Repairing Fine Lines Caused by Sun Damage

I have fine lines below my eyes, where my cheeks would get sunburn summer after summer as a child. So, when I smile, I have lines. I am on Retin A (.05%) once nightly. My crow's feet are acceptable, just these fine lines from sun damage. I am early 40's with sensitive skin (cannot use Prevage, peels, or coffeebean based products due to severe reaction - pigmentation, excessive peeling,pruritis). Can I use Botox in that area or do I need to do something different?

Doctor Answers 4

Botox on lower lid not advisable

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First, everyone has lines when they smile. If the skin has some fine lines when static, I would consider a good skin care line that has Retin-A and hydroquinone, and possibly IPL or even carefully consider light peels. Botox in lower lid is not a good idea.

Botox, Obagi and IPL

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I would have to look at your skin to give you my best answer. Than being said, based on your description I would suggest the following. Start with a skin analysis to determine the extent of your UV skin damage - the Visia system that we use at Spa Aesthetica is great for this. It determines the starting point and documents your progress with each treatment.

I would then start you on a comprehensive skin care program, such as the Obagi system. Why is this important? Obagi has a Cleanser (to gently clean the built-up oils, bacterial, dead skin, free radicals, pollutants and dirt that we all pick up during each day and night), an Exfoliant (with Pytic acid for more aggressive cleaning of the skin), a Toner (to correct the skin pH and allow better penetration of medications into the skin) and a Sun Screen (with UVA and UVB protection to help stop ongoing sun damage). I would also include a RetinA product (similar to the one you are already taking).

If you have significant sun damage, you would probably be a good candidate for IPL (Intense Pulsed Light) treatments. My patients really love this treatment because it improves or reverses sun damage, small blood vessels in the skin, sun spots, and skin texture and "tone".

I think Botox is great for fine wrinkles - that is why it was the #1 selling cosmetic treatment (surgical or non-surgical) last year.

You might also be a candidate for a hyaluronic acid filler, such as Juvederm or Restylane. These products work well in the upper cheek/eyelid junction and for mid-face rejuvenation.

Might need a combination treatment

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Botox works well for wrinkles caused by muscles. Areas that respond to botox include the forehead, the area between the brows, the area around the eyes (the crows feet) specially with smiling. Some of the lines around the lips respond to botox as well. However, the small fine line that you may find in other areas that I did not mention would benefit with laser resurfacing procedures.

Pretreatment can be done with hydroquinone to help with the potential of hyperpigmenting. Also a small area can be treated to determine you skin reaction to the laser.

Hope that helps.

Botox, fillers or skin resurfacing

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Botox will help with the crow feet area and the effect might extend medially for a little bit. I would not inject Botox close to the lid border or too medial.

Resurfacing with a light laser treatment will help. I would test your skin reaction first with an application behind the ear. Good luck

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