Ask Dr. Barber

Q. I have dark circles under my eyes that make me look tired. Is there anything that can be done to lighten my eyelid skin?

A. Dark circles under the eyes are most commonly caused by shadows that are cast in the hollow portion of the “tear trough” of the lower eyelid. Many patients have puffiness of the lower eyelid caused by fat pockets. This puffiness accentuates the groove that is just below the puffiness and it casts a shadow in the groove. This shadow frequently looks like dark circles that patients often interpret as pigmentation. One test that you can do to determine if the dark circle is due to pigmentation or a shadow is to pull the lower eyelid up, tightening the puffy skin. If the dark circle gets better, then the problem is shadowing and not pigmentation. The treatment for the dark circles caused by the shadowing effect from the puffy eyelids is to perform surgery to remove the fat pockets and tighten the lower eyelid skin. This will improve the appearance by flattening the lower eyelid skin. If a patient does have pigmentation and it is not shadowing that is causing the dark circles, then the treatment is to apply a skin bleacher cream such as hydroquinone (this requires a prescription from your doctor) and possibly a chemical peel which can further lighten the skin and additionally give some minimal tightening of the skin. Your best bet is to see a board certified plastic surgeon for an evaluation of your lower eyelids.

Q. I had a facelift about two months ago and I can still see my scars in front of my ears. I am worried that they will be permanent. What should I do?

A. First of all, relax. I am sure that your doctor told you that it can take months for scars to mature and “fade away”. It has only been two months for you, and that is not enough time for the scars to become inconspicuous. I advise my patients that it will take 4-5 months before the scars in front of the ears will fade away and about a year before the scars fade behind the ears. Although I do not have the benefit of actually seeing your scars, the redness and slight raised look of the scars almost always will mature and become nearly invisible, assuming the scars were placed in the correct location. You can try some over the counter scar creams, but honestly, the scars should heal and fade whether you put anything on them or not. If the scars are still visible after 6 months or so, then you should revisit your doctor to find out what can be done to help fade the remaining scars.

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