to hemosiderin deposition from a bruise or a Tyndall effect from too superficial placement of the product.  For persistent bruising, I recommend rubbing Arnica into the area.  If it is melasma as the 2nd doctor said (what is "bbl"?) there are several treatments than can help with that.  I wold recommend you see a Board-certified dermatologist who also does Juvederm injections under the eyes.

Lisa Zaleski-Larsen, DO, FAAD · Answer

Thank you for your question.  There are multiple possible causes for the color change under your eyes.

1. Juvederm is not the best filler for the tear trough.  I recommend Resylane or Belotero.  Juvederm can cause a bluish tint under the skin if injected superficially called the Tyndall effect.  Hyaluronidase injections could dissolve the Juvederm if the Tyndall effect is a concern.

2. Melasma is common on the face.  I recommend wearing a high spf sunscreen 24/7 because sun or even indoor light exposure can predispose you to developing melasma.  There are multiple topical creams that can lighten the skin (azelaic acid, tretinoin, hydroquinone) but if you have any light exposure it can make the topical creams less effective.

3. Seasonal allergies can cause dark circles under the eyes.  Claritin daily can help with this.

4. It is possible for a residual bruise to be present but it should have faded after a month.

I wish you the best.

Steven F. Weiner, MD · Answer

This darkening is one of a couple things. It is either the hemosiderin associated with the bruising from the injection. When the blood mixes with the filler, the breakdown products become hard to clear. Laser treatment might help as well as topicals but this can take months to get better. It may also represent Tyndall effect. Either way, Juvederm is not the right product for this area and you might want to get it removed. See link. I only use Restylane here and only with cannulas to prevent bruising.

Melasma darker after having Juvederm done in tear troughs. What's best way to get rid of it?

Answers (5)