UtahOC.com Blog
Salt Lake City's Eyelid Surgery Specialists
August 29, 2011 by Dr. Matheson Harris

Bags and circles: Why your eyes look tired and what to do about it.

When looking at other people’s faces, the first thing our eyes are drawn to are their eyes. The eyes and the skin around them can tell us a lot about a person, or so we think. When we see dark circles or bags under the eyes we may assume the person is tired or possibly ill. This has led people with this problem to search out all sorts of remedies to improve their appearance. Dark circles under eyes affect both men and women, usually starting in adulthood, although children can develop dark circles under their eyes as well. A common reason for dark circles is fatigue, but they may still form in a well rested person. Sometimes, what appear to be under-eye circles are just shadows cast by puffy eyelids or hollows under your eyes that develop as a normal part of aging. First, we need to understand the causes of bags and circles, then we can try to eliminate them.

The Mayo Clinic lists the following as causes of dark circles:

  • Allergies
  • Atopic dermatitis (eczema)
  • Heredity — dark under-eye circles can run in families
  • Lifestyle factors, such as physical or emotional stress, smoking, or chronic alcohol use can take a toll on your appearance
  • Nasal congestion (which can dilate and darken the veins that drain from your eyes to your nose)
  • Pigmentation irregularities — these are a particular concern for people of color, especially blacks and Asians
  • Rubbing or scratching your eyes (see allergies)
  • Sun exposure, which prompts your body to produce more melanin, the pigment that gives skin its color
  • Thinning skin and loss of fat and collagen — common as you age — can make the reddish-blue blood vessels under your eyes more obvious
Discoloration of the skin is not always the problem, however. Changes in the skin and underlying fat around the eye can cause dark shadows to appear, which are mistaken as dark circles, but will disappear if the skin is pulled taut. As we age, fat around the eye and the fine tissue that supports it gets stretched out. The skin also looses its elasticity. This combination leads to a puff of fat beneath and sometimes also above each eye coming forward, i.e. baggy eyes. This will cast a shadow forming a dark circle. In addition, the area called the tear trough, between the nose and the cheek, deepens as facial fat decreases and moves downward. This also causes a crease and shadow to appear.

Now that we know what causes these changes, what can be done about them? First, to be sure you have dark circles, look in the mirror and pull down on the skin of the lower eyelid. You truly have dark circles, not bags, if the circle still remains when the skin is tight. For mild to moderate dark circles due to discoloration of the skin, there are some simple and inexpensive treatments that may work

  • Bring in the cold- Try two chilled teaspoons, an ice pack or a bag of frozen peas wrapped in a soft cloth to temporarily reduce dilated and discolored under-eye blood vessels. Cooled cucumbers or used teabag have also been recommended, just remember it is the cold that helps, not the tea or some aspect of the vegetable.
  • Elevate your head - use two or more pillows to prevent puffiness that develops when fluid pools in your lower eyelids.
  • Protect yourself from the sun - Although a tan might hide dark circles in the short term, in the long run, the extra pigment it produces can make circles worse. Use a daily sunscreen and wear sunglasses.
  • Treat allergies and sinus problems. Use a daily allergy medication, such as Allegra or Zyrtec, if seasonal allergies are a problem. Rinsing your sinuses with a saltwater solution (mix 1/4 teaspoon sea salt with 2 cups warm water) or over-the-counter saline spray can help relieve nasal congestion.
  • Get your beauty rest - lack of sleep makes you paler and more hollow-eyed, so shadows and circles you already have are more obvious.
  • Find a good eye cream - There are hundreds of skin creams that claim to reduce or prevent under-eye circles, but you should shop wisely. The results of one study in the Journal of Cosmetic Dermatology showed that cream, among other things, the Brazilian suma plant, significantly improved the appearance of dark circles under the eyes
  • When all else fails, cover up - Find the right colored concealer to hide dark circles. For example, if the circles under your eyes are bluish, use a peach-colored concealer, not one that’s white or gray. Make sure the product is safe for use around the eyes. Stop using it if you get any eye irritation

When these fail, consider speaking with a dermatologist, who could recommend various skin treatments with chemicals such as hydroquinone or kojic acid, which can lighten the skin. Also, many laser treatments have been successful in lightening the skin, but again, these should only be performed by a dermatologist experienced in use of lasers around the eye.

