Sudden Under Eye Creases - Are these ordinary wrinkles and how can they be treated?

Question

Until a month ago, my under eye area was smooth. Suddenly, over the course of a week, these sharp under eye creases appeared for no apparent reason, and are not going away. Are these Dennie Morgan lines (I have no known allergies) or ordinary wrinkles? Is it normal for wrinkles to appear this rapidly and severely? How will they likely progress if untreated? Is it safe to get filler this close to my eyes? Are there any topical creams/products I can use to combat this instead? Based on the appearance of these under eye wrinkles/creases and my eye area, what would you consider my age to be?

Anna Chacon, MD, FAAD · Answer

Sudden, sharp under-eye creases are not typical of ordinary age-related wrinkles, which usually develop gradually over time. The rapid onset of pronounced creases over a week suggests an acute change, which is unusual for standard periorbital rhytides.

Ordinary wrinkles (dynamic or static) generally appear slowly due to chronic sun exposure, aging, and loss of skin elasticity.
Sudden onset of under-eye creases may be related to acute dehydration, significant weight loss, abrupt changes in sleep or stress, or rarely, underlying medical or dermatologic conditions. Allergic reactions (such as Dennie-Morgan lines) are possible but less likely if you have no history of allergies.
Progression:
If untreated, these creases may persist or worsen if the underlying cause (e.g., dehydration, lifestyle factors) is not addressed. However, if the cause is reversible, some improvement may occur with supportive care.

Filler Safety:
Hyaluronic acid fillers (e.g., Restylane, Juvederm) can be used in the tear trough area, but this is an advanced technique due to the risk of complications such as swelling, Tyndall effect, or vascular compromise. Only experienced injectors should perform this procedure, and it is generally considered safe when done properly.

Topical Treatments:

Retinoids (e.g., tretinoin, Retin-A): Promote collagen production and can improve fine lines over time.
Peptides and growth factors: May support skin repair.
Moisturizers with hyaluronic acid or ceramides: Provide temporary plumping and hydration.
Antioxidant serums (e.g., vitamin C): Help with skin texture and repair.

Age Estimation:
It is not possible to accurately estimate your age based solely on the appearance of under-eye creases, especially given the sudden onset and lack of photos. Sudden changes are not typical of chronological aging.

If the creases persist or worsen, or if you develop other symptoms (e.g., swelling, redness, vision changes), further evaluation by a dermatologist or oculoplastic specialist is warranted to rule out underlying pathology.

Camille Cash, MD · Answer

Sudden appearance of lines and wrinkles is typically affiliated with something other than normal aging such as lack of sleep, stress, dehydration, or allergies.  If the lines do not improve you may want to visit a dermatologist to be evaluated.  Treatment can vary based on underlying cause.  If you are wanting to treat the area aesthetically you can consider fillers and/or laser treatments.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Sudden Under Eye Creases - Are these ordinary wrinkles and how can they be treated?

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