Tear trough filler: Hemosiderin Staining Permanent? (photo)

Question

Hello I had tear trough filler late October . The PS who performed this told me the bruising under my eyes was my bags showing. I went for a second opinion and the PS confirmed it IS hemosiderin staining. He advised me to use vitamin k cream but i have seen no results. I'm hesitant to have a laser procedure done to my face. I was wondering if i have other options. Perhaps a tattoo removal cream such as wreaking balm? I'm actually scared that the hemosiderin staining under my eyes is permanent

Drew Varano, MD · Answer

hemosiderin happens because the iron pigment from the red blood cell infiltrates the skin . It can take several months to improve without intervention . Q-switched lasers have been successful ( which are some tattoo removal lasers) . Skin cell turnover treatments such as microdermabrasion can have some limited success

Daniel Chang, MSc, MBBS, MRCS · Answer

Dear melissa,
Thank you for your question. 
The general course for a bruise is from blue black, to green, to yellow and finally back to your original skin colour. 
Bruises can occur immediately, or a few days after. Generally, bruises resolve in 7 to 14 days. 
After 2 months, what you are seeing is likely the Tyndall effect, which is a bluish discoloration that appears if hyaluronic acid fillers are injected too superficially under the skin. Another possibility is hyperpigmentation from hemosiderin deposits contributed by red blood cells.
It's best to review with your doctor, who may offer you the option of dissolving the filler.
I hope this helps.

Shaun Patel, MD · Answer

Your photo does demonstrate some darkening under the eyes. Any bruising or staining should have resolved at this point after the injection. The darkening may represent Tyndall and if this is the case, it will likely need to be reversed using hyaluronidase. This occurs when the wrong filler is used under the eyes, too much of it is injected, or it is injected too superficially.

Michele S. Green, MD · Answer

It appears that there is some darkening under the eyes from the injections.  It appears that you may need the product dissolved to have this removed.  I would consult with an expert in tear trough injections.  Belotero has less of this problem than some of the other fillers.  Best, Dr. Green

Jean M. Casello, MD · Answer

Hemosiderin staining will usually occur when there is trauma/bruising  to the area.  The skin around the eyes is thin and that is why you often see it in this area. Usually this is not permanent and will resolve over time. Lasers or intense pulsed light and eye creams can  be used to expedite the process., I do not think wrecking balm would be helpful. Hope this helps.

Tear trough filler: Hemosiderin Staining Permanent? (photo)

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