Can Derma Pen, Botox, or fix these little lines under one eye?

Im about to turn 26 in June. My skin is in really good condition as I've been vigilant about skincare since my teens (including staying out of the sun, SPF etc..) The past year however, I noticed a small patch of lines form under my left eye. I have spent quite a bit of money on under eye treatments & creams & they haven't diminished at all, but they haven't gotten worse either. Could these have been caused by sleeping on my left side? My right eye doesn't have the same lines. Thank You :)

Doctor Answers 11

Fine Lines Under the Eyes

Hi Autumn.  The lines you point out are so fine that they are difficult to treat easily.  We do not typically use Botox under the eyes, but in your cases, a very small amount may help.  The downside is the results wear off pretty quickly when using a limited number of units.

As an alternative, we perform Sciton Profractional laser resurfacing for the type of under eye lines you have an an example of that can be seen at the link below.  

Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Fine lines under the eyes

Fine lines under the eyes usually require a combination of treatments such as neuromodulators, Dermapen, fractional laser, retinol cream, and moisturizers with hyaluronic acid.  A cosmetic dermatologist can recommend appropriate treatment for you.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 20 reviews

Fine lines under the eyes

Thanks for the photo. Your lines are quite fine and you will need to be careful not to be too aggressive in your treatment of them. A small amount of botox may help along with a non ablative resurfacing with chemical or laser. Finally a retinol cream long term should prevent things form getting worse.

best of luck

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 99 reviews

Fine lines under eyes

Laser treatments, peels and a medical-grade cream may help erase those fine lines. Continue to stay out of the sun and follow a customized skincare regimen to slow their development

Multiple options for treating lines under the eyes

I agree with my colleagues. Botox, chemical peels, fractional lasers, and Dermapen are all possible options. A very small amount of Botox under the eye might do nicely. It doesn’t work for everyone, but when it does it looks great. Most likely a combination of the above treatments will give you the best possible result.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
4.9 out of 5 stars 18 reviews

Fine lines under the eyes

All the answerwes above are ight. I would only add the segmental peel as a possible treatment. Usually a Jessner or a light solution of TCA would help best. Do not attempt fillers as this would not help. Botox is a grerat treatment aas it relaxes the oribicularis muscle and helps with the lines. In that area, however it wears off fast.

Vartan Mardirossian, MD
Jupiter Facial Plastic Surgeon
4.7 out of 5 stars 31 reviews


You need to see a board certified plastic surgeon in your area to discuss your options.  An in person examination is needed.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Fine lines under the eyes

For fine lines under the eyes I usually recommend treatment with a fractional resurfacing laser. One or two treatments with a fractionated erbium laser, for example, would be a good option for someone young like you with mild lines.  Botox and good topical skin care can also be added to the regimen to enhance results. Good luck. 

Jason R. Lupton, MD
San Diego Dermatologic Surgeon
4.3 out of 5 stars 7 reviews

Treatment of fine lines on lower eyelids

It might be reasonable to try a small amount of Botox to the lower eyelid to see if it helps with the fine lines.  The effects are temporary and last about 3-4 months on average.  If it helps, it could be continued, if it does not help it could be stopped.  

Fractional laser resurfacing can be very helpful for treatment of lower eyelid wrinkles.  I prefer a fractional CO2 laser using gentle settings for the eyelids where the skin is thin.  Internal eye shields are mandatory and allow safe treatment all the way up to the lash line.  The skin around the eyes is loose and tends to swell for a few days after laser treatment.  Downtime ranges from a couple days up to a week depending on the intensity of treatment.  Fine lines and crepey skin can be dramatically improved with fractional CO2 laser.

Microneedling is a nice new treatment for skin rejuvenation but is more difficult to perform safely in close proximity to the eyes.  We use the SkinPen and usually treat the full face.  It's become a very popular treatment in my office.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Lower Eyelid Wrinkles, What Are The Treatment Options?

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.
All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.

Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.