Are my dark circles allergic shiners or is it pigment? Will tretinoin cream help? (photos)

Hi Alaiatm, 
     There are different reasons to develop under eye circles. One reason can be volume loss in the   face,  which  causes  deep  tear troughs that  be improved by dermal  filler.  Second  reason  can be  genetically thin skin  as the  under eye vessels are more visible, giving the appearance of dark  circles. Other  reasons  can be skin  laxity  or allergies.  Each different  reason has a  different  treatment  option. Therefore it is best to consult with a medical professional.  

You would be a great candidate to have filler injected in the areas where you have volume loss. 
The volume loss is also the reason that area looks discolored due to shadowing. 
The best way to thicken the skin is adding volume. 

Thank you for your question. To determine if the color is from pigment or thin skin, it is best to have an in-office evaluation. If it is due to shadowing from texture and volume changes, filler can usually improve these areas. Some people have skin which has thinned or naturally increased pigment. Pigment can also increase due to other reasons such as chronic inflammation. Filler will not help in these cases and may make the area look even worse. Other options include bleaching creams, chemical peels, microneedling, and PIXEL laser treatments. Tretinoin cream can help thicken the skin but is not ideal for reducing pigment. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Dear LA,This is a really interesting question. You have clearly done your research about the matter, but have yet to have found the solution.It is quite possible that there are a combination of environmental and genetic factors going on.Allergies could do it, with secondary rubbing of the delicate skin and secondary redness and pronounced vascularity.Work on good balanced nutrition, good sleep hygiene, avoid areas with poor air quality, wear spf 30 daily, and sun glasses when outside or driving.Fillers may be of benefit to smooth out the under eye hollowing.Retin a used sparingly for fine lines lateral to the eyes. Avoid strong retin a cream under the eyes, for now, as that may cause more skin redness and irritation.You may need eye drops, as well.See your provider for more help.Best. Dr Brecht