How to help patients who don't want surgery to improve the appearance of the under eye skin.
Zoe Diana Draelos, M.D.I think the under eye area is the most challenging for cosmetic camouflage. It is the first area of the face to show age and due to the thinness of the skin and constant movement, it is difficult to find products that perform successfully. There are many pigmented under eye creams that contain light reflective particles to minimize line depth by decreasing the shadows.
These creams tend to migrate and collect in the fine lines ultimately increasing the crepe appearance of the under eye skin. Another newer formulation for under eye lines is a line filler containing viscous silicone literally filling in the skin depressions. This product can be applied to freshly washed skin followed by an under eye primer to keep the silicone in place. Then an under eye pigmented cosmetic can be applied to cover under eye circles followed by a loose power to set the multiple layers and keep the film even.
A different approach is to minimize under eye edema thereby reducing the line fullness. This can be accomplished by elevating the head of the bed at night to prevent dependent edema and, if allergies could be a contributing factor, taking a nonsedating antihistamine at night.
Some patients may find a decrease in under eye lines and bags after taking an OTC cetirizine (OTC Zyrtec) at bedtime.
I have found these suggestions helpful to patients concerned about the appearance of the under eye skin who do not wish a surgical solution.