Juvederm for possible allergic shiners? (Photo)

Hi, I believe my under eye darkness is part heretidary and part allergic shiners. Last few years there's been a lot of eye rubbing due to eczema and allergies, I believe the under eye skin has thinned a lot and redness has increased too. (Not sure if the "sullen-ness can be improved with weight loss). Would Juvederm be a suitable treatment, and if I am still exposed to allergens after treatment and rub my eyes, will this render the treatment useless?

Doctor Answers 6

Juvederm for under the eye

I would not use Juvederm for someone that is already having under eye swelling because injections there can cause more swelling. Instead, I would try some anti histamines and decongestants for a few weeks. If you decide to use a filler, I would try Restylane or Volbella in small amounts.

Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Juvederm Under the Eyes and Allergies

Thank you for your question.  "Allergic Shiners" are dark circles under the eye caused by allergies.  Basically some patients, particularly those with pigment in their skin that is greater than the middle of the spectrum of skin pigmentation (more like Mediterranean or darker) can tend to get darkening of the skin any place where there is chronic inflammation.  Allergies are a common cause of this problem around the eyes. 

Juvederm is a wonderful filler for many purposes, but it is not a good filler for under the eyes.  The reason for this is that Juvederm has a tendency to swell in that area.  This type of swelling can happen to anyone, but is even more likely in someone who has allergies.

For under the eyes I suggest Restylane, another hyaluronic acid filler, that is much less likely to swell. However there are two issues in your situation.

First, fillers to not help pigment.  They just add fullness. So your first step is to work on the extra pigmentation in that area.  The first step is to control your ocular allergies.  Your eye doctor can suggest very safe eye drops that will help you with that problem.  The next step would be to have you cosmetic surgeon/dermatologist suggest skin treatments to lighten the area under your eyes.

If you are happy with the appearance at that point, great.  If you still feel that your under eye area looks hollow then I would suggest considering Restylane injections by someone who is experienced in treating this area. 

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

Improving dark circles around eyes - allergic shiners

The pigment around the eye won't improve with filler. What filler will do is improve the volume loss around the eye. If there is shadows from volume loss, this is what will improve. Pigment requires skin care, peels, and maybe laser for best results. If you pull the skin down and the pigment moves, the problem is in the skin and filler will only minimally help. I wouldn't use Juvederm here because it leads to chronic swelling. Use Restylane with cannulas for this. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Under eyes

Good question. I would not recommend fillers if your issue is pigment. I would also not recommend juvederm for under the eyes. I would recommend volbella or belotero, however, filler will not help pigment.

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Rejuvenating under the eye--lasers, microneedling/prp and fillers

A combination approach would be best. Fillers, lasers, and microneedling/PRP can improve under eye hollows. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Causes for a prominent tear trough: allergic shiners, descended cheek, thin skin.

The tear trough exists on everyone. In some patients, it is subtle. In others it is very prominent. A prominent tear trough is the result of a contrast between light shining around it and shadow falling in the trough. Many factors can contribute to this light/shadow contrast: allergic shiners, a descended (ptotic) cheek, thin skin, congested vessels under the eye, and hyperpigmented skin. 

Identifying the cause helps select the appropriate treatment. Allergic shiners need to be treated with allergy control therapy. A ptotic cheek needs augmentation to improve the lid-cheek junction.  It's often a combination of treatments that produce the best results. A single treatment used too aggressively can cause problems in the sensitive eyelid. I recommend a consultation so you can be examined and photographed. Once a correct diagnose is made, your doctor will determine a treatment plan appropriate for your face to produce a safe and happy result. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.