Help! Why do I have so many wrinkles under my eyes? (Photo)

Question

I've had these under eye wrinkles as long as I can remember. I think they could be dennie Morgan folds, because I have excema. However I'm so self conscious about them and want them gone. Any tips?

James M. Economides, MD, FACS · Answer

Fine lines under the eye sometimes will respond to small doses of botox to relax the orbicularis muscle that causes them.  They usually do not go away completely, but will soften.  If these are Dennie-Morgan folds, the effectiveness of Botox may be less as those are caused by an inflammatory process from chronic dermatitis or eczema.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. Botox can effectively treat dynamic wrinkles around the eyes that are caused by repetitive muscle movements. Laser resurfacing is another favorable option for treating this area. This can diminish fine lines and wrinkles by using a laser to remove the outer layer of the skin and reveal the new, healthy skin below. 
I recommend scheduling an in-person consultation with an experienced expert injector. They will be able to discuss your concern with you and help you decide on the best treatment option.

Ryan Rebowe, MD · Answer

These rhytids, or wrinkles, are directly over the lower lids. In order to effectively tell you definitive treatment, would need an in person exam and more pictures. However, just with these pictures I can tell you that it would be extremely difficult to treat these wrinkles with neurotoxin alone.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photo. The horizontal wrinkles under the eyes can be tricky to treat. Some options include surgically removing a pinch of skin to tighten the area. Another option is injecting a small amount of Botox and then lasering the skin with an erbium laser. See an experienced oculoplastic surgeon for comprehensive evaluation and discussion of potential treatment options.
Good luck,

Amir Mortazavi, MD · Answer

Meso-Tox is a great treatment for this area. This treatment is a bit different than your usual botox/Dysport as the potency of the treatment has be adjusted to only affect those small muscles and not to affect the deeper muscle. This treatment can be done in 10-15 minutes and last about 3 months and needs to be repeated there after.

Camille Cash, MD · Answer

From your photo you may be a candidate for a pinch blepharoplasty.  This may help improve the contour and lessen the wrinkles by removing a little skin under the eye.  A photo or exam with and without you smiling would provide further information in helping determine the best recommendation.

Help! Why do I have so many wrinkles under my eyes? (Photo)

Answers (7)

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