40, female. What is the best non surgical treatment for under eye lines and wrinkles? (Photo)

Question

40 yr old female with lines/ wrinkles that have appeared under eyes .More noticeable when smiling. What is the BEST non surgical treatment for this?

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful question. The under-eye area is one of the most delicate parts of the face, and it’s very common to start noticing fine lines and wrinkles there in your 30s and 40s—especially when smiling.

The “best” non-surgical treatment really depends on what’s causing the lines, as this area can be affected by a combination of skin thinning, volume loss, and muscle movement.

Here are the most effective non-surgical options:

Neuromodulators (like Botox):
If your lines are more noticeable when you smile, this suggests a dynamic component. A very small, carefully placed amount can soften these lines without affecting your natural expression.
Hyaluronic acid fillers:
If there is volume loss or a hollow appearance under the eyes, filler can help smooth the transition and reduce the appearance of lines. This must be done conservatively, as the under-eye area requires a delicate approach.
Laser or energy-based treatments:
Treatments like fractional lasers or radiofrequency can stimulate collagen and improve skin texture over time. These are helpful for fine lines caused by skin thinning.
Topical skincare:
Medical-grade retinoids, peptides, and hydrating ingredients can improve skin quality gradually. While subtle, they play an important role in maintaining results.
PRP (platelet-rich plasma):
This uses your body’s own growth factors to improve skin quality and thickness, which can help soften fine lines in a natural way.

In many cases, the most natural-looking results come from a combination approach—addressing both movement and skin quality rather than relying on just one treatment.

40, female. What is the best non surgical treatment for under eye lines and wrinkles? (Photo)

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