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Child has hurt eyebrow bone during water slide. Eyelid area is swollen and having a black eye. Suggest the cure?

Dec 2013
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Practicing since : 2002
Answered : 4119 Questions
Hi- about 7 weeks ago, our 9 year old daughter hit her eyebrow bone very hard while going down a water slide (head first) and bumping another child's forehead. Her eyelid area swelled up immediately to the size of a golf ball... at the ER they checked her vision and eye movement and all that was fine. They told me she would have a very bad black eye because of how hard the hit was, but said it should clear up with time and there was no concern about any orbital nerve damage... they recommended against any CT b/c not a good idea to radiate the eye area, and even if she had a small fracture, they would just let it heal on its own. The next few days the area all around her eye turned terrible shades of black and purple.... But within 1 week it was looking much better. She continued to improve, but after about 3 weeks it seemed to stall and a residual darkening around (esp below) the eye area still persists. We have tried everything. Heat (after initial ice for first few days), arnica, Vit K eye cream, massages, etc. But I still have to apply concealer every morning b/c it is definitely noticeable and kids ask her... I think she probably did have a small fracture, as tenderness persisted on the brown bone and bone on the side of her eye for many many weeks, and just recently is that the tenderness id mostly gone. I am worried that she will always have the darker skin- I'm trying to be patient, but is there something else I should be doing for her? Do you think it still might clear up even thought it's been 7 weeks already?? Please advise...Maybe a dermatologist or plastic surgeon- or should I be more patient?
Posted Sat, 19 Oct 2013 in Skin Hair and Nails
Answered by Dr. Sanjay Kumar Kanodia 3 hours later
Brief Answer:
Do not worry dark area will clear up soon

Detailed Answer:

Welcome and thanks for posting your query to XXXXXXX

First of all I very empathetic to the little girl's injury and can understand as parent that it feels really bad if anything is troubling our children.

After reading the complete query with diligence and evaluating the complete situation, let me first and foremost reassure you that your daughter will be completely alright in terms of dark skin around and under the eye. It is not at all a permanent problem and she will be alright soon.

Let me explain it medically. After the injury to head as well as to the eye, there is seepage of blood from scalp which collects around the eyes. Along with this due to local trauma as well, there is more of collection of blood and inflammation. Because of all these events, your daughter had really bad black eye.

This remains at its peak for about a period of 1-2 weeks and then starts subsiding. Now it is due to absorption and disintegration of locally collected blood around the eyes. But as undereye skin is the dependent area of the eye so the residual blood can remain for multiple of weeks to months too giving darker appearance than the rest of the skin.

Along with above, due to local injury to the eye the melanocytes (the color producing cells of skin) also gets more activated producing more dark pigmentation at the local area which is known as "Post inflammatory hyperpigmentation". There fore both the things combinedly produces the dark area of pigmentation at the local site.

The third fact is that the skin around eyes is the thinnest in the body so also it is more prominent for multiple of weeks of time.

Now the good news is that it is totally temporary process and the condition improves with time. As it is 7 weeks only so it can take even longer to look it better. Though in general it can take16-20 weeks to get lightened but sometimes can take even longer than that too. But most important of the fact is that it is totally temporary and never a permanent issue.

If you are really worried then you can XXXXXXX a dermatologist who can guide you for the application of certain skin lightening creams which resolves the condition bit early. I personally request you to not to massage the area, no other of creams and even no heat application which can aggravate the situation and delay the resolution of the darkness.

Give your daughter a positive boost to have had overcome such big injury so that she can bravely and courageously face other children.

I hope these informations will help you. If you have further queries I will be happy to help.

"Wish you good glowing skin"

Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by
Follow-up: Child has hurt eyebrow bone during water slide. Eyelid area is swollen and having a black eye. Suggest the cure? 1 hour later
First let me thank you for your detailed and encouraging response- it really did make me feel better. I am very aware that it's not a life threatening situation, but it's hard to see our beautiful little girl wake up every morning for so many weeks with a noticeably dark circle under her eye and see the improvement be so little in the last few weeks. She is also a talented ballerina and so I want to help her get rid of this as soon as possible! :-) Sometimes it seems better and then a few days later it seems like it's a little worse again! I wonder if it's just that the seepage went deep into the thin facial skin and so it will take a long time to get to the bottom of that?? Anyways, a friend of mine had suggested to try something called manual lymphatic drainage with a massage therapist because supposedly plastic surgery patients sometimes benefit from this technique to get rid of facial bruising post-op quicker. Is there any benefit in that? She said the lymphatic system is sometimes sluggish and this can help it move quicker and flush out the dried blood. Let me know if you have any opinion about that- I definitely don't want to do anything that can cause any damage, but if it can help then I might give it a try... I was reassured to hear that you think it can take as long as 5 months or more to clear up, as most every case I've read about on the internet said black eyes should be completely cleared within a few weeks or 1 month maximum! Some people have posted complaints of darkening lasting a few months, but it seems like that's rare, no?? If she did have a small fracture, would that explain why hers has taken longer than average?? I just wonder b/c she was tender for so long (about 6 weeks) and I think she still has a little bit of swelling left, when you compare the two eyes closely. Thank you again. I really appreciate your feedback. XXXXXXX
Answered by Dr. Sanjay Kumar Kanodia 9 hours later
Brief Answer:
You can apply Kojic acid with arbutin cream

Detailed Answer:
Welcome to the forum again and thanks for your prompt reply.

I am really happy that you are now relieved a bit from the stress of the little XXXXXXX I can understand the anxiousness of so caring mother of wonderful ballerina. I very realize the importance of facial beauty in the same.

Now for the part of manual lymphatic drainage with massage therapies- these therapies are though harmless procedure but are useful in the phase of swelling rather than pigmentation or darkness. Lymphatic massage works by encouraging the colorless lymph fluid which is collected as a swelling at the area. As per your description the swelling has reduced to minimum so there might not be good use of this therapy in your daughter's problem. As it is now a pigmentation problem only so it will be best dealt by a dermatologist.

As per my suggestion you can apply mild lightening creams over the affected area. You can consult a dermatologist for the same. In my series of patient with such problem I usually prefer to give topical application of Kojic acid with arbutin cream. It is to be applied very gently and thinly over the affected area. The visible results can be seen after about 6 weeks of continuous application.

I again want to guide you that in your daughter it was the combination of black eye due to seepage of blood and due to local injury both. The black eye due to seepage of blood improved in its normal course of time within one month. But still the part of "Post inflammatory hyperpigmentation" or PIH is remaining which can take months to resolve.

So do not worry for the elegant ballerina, she will be alright soon and become as beautiful as you want!!!

I hope these informations will help you. If you have further queries I will be happy to help.

"Wish you good glowing skin"

Dr Sanjay Kumar Kanodia
MD (Dermatology)
Above answer was peer-reviewed by
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