How would you deal with bags and creases under eyes, like these? (Photo)

Thank you for your question. I understand that you’re concerned about the under eye creases and bags that
have appeared over the past year and you’re
wondering if the finasteride and minoxidil that you’re taking for thinning hair has something to do with
the wrinkling under your eyes.



Before I tackle your question, let me give you some
information about my training. I'm a Board-certified cosmetic surgeon and a
Fellowship-trained oculoplastic or oculofacial plastic surgeon. I was trained
primarily in eye surgery before specializing in complex surgery of the eyelids.
Oculoplastic surgery is a super-specialty, and is distinct from general plastic
surgery which is a broader in the field of Plastic Surgery. General plastic
surgeons are trained in many things, but do not specialize as intensively in
one area as we do in Oculoplastic Surgery. In addition to this, I am also a
hair loss specialist and the founder of Trichostem™ Hair Regeneration, a non-surgical hair loss solution.
Prior to the development of Hair Regeneration, weperformed
hair transplants for many years, and have treated many patients from all over
the world.



To answer your concern about your hair loss
medication, I have not seen any direct correlation between the use of
finasteride or minoxidil and skin irritation. However, if you are using
minoxodil solution as opposed to the foam, you must know that it contains a
chemical called ethylene glycol, which is a diluted version of the ethylene
glycol that's used in antifreeze. If you’re
inadvertently touching your eyelid area after applying minoxodil, it’s important that you wash your hands to avoid drying
your skin.



It’s important to keep in mind
that the eyelid skin is the thinnest skin on the body, so it is very sensitive.
It is sensitive to environmental factors like sun damage and dryness, and also
to your hydration, nutritional status, and even stress levels. Eyelids can be a
very telling indicator of the status of your health—in fact, we can almost always tell who's a smoker just
by looking at the quality of their eyelid skin.



In your case, being a young man in an
appearance-driven industry, you may want to consider the aforementioned factors
as well, and how they could be affecting your skin. If you are indeed getting
too much sun exposure, not sleeping enough, or habitually smoking, you should
address these first before considering an actual procedure.



That said, I would recommend a treatment like
platelet-rich plasma (PRP) for your situation. Platelet-rich plasma is derived
from your own blood and contains several growth and healing factors that help
improve skin quality and texture. It is a non-surgical treatment that has shown
wonderful results in many of our patients after only one session, but many need
more than one treatment. In our practice, PRP treatment is often combined with
topical creams.



I don’t recommend lasers for
someone as young as yourself, because lasers, if done too aggressively or too
early on, can thin skin rather than thicken it. A small amount of heat does
have some benefit on the skin, but I would not recommend it for younger people.
I do think that you would be a good candidate for platelet-rich plasma, and in
addition to that, I will reiterate that it is also important for you to make
any necessary lifestyle changes as well that will help improve the state of
your skin.



I hope that was helpful and I wish you the best of
luck!

Thank your for the question and sharing your photos. It would be best for you to make an appointment for in office consultation with a specialist, because the appropriate treatment option is difficult to judge from those photos. If the eyelid bunches up when you smile, then Botox might be the right solution. If the puffy area can be blended into the cheeks with fillers, then that would be a good choice. If you are not a candidate for Botox or Fillers, then a pinch of skin and underlying fat can surgically be removed to flatten out the area. As you see, the best approach has to be tailored to your specific problem. I hope you find this helpful. Good luck.

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.