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.
Undereye swelling, too, is caused by several factors; genetics is one of them. If you have prominent pads under your eyes, take a look at your relatives. Do most of them appear to need a monthlong nap? Then the only way to reduce your puffiness is with blepharoplasty (lower eyelid surgery, $3,000) or phosphatidylcholine injections. But say you notice puffiness only after an evening of dim sum. Cut back on the salt and see if your puffiness diminishes, says Doris J. Day, MD, clinical assistant professor of dermatology at NYU Medical Center. Finally, try sleeping with an extra pillow so that fluid doesn't pool around the eye area at night, which causes bags in the morning.
Of all the kinds of wrinkles you can get on your face, I think crow's-feet are the least unbeautiful. They're caused (in order of pleasantness) by smiling, squinting, sun exposure, diminished estrogen levels due to menopause, and smoking. The best way to treat them is to prevent them, says Jeffrey Benabio, MD, a dermatologist for Kaiser Permanente in San Diego (he also writes thedermblog.com). Benabio advises patients always to apply a broad-spectrum sunscreen that blocks UVA and UVB rays and to wear sunglasses. Also, especially if you spend hours a day in front of a computer monitor, make sure there's no glare on it. Topical retinoids have been shown to help crow's-feet by inducing collagen growth, he says. Botox injections partially paralyze the orbicularis orbis muscle to prevent it from contracting, which causes wrinkling (though Benabio is quick to remind us that if the Botox is overdone, you won't be able to smile about your wrinkle-free face). Injectable fillers can be used to plump up the lines, and chemical peels and lasers can also improve crow's-feet by stimulating collagen, Benabio says.
A few words about camouflage
Concealer can go a long way toward improving the look of undereye problems. Use one the same color as your complexion; a lighter one will emphasize puffiness, says Pati Dubroff, Dior international celebrity makeup artist. And try a creamy formulation, rather than a liquid, tapping it right along the shadow or crevice. A very sheer dusting of loose powder will help set the concealer.
Printed from Oprah.com on Tuesday, May 21, 2013
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