56 year old woman with sleep wrinkles. Any suggestions to help reduce them and/or tighten them without surgery or lasers?(photo)

I have wrinkling around my eyes, but my biggest concern are the sleep creases/wrinkles next to both eyes and slightly on my cheeks. I first noticed them in 2009. I have been using Retin-A Micro .04% every night since 2012. As I have aged the sleep wrinkles seem to be permanent. I have tried diligently to force myself to become a back sleeper! Nothing seems to work. Now I am so worried I only sleep 3 to 4 hours a night. Any suggestions to help reduce the sleep wrinkles and creases or to tighten them without surgery or lasers ( as I scar very easily)?

Doctor Answers 5

Sleep Wrinkles

Patients with sleep wrinkles should first check their pillow. I generally recommend a soft pillow compared to a hard one. If you are not experiencing any flaking you may want to consider increasing the amount of retinA you are applying. BOTOX and fillers can help. Laser, micro needling  or chemical peeling can help as well.


Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Wrinkle around the eyes

Hia and thanks for your question. You are very good candidate for combination therapy . 

I suggest combination of Botox , filler and laser see an expert physician 

Reza Akef, MD
Toronto Physician
5.0 out of 5 stars 1 review

56 Year Old Woman With Sleep Wrinkles. Any Suggestions To Help Reduce Them And/Or Tighten Them Without Surgery Or Lasers?

Thank you for your excellent question and for sharing your photographs.  Sorry that you are having some concerns about your facial appearance.  Based on your photos, I would recommend the use of Botox and possibly fillers in order to most effectively address your concerns.  Beautiful and natural results can be achieved.  Please be sure to see an expert injector for an in-person consultation to fully discuss your concerns and your goals and expectations in order to determine the best treatment plan.  Hope this helps and best wishes! 

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Softening of Sleep Wrinkles

Dear Bethj404:

Looking at your photos, I would recommend a combined approach using Botox, fillers, chemical peels and using a higher concentrate topical retinol to help soften up lines around your eyes and cheeks.  All the best.

Sleep wrinkles

Dear Beth,

In addition to the traditional approach of botox and fillers and retinoids, I would suggest to consider Infini microneedling radiofrequency treatment that produces collagen in the dermis.   This procedure can be done on the skin as long as there is bone underneath.  That means treatment close to the eyelids and cheekbones is possible.   This is not a traditional laser treatment as the heat is delivered deep into the dermis and not on the epidermis, the outermost layer of the skin.  Hence, there is practically no down time.  Typically, three sessions are needed one month apart. 

Fillers such as Restylane are typically injected deep on the bone in this area.  It would help if there is hollow under the eye but not so much with wrinkles.  Fillers like Restylane and Belotero can also be injected just beneath the skin in this area, and may help with the wrinkles. Wrinkles in this area do not respond perfectly to botox.  

Best wishes.


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.