What is the Best Treatment for Under Eye Wrinkles?

I am 23 years old and I have had a single deep wrinkle under each eye for a long time, but recently they have become very severe, and smaller ones have begun appearing around them. I do the correct skin care procedures, using a cleanser only every other wash, followed by eye cream, moisturizer spf15, and now a Garnier product for deep winkles. How did this happen and how can I fix it? Once corrected how do I prevent it from happening again? The pic included doesn't quite show the severity of the problem, but I thought it might help.

Doctor Answers 4

Best Approach to Lower Eyelid Wrinkles

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Lower eyelid wrinkles are common and occur even at young ages. Treatment should be taylored to the cause. If the wrinkles occur because of laxity of the skin, then Pelleve treatments could be considered to increase collagen. Chemical peels (medium) can help as well with the wrinkling of skin as an option to Pelleve. However, there is little or no recovery time needed for Pelleve, and chemical peels cause redness and peeling of the skin for nearly a week.

Laser treatments for skin tightening can be considered as well. Eye protection, although very important, is difficult for some wrinkles because of the proximity to the eye.

If the lid is sunken in, then a filler such as Juvaderm or Fat grafting could be considered. Fat grafting has the potential for a longer lasting result, but does require removal of fat from a donor site.

Burley Facial Plastic Surgeon

Lower Eyelid Blepharoplasty: Dynamic vs. Static Wrinkles

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Lower eyelid wrinkles can occur because of a variety of causes, including:

  • Loss of skin resiliency
  • Loss of volume
  • Reduction in collagen content

In the case of mild lower eyelid wrinkles that are present at rest, the mainstay of treatment is to improve the quality and resiliency of the skin. This can be done with chemical peels, lasers, or topical agents. If the lower eyelids have dynamic wrinkles that are increased with animation, a treatment with Botox may provide termporary benefit.

Lastly, patients with moderate wrinkles, skin redundancy, and orbital fat herniation may be candidates for a blepharoplasty or eyelid tuck procedure.

Under eye wrinkles at a young age

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Wrinkles under the eyes at a young age are primarily genetic. A good skin care regimen is helpful. I typically recommend a medical-grade cleanser, toner, exfoliant, moisturizer, and sunscreen. Depending on the actual anatomy in the area, neuromodulators like Botox/Dysport/Xeomin can be helpful. Lower eyelid surgery (blepharoplasty) may also be helpful depending on any excess skin, fat bulge, or excess muscle folds. Finally, resurfacing procedures like peels or lasers can also be very helpful. 

A consultation with a board-certified physician specializing in facial aesthetics is always recommended in order to obtain an individualized treatment plan. 

It depends on the cause of the wrinkles

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If the area under the eyes is sunken in then a filler such as juvederm or fat helps temporarily (4-6 months) to plump it up. If the creases are worsened when you smile then botox ($300) helps for about 3-4 months. If the creases are noticeable all the time then a more superficial filler such as collagen or juvederm is helpful ($550/syringe).

Sometimes it is better to just chemically peel ($350/session for 3 session) with TCA or maybe laser ($750-1000/session) the areas to give a 1-3 yr improvement. Then you can touch up the areas with fillers afterwards if any lines remain.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 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.