Persistent "Dark Circle" After Facial Trauma

[Nateo2015]

I also posted this in the dermatology and neurology forums, but I also wanted opinions from here because my situation kind of straddles a few medical fields. I figure the widest range of feedback is the best idea.

About 2.5 months ago I was involved in a fight that broke out at a bar. During the fight, I was hit in the face with either a bottle or cocktail glass (I couldn't tell which due to poor lighting and the fact that it came from somewhere out of my peripheral vision). I walked back home with a couple of my friends and one of them drove me to the hospital. I had a vertical gash, about 1 inch long pretty much right on top of the point of my left cheekbone. The ER gave me 6 stiches which only had to stay in for 4 days and sent me home. The next day I had a black eye to go along with the gash.

It all healed fairly well and the black eye went away, but then the black eye sort of came back and has stuck around. It's not really bad, but it looks like I have a large dark circle, from lack of sleep or something, under my left eye compared to virtually no circle under my right eye. I'm only 24, so you can imagine this is kind of annoying.

I've seen a local dermatologist for an IPL (Intense Pulsed Light) treatment to reduce both the redness of the scar and the dark circle under my left eye. I plan on seeing him again and am considering a treatment called Deep FX in case I'm not satisfied with IPL. I just wanted to see some opinions on this and also if there is anything else I should be concerned about that might be causing the dark circle under my eye.

Some additional info: I also had some tooth numbness in my upper left jaw from this and a feeling of tightness around the scar on my face. I also have some ocassional twinges of pain around my left eye and that part of my head, similar to a mild headache. I have no trouble with my eye itself or with my vision though, so I'm not sure if this is anything to worry about or not. I went to my family dentist who did a full series of X Rays and he said he saw no visible damage to my teeth or surrounding bones.

The numbness significantly improved after the first IPL treatment I had which was a pleasant suprise. But the occasional "aches" are still there and the dark circle seems like it was only minimally affected. Any thoughts on this? Again, none of this is really debilitating or anything, I'm just wondering if there's any potential for serious nerve problems or other major issues in or outside of dermatology I might want to consider?

Thanks!

[John C Hagan III, MD, FACS]

I would see an eye MD to make sure there's no problem like retinal detachment.

Others here have complained of dark circules under eye after trauma. The most likely cause is blood pigments trapped in scar/fibrous tissue.

I have no experience with the type of laser RX you've going to have.

If its still a problem after 6 months many of both sexes have used a covering makeup below the eyes to cover the circles.

JCH MD

[Nateo2015]

I see, thanks Dr. Hagan!

Are there any other treatments that you're familiar with that have been used to treat the pigmentation problem? I've heard that Vitamin K in either supplement form or a cream or lotion might be helpful. What's your take on that?

[John C Hagan III, MD, FACS]

I have no experience with any supplement working, I don't see how vit K would help. No one has reported anything here that was successful

JCH MD

[JodieJ]

I got some staining from a black eye I got from a local anesthesia injection for retinal surgery.  Don't waste your money on creams or lotions containing Vitamin K--a dermatologist told me they cannot penetrate the skin deep enough to be of any benefit.  I found that time and a little flesh-tone concealer work best.

[John C Hagan III, MD, FACS]

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[Nateo2015]

Ok, thanks again to both of you for the advice. My dermatologist is pretty busy and my next appointment is almost a month away so I was trying to see if there was anything I could do in the interim.

I may try some stuff my mom has the next time I see her. If that or any of the treatments my dermatologist reccomends ends up working, I'll let both of you know!

[JodieJ]

Thanks, Nateo2015.  They sell concealers which work sort of like a crayon at most drug stores.  The trick is to dab it on lightly and then blend with your finger.  Some dermatologists and plastic surgeons sell concealers in their offices.  If there's an Ulta store nearby, they sell excellent products for covering scars/discoloration, and they could give you a demo about how to use it.