How to Improve Crepey Skin on Face?

Regular use of Retin-A should stimulate collagen production but you need to be out of the sun and use daily sunblock.  Overall you need to stay well hydrated with both drinking water and facial moisturizer. 

Botox and Dysport work by reducing the ability to squint and minimize the wrinkles around the eyes; the products and their results are temporary but highly effective. 

Chemical peels (TCA, lactic acid) get rid of the epidermis and outer dermis with the goal of stimulating your own collagen for a more youthful appearance.  Combination therapies are frequently common to achieve the best aesthetic results.

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

The kind of  "gathering" you describe around your eyes is likely to be what we refer to as "periorbital" wrinkling or more commonly "crow's feet."  Dynamic wrinkling, i.e. wrinkling from the motion of the movement of the facial muscles of expression is a common problem, which first begins to appear in a person's thirties when sun-damage related and age-related losses in the quality and quantity of collagen and elastic fibers first begin to appear. 

Happily, dynamic wrinkling of this kind can be easily treated with injections of neuromodulators, such as Botox, Dysport and now Xeomin, which suppress slightly the motion of these muscles thereby alleviating the "gathering" and bunching that are so cosmetically troubling. I first began using Botox for this purpose in 1991, so its use for this indication is hardly new. 

Of course, sun protection and the use of topical retinoids and alpha hydroxyacids would be helpful to maintain and prolong the results you achieve with treatment.

You sound like you would be the perfect candidate for the newest treatment we offer, the Jet Peel. Jet Peel treatments are highly beneficial for skin texture improvement, wrinkle reduction, and overall skin rejuvenation. These treatments are also beneficial for minimizing acne breakouts. The Jet Peel treatment combines 100% oxygen and sterile saline to gently cleanse and hydrate the skin. The combination is delivered much like an airbrush treatment (mini pressure wash) and the effect is amazing. This gentle cleansing unclogs pores and removes dirt and makeup that can build up on the skin’s surface over time. The infusion of oxygen acts like a dose of Vitamin E to refresh the skin’s texture and appearance. 

The first and most important thing you can do is find a board-certified dermatologist or facial plastic surgeon who has a lot of expertise in treating fine lines and crepey skin around the eyes.  While you have not seen much improvement with the topical RetinA (tretinoin), I would still recommend you continue to use it as much as you can as long-term use will improve fine lines and textural issues. The fine lines you see around the eyes when you smile or squint will benefit from Botox or Dysport (neurotoxins) as they will reduce your ability to smile or squint thereby reducing those visible lines.  Sometimes you can put a little Dysport or Botox immediately under the eyes to soften the lines there as well.  An appropriate type and strength of chemical peel can be very effective for improving the fine lines, texture and crepey nature of the skin around the eyes and may be used in conjunction with the neurotoxins for optimal improvement.  Again, your physician will be able to select the appropriate treatments based on your specific concerns and the clinical presentation.