If you truly have bags under the eyes, no amount of eye cream of concealer will eliminate these changes, and lasers are usually only effective for the most minor of changes. You now need to consider a cosmetic procedure to get the most benefit.

  • Blepharoplasty is a procedure that involves removing the redundant fat beneath the eye (and above when necessary) as well as removing some excess skin in certain individuals. This leads to a more natural transition from the cheek to the eyelid and a younger appearance. Consider this middle aged patient before and after upper and lower lid blepharoplasty. A small change to her lower lids makes a dramatic difference.

  • Injectable fillers: The tear trough deformity shown above can now be treated with fillers, such as Juvederm, which can soften or eliminate its appearance for 12 months or more.

If you are fed up with those baggy lower lids and no amount of home remedies have helped, contact us for a consultation and we can discuss your options.

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August 16, 2011 by Dr. Matheson Harris

10 things you can do now to save your skin

We regularly get questions about which skin cream will reduce wrinkles or what is the best thing to reverse aging. There are many things you can do and avoid, no matter your age, to maintain your skin looking its best. Here are the 10 that we recommend everyone put into their daily skin care regimen (in no particular order).

10. Control the sun: We all need the sun. Besides keeping our planet alive, it is necessary to synthesize vitamin D, which is good for bone health, the immune system and may reduce the risk of certain cancers and other diseases. Excessive sun exposure, however, is the number one reason skin goes from tight and youthful looking, to loose and more aged in appearance. Sunlight destroys elastic tissue causing lines and wrinkles. It also leads to telangiectasias (fine blood vessels visible under the skin), sallowness (a yellowing of the skin), as well as freckles and potential skin cancers. The myth that the majority of skin damage occurs in our youth and we can’t change it now has led many to not bother with sunscreen in older age. This has been debunked and all ages should use sunscreen.

Finding a sunscreen that you’ll use everyday is the best way to avoid harmful UV exposure. Olay Regenerist UV Defense is one particular cream that has SPF 15 protection, doubles as a nice face cream, rather than an oily sunscreen, and won’t break the bank. There are many similar products that may be more or less expensive. Click here for an alternate list of sunscreens. Don’t forget your neck and upper chest, as these areas are prone to premature aging as well.

9. Stop smoking: Just in case you hadn’t heard, smoking is really bad for you. Not only does it harm your lungs, it also prematurely ages your skin. Smoking leads to premature development of deep wrinkles and an unhealthy yellowing of the skin. Facial aging can be seen under a microscope in smokers as young as 20. Many of these changes or partially or totally reversible by stopping smoking.

8. Rebuke the tanning bed: Look at it this way, do you want to look good (in your opinion) for a few years, or good (in most other people’s opinion) for all of your years. Tanning is a one-way street to major wrinkling and loss of skin tone. Also, a recent study showed that those who use tanning beds 10 times per year are 8 times more likely to get malignant melanoma, which is very often deadly. The skin effects of indoor tanning are similar to smoking, and the potential addiction is also very real (read the NY Times article on the subject)

7. Understand facial expressions: You know those deep lines between the eyebrows you see in older people, well those were carefully developed with decades of smirks, scowls and squinting. Humans are expressive people and much of what we say is projected nonverbally by our face. Unfortunately, this constant flexing of facial muscles folds the skin, leading to the formation of static wrinkles. While I don’t recommend becoming an expressionless zombie, there are a few ways to lessen the effects of our expressions. 1) Be aware of your expressions - if you are developing deep forehead lines or crows feet prematurely, look in the mirror and make the expressions that deepen these wrinkles. Being aware of these expressions will allow you to avoid making them (we’ve all seen people who scrunch up their face while listening to a compelling story). 2) Wear sunglasses - not only do they protect your eyes and eyelids from UV exposure, they also reduce your desire to squint, which causing wrinkles. 3) Be happy - the wrinkles that come from smiling are arguably better looking that those caused by frowning.

