Lower undereye crepe-like and thin skin - skin pinch or C02 laser? (Photos)

Question

Hello all, I’d like your input about which treatment would be the most beneficial. I’m llooking to ‘permanently’ treat my lower undereye crepe-like and thin skin. I’ve read on different forums that the C02 laser isn’t recommended for my skin tone, due to the risks and possibilities that it could cause hyperpigmentation. On the other hand, I’ve also read that a lower eyelid ‘skin pinch’ isnt all that reccomenfed either. So, I don’t really know which way to go about this, aside from my pros and cons list of them both; I’d appreciate your respective feedback on my question. Thank you so much!!

Nick Slenkovich, MD · Answer

Hi there! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center. Both CO₂ laser and lower eyelid surgery can improve crepey under-eye skin, but in most cases, I recommend trying a deep CO₂ resurfacing first before considering surgery, especially if your main concern is texture and thinness, not excess skin.
CO₂ is one of the most effective treatments we have for tightening and stimulating collagen in that area. When done by a provider experienced with skin of your tone, using the correct settings and proper pretreatment and post-care, the risk of hyperpigmentation can be significantly minimized. It’s not a one-size-fits-all laser, but it is customizable. I see great results in patients with similar concerns who were hesitant at first.
A skin-pinch procedure is typically best when there’s loose or redundant skin. With just crepiness and thinning, you may get better improvement from collagen remodeling before exploring something surgical.
I would schedule a consultation with someone who has extensive CO₂ experience on a range of skin tones, it’s all about the right settings and prep. If we can get your skin to respond well to that first, you may not even feel surgery is needed.

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