Under Eye Treatment Options for lines and crepey skin? (photos)

Question

Hi - I have a problem area under my eyes. I'm not sure how to get rid of these lines and crepey skin . I've read about options such as microneedling and the plasma pen. The plasma pen has side effects which concern me and I presume the microneedling would take a long time as I could only have one session per month. Is there anything else I can do about this?

Raffy Karamanoukian, MD, FACS · Answer

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.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. 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

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Vibha Gambhir, MD · Answer

Hello, and thank you for your inquiry! PRP/PRF under the eyes. This is a collagen building procedure. This procedure helps with fine lines, creepiness, and discoloration. PRP/PRF should be completed in a series, typically 3-4 times 4 weeks apart. There is swelling associated with this procedure to make sure to plan for some downtime. Good luck on your journey!

Camille Cash, MD · Answer

Morpheus8 treatments can improve overall skin tone and texture.  This treatment combines microneedling with RF technology for noticeable results.  We also recommend using medical grade skin care products and wearing sunscreen every day.

Darryl J. Blinski, MD · Answer

An alternative option is micro dose BOTOX with hyper diluted HA fillers ie VolBella, in a few weekly sessions. Fees per sessions range $1,000+

Robert T. Buchanan, MD (retired) · Answer

What you have is simply sin damage and aging. It is best treated with good skin care and sun protection daily ant then reversal of what you have. Good skin care consists of a good cleanser, a pH balancer (toner), an exfoliant, and a good zinc oxide sunblock. A moisturizer is not a part of this. To reverse the problem you need to be using tretinoin (Resin-A) and Obagi's ELASTIderm daily to build collagen and thicken the dermis (the skin's support layer) and stimulate elastic tissue respectively. Adding microneedling every 4-8 weeks also significantly helps build collagen. Although this is slow, it is sure and should result in significantly better skin.

Under Eye Treatment Options for lines and crepey skin? (photos)

Answers (6)

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