Which Laser Provides the Quickest Results for Removing Crows Feet?

Crows feet are causes by repeated facial expressions. Whether it's smiling or squinting, over time these wrinkles can become more permanent.

For a more long term solution a CO2 fractional ablative laser skin resurfacing treatment is a viable option for treating unwanted wrinkles. A CO2 laser emits short bursts of high-intensity light in a grid shaped pattern. The light emissions remove the skin's damaged surface layers to boost collagen growth and tighten the treated skin.

Between one and three treatments are typically needed to treat wrinkles. The thinner and more shallow the wrinkles the fewer treatments requried for noticable enhancement. Collagen stimulating topical lotions may also be used following treatment to further stimulate collagen regeneration. 

To learn more about what an actual CO2 laser skin resurfacing treatment and recovery period is like, please view the below video.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

You mention crows feet but then refer to the skin underneath the eyes. Botox injections work the best for crows feet which are the lines that extend from the outer corners of the eyes to the temples. That is because the crows feet are caused by muscular contraction of the squint muscles.  The lower eyelid skin could be improved by Botox injections but that would cause functional problems of the eyelid so thin fillers, usually not Perlane nor Juvederm Ultra Plus, can be done carefully using Juvederm ultra or Restylane but there are risks and high chances of bruising and lumpiness close to the eyelash margin.  Resurfacing lasers, even the most aggressive, can help with smoothening the skin but the creases will come back because the muscle will continue to contract. Carbon dioxide laser, non fractional which induces a second-degree like burn and the fractional ablative carbon dioxide laser help reduce wrinkles more than the Fraxel Restore laser or heat generating devices such as Thermage.

For the crow's feet - lines which extend laterally from your eye - Botox Cosmetic is a great treatment.  If you have moderate lines, then it may take a few treatments to achieve full effect, but you should be happy even with the first treatment.  For small wrinkles on the lower lids, Botox can help, but you may also consider a TCA chemical peel or Erbium Yag or fractionated CO2 laser in the office.  Otherwise, a pinch blepharoplasty may be helpful.  If you post pictures, we may be able to give you more specific advice.

Fractional CO2 laser resurfacing is the most potent way of treating this problem for those lines at rest.  This will improve the tone and texture as well as the thickenss of the skin in the area.  Botox may be necessary for those additional lines of motion that occur when smiling.  The combination of these two treatment would yield the best result but remember that fractional CO2 laser does have some downtime associated with it - typically 5-7 days depending on the settings.  If downtime is not something you can arrange then you might consider IPL (intense pulsed light) which does not disrupt the skin and therefore there is no downtime associated with it.  IPL typically requires several session - how many would have be determined at the time of consultation.

Generally it is best to treat Crow’s Feet a combined therapy of Fractional and then Botox once the skin is healed. In any case when you are ready to undergo any esthetic procedure, it is best to have a consultation with a board certified cosmetic doctor or dermatologist who you trust. They will give you the honest answers for your unique situation (your starting point, your objectives and your budget). From experience, while sometimes Botox may treat crow’s feet adequately, the synergy from both treatments together is worth the downtime as you will achieve superior results and a more even skin tone and texture. At the Victoria Park Medispa, we take off the consultation fee from any appointment booked, therefore reducing a client’s risk of having a treatment performed without taking the time to think about what they really want. Any esthetic tool needs to be in the right hands, to achieve the right results.

Botox injections may be the first thing to try to address crows feet wrinkles around the eyes, which are caused by squinting.

There are several options for the lower eyelids for you to at least consider.  There are non-ablative treatments such as Pelleve or Thermage that work by heating the skin and building new collagen to tighten the eyelids. There is no downtime with these procedures and generally 1-2 treatments are required.  A better options, but one that has downtime, is CO2 resurfacing (fractionated or traditional).  The CO2 laser is the gold-standard for skin tightening and resurfacing.  The results on the lower eyelid are excellent and last many years.  Depending upon the treatment and the laser settings, you can expect 10 days to 3 weeks for the peeling and redness to fade away. 

Crows feet are wrinkles that fan out laterally from the outside corner of the eye and are due to contraction of muscles when smiling or squinting.  Eventually dynamic wrinkles (present when the face is in motion) become static wrinkles (present when the face is completely relaxed).

If the crows feet are dynamic, that is they disappear when the face is relaxed, the best treatment is Botox to relax the muscles that cause these wrinkles.

If they are present when the face is completely relaxed, then a resurfacing procedure like MicroLaserPeel for very shallow wrinkles or fractional erbium for deeper wrinkles should improve the appearance and texture of the skin.

Fine wrinkling underneath the eye is probably due to loss of soft tissue in the eyelid or at the cheekbone or even bone mass.  For that fillers deeper in the periorbital area may be helpful.

The other place that should be looked at is the brow itself.  We lose soft tissue and bone at the brow that would also contribute to sagging of the skin around the eye.

One more consideration is that the eyelid skin is dry.  That would also give an appearance of fine wrinkling and crepiness.