Valerie Monroe, O's beauty director
I once asked you about your most vexing beauty problems. Most of your mail concerned the usual hair, skin, makeup, and aging dilemmas, but an intriguingly high proportion of you are contending with undereye issues. Discoloration, puffiness, and crow's-feet seem to infect this readership like the plague. Why? Exhaustion? Genetic proclivity? Bookishness? All of the above? Anyway, you need help. So I called in the experts.
Dark circles and shadows
There are several reasons for undereye discoloration, says Heidi Waldorf, MD, director of laser and cosmetic dermatology at Mount Sinai Medical Center in New York City. Before you can figure out what to do about it, you have to know what's causing it. If you apply pressure to the circle or shadow and it disappears, your problem is due to visible blood vessels underneath the thin skin of the eye area. If the color doesn't disappear, the darkness is caused by excess pigment. And if the shadow forms at the inside corner of your eye, where a tear would flow, it's probably due to a deep tear trough.

To diminish the appearance of vascular discoloration, Waldorf suggests two to three treatments with a Vbeam laser, at $100 to $600 per treatment. For shadows caused by excess pigment, try a topical solution such as a prescription retinoid cream (Retin-A, Tazorac), a lotion containing the lightening agent hydroquinone, or one with soy, niacin, or licorice. A shadow from a tear trough is treated by filling in the area with injections of a hyaluronic acid filler such as Restylane or Juvéderm.


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