Injectable neurotoxins, better known as Botox and Dysport, have become popular due to their ability to prevent certain expressions that lead to wrinkles. When properly administered, they can block certain facial contractions, but still allow for an expressive face. A little can go a long way when placed in the right sites on the face. Once static wrinkles have formed due to repeated facial contortions, these medicines cannot totally eliminate lines. Injectable fillers (Juvederm, Restylane, Perlane, Radiesse, Sculptra) then must be used to lessen or eliminate the lines.

6. Hands off your skin: You are already battling gravity, loss of skin elasticity, and the elements. Why further age your skin by pulling and rubbing it? As an eye doctor I frequently see patients who have rubbed their eyelids so much that they are stretched out and need surgery to correct.

5. Sleep on your back: If you can, train yourself to sleep on your back. Sleeping on your side or face down leads to premature creases forming, especially between the nose and mouth (nasolabial fold). I often will ask my filler patients which side they sleep on and I am right most of the time. The side they sleep on has a deeper fold and sometimes the eyelids are noticeably more lax.

4. Get your beauty sleep: While you should sleep on your back, it is just as important to actually get that sleep. Inadequate sleep will quickly cause changes in your skin. The peak hours of sleep are when collagen production is accelerated and cortisol and insulin production increase. This leads to better repair of damaged skin. To improve your sleep, get into a healthy schedule of getting up and retiring at the same times each day. Make your bedroom a place for sleep (banish the TV). Don’t eat or exercise just before going to bed. And make sure you have a comfortable pillow and mattress.

3. Keep hydrated: Drink ample water to maintain hydration, which will keep the skin more perky. Moisture inside and out is important. Dry skin is not a cause of wrinkles, but moisturizers have been shown to reduce the appearance of lines, temporarily, by plumping them up. Applying them to skin moistened with water is the most effective way to lock in that moisture. Just don’t get sucked in to spending a fortune on these creams, as the very expensive creams rarely are much more effective than the more affordable alternatives.

2. Consider a retinoid: Dermatologists, nearly across the board, recommend prescription retinoids (Retin-A, Tazorac) as the only anti-aging creams that really work. They have been shown to reduce fine lines and many say they give an nice glow to the skin. They do not reduce your pore size, as is claimed by some. They also will make you more susceptible to sunburn and will cause some redness in the beginning.

1. Develop daily skin habits: Just pampering your skin some of the time won’t cut it. Wash your face well nightly to remove the dirt and pollution floating around in the air. Start each morning with an application of a sunscreen product. Find time to exercise daily, which will improve circulation and tone.

Share your skin related comments with us below.

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August 16, 2011 by Dr. Matheson Harris

Welcome to the Utah Oculoplastic Surgery Blog

Just to get introduced, I’m Mat Harris. I am an oculoplastic surgeon and ophthalmologist in Salt Lake City, Utah and owner of Utah Oculoplastic Consultants. My partner, N. Branson Call, MD and I practice oculoplastic and reconstructive surgery, as well as general ophthalmology, from our office on 4400 south and 700 east (suite 130 of the Rocky Mountain Eye Center). This blog serves as a medium where we can share the latest information regarding surgery around the eyes and face as well as new methods of facial rejuvenation and aesthetics. We will also be sharing new developments in our clinic and our humanitarian work.

To start, our biggest news is the remodel we are about to undertake. Our office has served us well, but is in need of some updates. We will be making some changes this week including new paint, countertops in the reception area, new waiting room furniture, an updated decor, and new flooring. We hope the updates will make our office even more inviting. Before and after pictures will be placed shortly (as soon as “after” occurs).

Another change we are making is the use of electronic medical records. This will allow us to keep a better record of your health, send electronic prescriptions, give you a portal to review your medical records from home, and allow us to more easily communicate with the doctors that refer you.

Lastly, this blog will serve as a place where we can offer special promotions and discounts to our blog followers, including discounted pricing on facial injections and fillers. So follow along if you are interested, and share our blog with your friends.

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