33 y/o very crepey under eyes, what do I do? (Photo)

Question

I've gotten recommendations for lower bleph, lasers, intense peels. What would help most? Worried it might be too early for surgery? If lasers, what specific laser would you recommend? Should I go to a derm or oculoplastic surgeon? So much information out there but it’s hard to know what is best

Carey Nease, MD · Answer

Since you are young I would not recommend surgery yet. The best treatment would be a CO2 laser resurfacing. The down time is about 7-10 days and results are very good. Other choices include deep chemical peels (TCA) and plasma pen treatments. But the CO2 laser is the best!

Anil R. Shah, MD · Answer

Hello. My name is Ranen and I am an Aesthetic Nurse at Aesthetic Skin.  Looking at your photo I would recommend doing some resurfacing laser to treat the loss of elasticity.  I would recommend doing cool peel Co2 for your undereyes and you will notice a great difference with more of a tightening effect.  If you have any additional questions please feel free to contact me at 312-944-0117

Anna Chacon, MD, FAAD · Answer

Addressing crepey skin under the eyes is a common concern, and there are several treatment options available depending on your specific needs and goals. Here are some considerations:

Non-Surgical Options:
Lasers: Fractional laser treatments, such as Fraxel or CO2 lasers, can help improve skin texture and stimulate collagen production. These are effective for reducing crepiness and fine lines.
Chemical Peels: Mild to moderate chemical peels can help rejuvenate the skin by promoting cell turnover. However, the under-eye area is sensitive, so it's important to use peels specifically designed for this area.
Microneedling: This can be combined with platelet-rich plasma (PRP) to enhance skin rejuvenation and improve the appearance of crepey skin.

Surgical Options:
Lower Blepharoplasty: While you may be concerned about the timing, lower blepharoplasty can provide a more permanent solution by removing excess skin and tightening the under-eye area. Consulting with a specialist can help determine if this is appropriate for you at this stage.

Choosing a Specialist:
Dermatologist vs. Oculoplastic Surgeon: Dermatologists are skilled in non-surgical treatments like lasers and peels, while oculoplastic surgeons specialize in surgical procedures around the eyes. Depending on your preference for surgical or non-surgical interventions, you may want to consult both to explore your options.

Consultation:
A consultation with a board-certified dermatologist or oculoplastic surgeon can help you determine the best treatment plan tailored to your needs. They can provide insights based on your skin type, age, and the severity of the crepiness.

Ultimately, the best approach depends on your comfort level with different treatments and your desired outcomes. A professional evaluation will guide you in making an informed decision.

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

Donald B. Yoo, MD, FACS · Answer

For under-eye concerns, there are several advanced treatments that may provide more effective results alternatively to surgery.  Based on your photos, injectable skin boosters like Rejuran or Juvelook may be worth considering. Rejuran, made from polydeoxyribonucleotide (PDRN), helps improve the under-eye area by reducing dark circles caused by sagging, enhancing skin elasticity, and increasing moisture retention. Juvelook, which contains poly-L-lactic acid (PLLA), stimulates natural collagen production for long-lasting effects, improving skin texture, elasticity, and brightness while minimizing wrinkles and skin fold thickness. This makes it an excellent option for addressing both hollowness and fine lines under the eyes. Each treatment offers distinct benefits, so the best choice depends on your skin type and goals. Consulting with an experienced provider is recommended to create a personalized treatment plan tailored to your needs.

Danielle Shanley, MD · Answer

There are many approaches when it comes to treating the undereye. Neogen Plasma would be a great option. This is a regeneration treatment used for skin tightening, resurfacing and rejuvenating. It works by converting a nitrogen gas into plasma energy to penetrate different levels of the dermis. Only one treatment is required. Best results are seen in a few short months after your treatment as it will take time for your skin to both heal and produce more collagen and elastin. This is a great option if you are looking for something with little downtime and avoiding surgery.

33 y/o very crepey under eyes, what do I do? (Photo)

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