Wrinkles at the outer aspect of the eyes are often referred to as “Crow’s feet.” Fine lines or deeper lines can also be noted in the region of the upper and lower eyelids. Wrinkles are usually related to three things:
- changes in the skin which are often age and/or sun related
- loose or excess skin
- overactivity of the muscles beneath the lines.
1) Photoaging is a term used to describe both age and sun-related skin changes. Most treatments aim to remove dead and damaged skin cells and stimulate collagen for production of new skin cells resulting in a smoother, fresher and more youthful appearance. Skin care products containing vitamin A (such as Retin-A and Redermic R cream) or vitamin C (such as Active C10 cream, and 10% or 20% vitamin C serum) help to maximize dermal collagen formation. Skin refreshening can also be achieved with a light chemical peel such as the Eye Peel or a slightly deeper peel such as the Face Peel with TCA. For a deeper and more effective treatment, DOT or CO2 laser resurfacing can be done.
2) Loose or excess skin usually requires surgical treatment, but sometimes improvement in the skin texture with the Eye Peel or Face Peel with TCA or the DOT or CO2 laser can give a smoother appearance.
3) Muscle activity around the eyes results in fine and often deep wrinkles over time. Overactivity of the orbicularis oculi muscle can be softened by treatment with Botox® or Dysport®. The FDA has approved Botox® for treatment of “Crow’s feet” wrinkles around the eyes.
A sunken or depressed appearance at the lower aspect of the lower eyelids is usually a result of soft tissue deficiency from loss of fat and mid facial drooping over time. Sometimes bulging of the lower eyelid can make the area below it look more depressed. These areas of depression can be treated by placement of injectable filler to give a smoother appearance. This is considered “off-label” use.
Sparse eyelashes can be treated by Latisse® which is a prescription treatment for hypotrichosis (inadequate or not enough eyelashes). Daily application helps to grow eyelashes, making them longer, thicker and darker.