Any suggestions for intense purple in lower eyelids? (photos)

You may want to talk to a doctor to see if fillers may work for you. Maybe talk to them about Belotero, or what other fillers they recommend. this is something that you do not need surgery for unless it is necessary

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.  All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

The discoloration results from thin eyelid skin with underlying fat prolapse (eye bags) in addition to hollowness below it (dark circles).  You should be a candidate for either lower blepharoplasty (with fat repositioning) or filler injection, depending on the amount bags vs. dark circles. Best to see an oculoplastic specialist for evaluation.

I would see an oculoplastic surgeon in your area to get a good look at your orbital anatomy and look at old photos to see if there are any new changes. Your cosmetic options vary from fillers along bones below your eyes to help lift this area and get rid of the hollows to surgery around this region to help you reach your cosmetic goals.Sean Paul, MD

Hi Abreen1991,Thank you for your question. A few more pictures would help us get a better idea of what we were dealing with. However, based on the photo you provided, there appears to be some hollowing of the tear trough and lower lid regions. There are many different approaches to fixing this problem including lower lid blepharoplasty, fat transfer and filler placement. As each individual is different and thus requires a personalized approach, I would recommend you seek out a consultation with a qualified oculoplastic surgeon in your area. Good luck!