How Effective is Botox for Under Eye Wrinkles?

Hi, there. I'm a 27 year old woman who has unsightly under eye wrinkles. I take pretty good care if my skin.

However, there seems to be nothing I can do to get rid of the creases under my eyes. My makeup settles in them, they are really aging me.

Will Botox help with this and if not what will? Really appreciate any help with this. Thanks

Doctor Answers 39

Don't let anyone talk you into eyelid surgery

Dear Leanne

Botox can be used to weaken the lower eyelid orbiclularis that is responsible for making the lower eyelid wrinkles. The problem is that this same bit of muscle also helps hold the lower eyelid up against the eye. Weakening this muscle may smooth the eyelid but the price is usually mild slumping of the lower eyelid margin. This is not a good trade off. Filling the lower eyelid is a good alternative. The product to use is Restylane. An additional option is an appropriate chemical peel to firm the lower eyelid skin.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox works only 50% of the time for under eye creases

Botox or Dysport only works 50% of the time for under eye creases but when it does it is so nice. Expect it to last 3-4 months at a cost of $300 roughly. 

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

Consider CO2 laser for under-eye laxity

For crepiness under the eye, start with a good eye cream and sun protection (sunglasses).  Botox, which only acts on underlying muscles, will not help the loose skin.  I would recommend a chemical peel or CO2 laser for skin tightening.  In more severe cases, blepharoplasty may be a better option.

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Botox under eye

Thank you for your question and for sharing your photo. Botox may help to soften the wrinkles under the eyes. It does require a very small amount and it will help to soften the lines. It will not necessarily reduce all the wrinkles like you might see in the forehead or crows feet region. You will notice a soft relaxation of the dynamic lines under the eyes, and you may notice a slight opening of the eyes. I would start with 1-2 units under the eyes on each side. If you like the effects, then it is very easy to incorporate this into your future treatments. I would recommend visiting with a board certified plastic surgeon or dermatologist in your area to address your concern as it is an advanced area to treat.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews

Botox and Eyes

The simple answer is: Yes!

The key is to distinguish between wrinkles as a result of movement (smiling for instance) vs at rest. Botox and Dysport help with wrinkles as a result of movement; when used correctly they can widen the eye, relax the wrinkles and give a well-rested look. Fillers can be added to correct any hollowing of the area for a better result.

The key is to be examined by an expert and have the right doses of the right material chosen and injected correctly.

Tanya Kormeili, MD
Los Angeles Dermatologist
5.0 out of 5 stars 6 reviews

Noninvasive treatment for undereye wrinkles

Botox will help IF the lines are caused by an extrastrong muscle under the eye.  If so, injecting a tiny amount of Botox Cosmetic (or Xeomin or Dysport) midline in the lower lid and along the side crow's feet area will help. Avoid botulinum toxin in that area if you have a diagnosis of dry eye because it can aggravate that condition.

 If the skin under your eyes is 'crepey' -- wrinkly like crepe paper -- a great treatment is the Fraxel Dual with either the 1550nm or 1927nm wavelength.  The Fraxel fractionates the laser beam so it leaves skip areas between treated areas and the skin heals faster, usually in 3 - 5 days.  In between it looks like a sunburn with dry scale and swelling.  We use the fraxel to treat wrinkles, acne scars and signs of photodamage like pigmentation and texture change.  Deeper wrinkles and scars take multiple treatments, but improvement around the eyes usually happens in one treatment.

In the meantime, start using a primer under your makeup or a tinted sunscreen/moisturizer that acts like a primer and coverup like Colorscience whipped mineral sunscreen.   

I hope this answer was helpful. Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 11 reviews

A combination of Botox and skin resurfacing may do the trick

Botox can help relax these lines, but must be done conservatively to prevent sagging of the lower eyelid rim. Coupling this with light skin resurfacing (chemical peel or laser) will help soften these lines. Another adjunct that will help is daily Retin A use under the guidance of a dermatologist.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Under eye wrinkles.

Hi UKgirly!

It is possible to use a muscle relaxant such as Botox underneath the eye to soften fine lines and make the eye slightly wider (1-3mm) when smiling - for this reason it is a common treatment in some Asian countries. This treatment, however, requires very careful patient selection - treating the wrong person in this area can worsen bags under the eyes and cause eye-related symptoms, and in some people widening of the eye is not desirable. When considering this treatment be sure to consult a physician who is experienced in this area.

Alternative treatments that could be considered include chemical peels and skin tightening with laser therapy. For any treatment in this area it is important to consult a reputable surgeon/physician as this delicate area requires careful physical examination, evaluation and precise treatment.

All the best!

Dr Scott.

Scott Ellis, MBBS
Adelaide Physician
5.0 out of 5 stars 6 reviews

Under Eye Alternatives More Effective

Crows feet is a common area where Botox is injected. Lines directly beneath the lower eyelid are addressed in a different fashion because Botox injected here can decrease the tone of the lower eyelid which can result in an untoward shape of the eyelid. Better alternatives you can consider would be some of the new fillers such as Volbella or Belotero which can be injected more superficially. Other options include laser and chemical peels. The type of treatment will be based on the depth of the wrinkles, their exact location along position and tone of the lower eyelid. It is best you consult with someone experienced in treating similar problems.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 31 reviews

Under eye wrinkles botox vs. LASER

So it depends which lines you are talking about. Those dynamic lines when you smile are from the orbicularis muscle contracting which is a round sphincter type muscle. The wrinkles are then perpendicular to that contraction. This can be improved with botox. I use only a few units under the lid in patients.

The really fine lines that people get under the eyes of the lower lid are really best treated with resurfacing techniques such as chemical peels or lasers. In my hands I get better results with the laser. If you add volume with either fat or fillers this puts the cherry on top to treat this issue. The reason is this is caused by skin aging (loss of elasticity) and volume loss (bone absorption and fat loss). So to best treat we need the combination.

Hope this helps.

Best of luck.


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.