50 years old - What would help my wrinkly under eye area? (Photos)

Question

Hi..50 year old female been doing tox, biostimulatores and laaer for years now..but in the past year my unfer eyea are so wrinkly when i smile (yes i expect some for natural movement) but this is aging me...what would help this area?

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic Skin in Chicago.  Co2 coolpeel would be a great treatment to help with your fine lines and wrinkles under your eyes.  It may take a few treatments.

Erik Peterson, MD · Answer

if your under‑eye area looks very wrinkly and crepey when you smile even after years of treatments, the reason is usually skin laxity and loss of collagen/elasticity, not volume. For that, a strong resurfacing/tightening treatment is often more effective than fillers or light lasers.
A fractional CO₂ resurfacing laser (like DeepFX/ActiveFX) is one of the most powerful options for rebuilding collagen and tightening deeper wrinkles and crepey skin around the eyes because it removes aged surface cells and stimulates deep renewal. It’s often considered a “gold‑standard” for this concern when done properly, but it also has downtime and needs to be performed by someone experienced around the eye’s delicate skin.
Other resurfacing lasers or hybrid options (like CO₂ + fractional non‑ablative dual wavelengths) can also tighten and smooth while moderating downtime.
You can also support results with prescription‑strength retinoids, which help thicken and strengthen under‑eye skin over months and are a good long‑term foundation.
A skilled dermatologist or oculoplastic surgeon can assess whether deeper lasers are right for you, or if a combination approach (energy‑based device + retinoid) will get the best result for your under‑eye wrinkles.

Nelson Lee Novick, MD · Answer

For crinkly under-eye skin, you may wish to consider a consultation with a board certified cosmetic dermatologist regarding an in-office treatment series of superficial peels, such as with high concentrations of glycolic or salicylic acid, Jessner's Solution, or low concentrations of TCA to be coupled with the at-home regular use of a topical alpha hydroxyacid cream and an appropriate retinoid. Best of luck and Happy New Year.

Vikram Mookerjee, MD · Answer

Wrinkles ("rhytids") under the eyes can be caused by a number of factors including crepey and loose skin, uneven skin texture, volume loss, and the action of the surrounding musculature.
When determining the cause of the rhytids, it can be helpful to distinguish between "static" and "dynamic" rhytids. If the rhytids are purely dynamic and present only when animating the face, they are mostly due to muscle activation and be softened with neuromodulators such as Botox.
Over time, rhytids that were once only present during animation become deeper and remain permanently visible, even when the face is still. These static rhytids can be addressed with skin resurfacing such as laser or chemical peels, volume replacement of the midface with fat grafting, and possible removal of excess crepey skin as might be performed in a lower eyelid "pinch" blepharoplasty. These treatments can also commonly be combined.
Without an in-person evaluation, it is difficult to determine which treatments would help you most. However, if you have noticed that lasers, biostimulators, and neuromodulators are no longer effective, it may be time to consider other treatments such as lower eyelid blepharoplasty with or without fat grafting. An in-person consultation with your local plastic surgeon will be helpful for a more detailed evaluation and specific recommendations. Best of luck!

50 years old - What would help my wrinkly under eye area? (Photos)

Answers (5)

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