Chemical peel damaged my undereyes. Do I have nonsurgical options? (photo)

Question

I'm 35 and last year had a lower blephoraplasty (Nov 23). It was only fat repositioning - no skin was removed. The bags are gone but the surgeon did a 30% TCA chemical peel and my skin didn't like it. I developed a rash that took an entire year to finally heal. Now, I feel my skin is very crepe and more wrinkly than it used to be. I don't know if this is skin texture, extra skin that should have been removed or age? Can jellyroll tox or laser or anything help?

Anna Chacon, MD, FAAD · Answer

It sounds like you're experiencing some unwanted skin texture changes following your chemical peel. Fortunately, there are several non-surgical options that may help improve the appearance of your under-eye area:

Consultation with a Dermatologist: Start with a professional evaluation to understand the specific nature of the skin changes and to develop a personalized treatment plan.

Topical Treatments:

Retinoids: Prescription retinoids can help improve skin texture and stimulate collagen production, which may reduce the appearance of fine lines and crepe-like skin.
Moisturizers: Products containing hyaluronic acid or peptides can help hydrate and plump the skin, potentially improving the appearance of fine lines.
Injectables:

Botox (Jellyroll Tox): This can relax the muscles around the eyes, reducing the appearance of dynamic wrinkles and potentially improving the overall smoothness of the under-eye area.
Dermal Fillers: Hyaluronic acid fillers can add volume and smooth out hollows or wrinkles under the eyes.
Laser Treatments:

Non-ablative Lasers: These can help improve skin texture and stimulate collagen without significant downtime. Options include fractional laser treatments like Fraxel.
Radiofrequency: Treatments such as Thermage or RF microneedling can tighten the skin and improve texture by stimulating collagen production.
Microneedling: This treatment can enhance skin texture and tone by promoting collagen production and improving the appearance of fine lines.

Chemical Peels: While another peel might seem counterintuitive, a milder formulation under professional supervision might help improve skin texture once your skin has fully healed.

Sun Protection: Regular use of a broad-spectrum sunscreen is crucial to protect the delicate under-eye skin from further damage and aging.

Discuss these options with a dermatologist or a qualified cosmetic surgeon to determine the best approach based on your specific skin condition and goals.

Viva Eve Dermatology - New York · Answer

Hi!
This is a great question. I would first bring your concerns to the surgeon who performed your procedure. The lines and crepey skin appear to be when you are smiling/moving your eye muscles, which in turn, will move the skin. These are called dynamic wrinkles. A small amount of neuromodulator like Botox can help to relax these wrinkles. Another thing to consider is that the skin of the undereye is some of the thinnest on our body and most prone to wrinkling, therefore collagen stimulating treatments such as RF microneedling or a series of gentle CO2 lasers would help to address this. Botox & skin treatments over time should yield great results!
As always, an in person, in depth consultation is required for best evaluation and treatment options. 
Sincerely,Eleni SgantzosBoard-Certified Physician Assistant

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