Jun 17

Why is the NY Times promoting off label usage of Fillers for the Treatment of Dark Eye Circles?

Dark circles under the eyes have always been understood to be largely a function of pigment, and as a result there really has never been a good treatment for the problem.

Dark eye circles

There is the occasional patient who we find who has allergies which result in blood pooling under the area, or the even more rare patient who has noted the problem since starting birth control pills; but for the vast majority of patients presenting with this problem there has always been few treatment options. So we were surprised to see the NY Times tackle the subject in a recent article.

As we read the article we were first somewhat surprised at the sheer magnitude of the numbers quoted as being bothered by this phenomenon, but also the money involved in addressing the issue. The NY Times quotes a Clinique company survey of 13,000 Clinique users in 2006, of whom roughly 53%  cited under-eye circles and puffiness as their No. 1 beauty concern. Almost as fascinating was the fact that sales of “anti-aging” skin care treatments have nearly doubled over 6 years to a whopping $1.08 billion dollars in 2006. Sephora alone is noted to now sell more than 50 products designed to specifically treat under-eye circles.

While all of this was interesting because the article itself goes on to note that, “The problem is that few, if any, of the creams on the market are formulated for people with excess pigmentation or dilated veins,” we were more bothered by the fact that the article then goes on to tout how a number of physicians and patients have gone on to  use restylane or juvederm off label under the eyes for treatment.

What is disconcerting is that though they do note the off label nature of this treatment, we think that they under state the number of problems encountered by patients who have undergone this treatment. In our own experience we have had a number of patients who presented after being treated elsewhere who noted that the circles actually appeared either darker after injections of restylane/ juvederm or who noted a blue tint under the skin from the injected material.

There have been others who had lumpy/ bumpy appearances after the injections. But perhaps the most disconcerting problems are left for those patients who then had injection of products meant to break down the filler in trying to resolve these problems. These patients have presented with significant thinning of the overlying skin and a resulting crepe appearance which usually can only be treated with a lower eyelid blepharoplasty to remove the now excess skin.

Unfortunately the number of people who read this will be far less than those who read the NY Times article and go running to whichever doctor they can find who is promoting this off label treatment.

As a final note to the article we wanted to note that one doctor quoted regarding all the products available for treatment of under eye circles said, “If there are that many of them available, that usually means they’re not terribly successful.”


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