How do I address this? Under eye wrinkles (Photo)

Question

I have heavy wrinkles under my eyes which deepen dramatically when I smile. I look old and tired and I hate them! Wondering if I’d see much benefit from CO2 laser (happy for a long recovery a the rest of my face would benefit from some brown spot reductions/lip line reduction - it’s just that the eyes bother me most). Very open to a fully ablative procedure. Or would something else be better? Not at all interested in fillers and on the fence about blepharoplasty

Michael S. Mall, MD · Answer

Currently, the micro-fractionated CO2 laser Accupulse II is an excellent choice for those lines under the eyes. An experienced user of this technology can treat the skin just up to the eyelash kine. The settings for the treatment depend upon your skin type. The improvement is about 70% improvement in the lines and brown spots you may have from the sun. The treatment is done with a strong topical anesthetic, typical BLT cream is not adequate for the procedure. The entire face can be treated or just the eyes as there is no demarcation between treated and untreated ares. Recovery time is minimal with four days of just washing treated areas with an enzymatic cleanser and applying aquaphor before sunscreen and/or makeup can then  be applied. The residual pink color of the treated skin fades over 6-8 weeks. The effects take up to six months for the full effect. There are settings that can be adjusted to treat a higher percentage of skin area, but the depth is set to avoid scarring, as the depth of the laser cannot go past the bottom dermal border. There are other non-invasive laser treatments to address the lines, but the 
micro-fractionated CO2 laser is the most effective option.

Guray Yesiladali, MD, FEBOPRAS · Answer

Thank you for your question. Your clear description makes it easier to understand your priorities, and it’s great that you’re open to advanced treatments.
Fully ablative CO2 laser can be an excellent option for improving overall skin texture, reducing brown spots, and softening lip lines. When applied to the full face, it often delivers meaningful rejuvenation, especially for patients willing to go through a longer recovery.
However, the under-eye region often requires a more tailored approach. From what you’ve described, the lines under your eyes may not be caused solely by surface-level texture, but by actual excess skin. In such cases, laser energy alone may not be enough to produce the outcome you’re looking for. You can think of it like laying a cloth over a pillow. If the cloth is longer than the pillow, no matter how tightly you try to smooth it out, it will still bunch up. The most effective solution is to shorten the cloth. In facial terms, that means surgically removing the redundant skin with a lower blepharoplasty.
This doesn’t mean you have to give up on laser entirely. It can still be part of a comprehensive plan, either in combination with surgery or in a staged approach, to enhance skin quality and support longer-lasting results.
A detailed consultation will help determine which combination best suits your anatomy and goals.
Warm regards,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon

Glenn Murray, MBBS · Answer

Hi, 
The best treatment for static under eye lines would be a combination of collagen stimulating and skin resurfacing treatments. Resurfacing treatments may include a series of C02, pixel or erbium laser. Although, these have a longer downtime it will also give faster results. On the other hand, collagen stimulating treatments such as RF needling, micro-needling, salmon dna and Platelet rich plasma will improve the quality and texture of skin. This will lighten static lines and preventing them from deepening. It is imperative to also have a good skin care regime. Look at integrating medical grade skin care with active ingredients. Glowing skin takes commitment, time and investment! Consistency is key! I hope this helps. Take care.

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

Viva Eve Dermatology - New York · Answer

Hi!
This is a great question! A blepharoplasty would be the most definitive treatment for your concerns, but a comprehensive plan with Botox, RF microneedling, and CO2 laser and growth factor serums would also benefit you. It would be a more gradual result, as a series of these treatments are recommended, but still can yield great results if done properly. As for skincare, medical grade, professional products will be your go-tos, somethings that contain peptids, retinols, and AHAs for skin maintenance.

How do I address this? Under eye wrinkles (Photo)

Answers (5)

Answer: A light co2 laser can help tighten the skin under the eyes and reduce appearance of fine lines and wrinkles.

Answer: A light co2 laser can help tighten the skin under the eyes and reduce appearance of fine lines and wrinkles.

Answer: Undereye skin

Answer: Undereye skin

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How do I address this? Under eye wrinkles (Photo)

Answers (5)

Answer: A light co2 laser can help tighten the skin under the eyes and reduce appearance of fine lines and wrinkles.

Answer: A light co2 laser can help tighten the skin under the eyes and reduce appearance of fine lines and wrinkles.

Answer: Undereye skin

Answer: Undereye skin

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Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.