Persistent dark spot after under eye filler, PIH or herosidian bruising? (Photos)

Question

I got under eye/tear trough filler done a year ago. I bruised pretty badly and I noticed I had a blue/brown hue a few weeks after. I suspect it was the Tyndall effect. I had it dissolved and refilled and the dark brown spot persists, even when the filler was dissolved it was still there! PIH or hemosiderin bruising? I just want to know what it is so I can best treat it. Not sure if lasers or a topical cream like hydroquinone is the best option.

Randal Haworth, MD, FACS · Answer

It is possible that the dark spot is due to post-inflammatory hyperpigmentation (PIH) or hemosiderin staining from the bruising. PIH is a common side effect of filler injections, and it can appear as a dark spot or discoloration on the skin. Hemosiderin staining can also occur as a result of bruising and can take several months to go away.

Lasers and topical treatments like hydroquinone may be effective in treating both PIH and hemosiderin staining. Laser treatments such as intense pulsed light (IPL) or fractional laser resurfacing can help to even out skin tone and reduce the appearance of dark spots. Topical treatments like hydroquinone, retinoids, or vitamin C serums can also be helpful in reducing hyperpigmentation.

However, it is important to consult with a qualified dermatologist or plastic surgeon to determine the cause of the discoloration and the best treatment plan for your specific situation. They can also provide you with more information on the risks and benefits of each treatment option.

I hope this helps,
best of luck !

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

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