• Nikki Nicole Miller

The Under Eye

So many mornings, you're applying your makeup under your eye and it seems the more you apply the more defined the lines under the eye become! So frustrating! You're not alone, this is a common problem area for many. So you start to look for an eye cream that will banish those lines or bags forever. You notice there seems to be a forever long list of options on the skincare isle of your beloved department store. So you pick one but don't notice much improvement after using it for months. Why? The under eye area is a bit more complex than we may realize.

Skin is not the only thing that effects how your under eye looks. There are structures beneath at play that change as we age. Most of the time you think fat is your enemy, but not this time. Beneath your skin are fat pads of different shapes and sizes. When we are younger, these fat pads sit right beside one another, like a perfect, tightly put together puzzle.



But, as we age, these fat pad puzzle pieces begin to change, they become smaller and smaller. As they become smaller, they drift apart leaving more and more space between them. This can cause the skin above them to look different. For example, the lid cheek junction is the area where the lower lid fat pad and cheek fat pad meet. Once we begin aging, losing fat, the junction can become more and more distinct. This causes the under eye to appear as a bag, or cast a shadow (dark circle). If you are wondering if this is what is at the root of your problem, there is a quick trick to testing that theory. If you take a handheld mirror and hold it eye level, notice your under eye area. Then hold the mirror higher above you and look up at it. If you notice, the under eye area looks better, or your dark circles/bags improve -- bingo! You've got some volume loss. There are multiple ways you can address this problem. You can use dermal filler, fat transfer, or lower lid blepharoplasty. Of course this area is best treated by experts only, so be sure to seek a board-certified plastic surgeon, ophthalmologist, or oculoplastic surgeon.

In other cases, the hollowing under the eye, or loss of fat is not the problem. Sometimes the fat under the eye protrudes causing a shadow. In this case, lower blepharoplasty, where the eye fat bags are repositioned to the hollow may be considered. The best way to know for sure is via consultation with an expert!




Another issue causing under eye distress, is dry skin. What could cause this dryness? The skin under the eye is much more vulnerable than the rest of the skin on your face. This makes it more susceptible to damage and breakdown. It's more prone to laxity, fine lines, and becoming looser and thinner. Sun damage/Ultraviolet (UV) exposure is responsible for 80% of visible signs of aging. Also squinting due to the sun can cause crow's feet and deepening of wrinkles over time. UV rays from the sun reach you by invisible wavelengths, producing DNA changes that can lead to skin cancer and premature aging. Sun exposed skin can gradually lose moisture and essential oils, making it appear dry, flaky and premature wrinkles, even in younger people. These UV rays cause long-term changes in the skin's structural protein, COLLAGEN!

Solution? Wear sunglasses, SPF 30+ broad spectrum daily, and use a moisturizer with at least one of the following ingredients: glycerin, urea, pyroglutamic acid, sorbitol, lactic acid, lactate salts or alpha-hydroxy acids (AHA). Avoid using AHA's, or any other acids, on sun burned skin. Also, using unscented soaps with high fat content or glycerin helps. Sometimes, your dermatologist may prescribe you tretinoin cream (a derivative of vitamin A). Botox helps with crow's feet, and can be done every 3-4 months. If you have moderate or advanced wrinkling and crepey skin under the eye, a more advanced solution may be ideal, such as laser resurfacing, cryosurgery, or dermabrasion. But, again, seek the experts for these procedures!



Some dark circle are caused by periocular hyperpigmentation (POH). This can be caused by multiple factors, including: post inflammatory hyperpigmentation (PIH) from conditions like eczema, hemosiderin deposits, congenital hyperpigmentation, blueish veins, or melasma (hormonal changes/pregnancy/contraceptives). For the hyperpigmentation, your doctor may prescribe topical hydroquinone, which can take a few months to see the best result.

Hemosiderin staining represents the deposition of residual iron oxide pigments from the breakdown of the hemoglobin molecule. While most hemosiderin staining problems resolve on their own, they do so within months due to macrophage activity. Once this problem exists beyond 6 to 12 months after surgery, the body is telling one that it will not remove it on its own. Iron pigment in the subcutaneous tissue is not going to respond to any form of topical cream. Bleaching creams work on the skin for pigment, the iron oxide molecules lie much deeper. One of the few treatments recommended is a Q-switched laser, the type of laser used in the treatment of tattoos. This is best treated by someone who is an expert in this particular field, such as a plastic surgeon or dermatologist.

The main thing to remember is that there are many treatments available to help improve the under eye, so don't sweat it! Schedule a consult at Georgia Center MedSpa today!


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