What's the Best Eye Wrinkle Treatment?

What eye wrinkle treatment is the best for crow's feet and under-eye wrinkles?  Thanks.

Doctor Answers 9

Treating eye wrinkles

Dear Vivy

It is very important for you to understand that there is no single best treatment for your crows feet and lower eyelid lines. Or for anyone's crows feet and lower eyelid lines for that matter. It is critical to understand that our needs and what is needed to address these concerns also change over time. What was unnecessary or over aggressive at one point in time might be essential at another time. How you feel about treatment approaches and what types of things you can afford, have recovery time for, and are comfortable with are also very important. So the simple answer is that the safest, most affordable approach tailored for your needs and concerns is the best approach. This will vary with the surgeon you are seeing as there is a unique chemistry between each and every patient and their doctors that influences what solutions make sense and work for you. I am not looking to get Zen here, I just want to emphasize that "Best" is a very fluid concept.

WIthin this clinical frame work, there are a range of options. It is critical for you and your surgeon to think long term about your needs. It is not enough to have a fix that works for the next 6 months. It is also important to think about the next 30 years. Treatments that use up facial resources (fancy doctor speak for damage) should always be avoided in favor of treatments that are less invasive.

For relatively mild changes, treatments like BOTOX and under eye Restylane are powerful treatments that provide results that rival or are better than surgical results. They do not last forever. BOTOX lasts 4 to 6 months and Restylane treatment lasts about a year. However, they do not require surgery or down-time and if there is ever an issue with a treatment, the effects are going to wear off or in the case of Restylane, can be dissolved with hyaluronidase. Yes over time the costs of these treatments can be more than the cost of surgery. However, because there is essentially no risk of damaging the face, there is tremendous value in these services (Don't you think that Daryl Hannah wishes her services could wear off?).

The next step in my arsenal very much depends on the individual situation. It might be a phenol chemical peel for the right situation. This might be combined with an arcus marginalis release to address fullness in the lower eyelid. The point is that the treatment approach must be individualized. I would caution you to avoid the early adopter trap: you see a brand new treatment on a talk show and the next day you are scheduling a consultation with someone offering that service. It is a good bet that how that service will be viewed will be very different with a little time. That is true of virtually all the technologies that have been introduced to aesthetic medicine. Let other be cut on the leading edge.

Do your home work regarding your surgeon. Yes credentials are important but understand what those credentials mean. For the services you are interested, you would do well with any of the core specialties: derm, plastic surgery, facial plastics, and oculoplastics. The key is don't let yourself get pushed into a service that you are not comfortable with. Try the work of the surgeon by seeing how things go with minimally invasive services like BOTOX and Restylane. Believe me, if the doctor is not good at these treatments he or she will also not be great for the surgeries either.

Please share your experiences with the RealSelf community once you have decided on treatment.

Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 22 reviews

Best eye wrinkle treatment

In general, I recommend botox in combination with a resurfacing procedure (chemical or laser) for wrinkles around the eyes. Some individuals, however, are poor candidates for botox to the crows feet - especially people with very loose skin and soft tissue and bulging fat of the lower eyelid. As far as creams are concerned, those containing retinoids (e.g. renova), potent antioxidants (e.g. Revale or Prevage), glycolic acid (Vivite) and a mixture of growth factors and antioxidants (SkinMedica TNS Recovery Complex) are some of the better products for wrinkles, discoloration and sun-damaged skin around the eyes.

There are of course many considerations - for example, not everyone can tolerate the down-time associated with a re-surfacing procedure and some may find some of the anti-wrinkle creams too irritating.

I would consult with your aesthetic physician to determine which option or combination of options would be best for you.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

The best eye wrinkle cream does not exist

There is no cream that is 100% effective at removing eyelid wrinkles. There are various plumping agents from skin ceuticals, obagi and md forte that help but they do not completely eliminate the problem

Laser treatment is perhaps the best long term solution and botox is also effective temporary treatment.

Other options include skin care moisturizers. However, a little trick that I have seen that works well is to wet your lower eyelids at night and then while it is still wet coat them with vaseline and when you wake up at least temporarily the wrinkles will be gone.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Only one cream and one laser really work for eyelid wrinkles

Of all the creams available for wrinkles, especially eyelid wrinkles, only one has a substantial amount of real scientific data to support the claims of wrinkle reduction. That cream is tretinoin (available as both a generic prescription cream and brand name prescription cream - Retin A, Renova, etc). This medication has been proven to be effective for reducing wrinkles in multiple rigorous studies published in peer reviewed medical journals. No other cream has as much data to support claims of wrinkle reduction. It is the only cream I recommend.

So the question I always get is: If Retin A is really so effective, why don't more people use it? The short answer is that some people are discouraged by the initial irritation that the cream produces. Almost anyone's skin can be trained to accept the cream without irritation, but this takes some patience. Unfortunately, people tend to give up on the cream before they see real results.

As for procedures to treat eyelid wrinkles - nothing beats the carbon dioxide laser - the machine I currently use is my favorite - the Active Fx fractional laser. I have been incredibly impressed by the results of this laser in tightening the skin, particularly in the eyelid region, as well as diminishing wrinkles and fine lines. This is my main tool for dealing with eyelid wrinkles as well as for overall skin resurfacing. I tested almost every other laser on the market, and none could deliver the results attainable with the Active Fx.

Ilya Reyter, MD
Beverly Hills Dermatologist
5.0 out of 5 stars 2 reviews

Best eye wrinkle treatment is tailored made for you

The best wrinkle treatment will depend on what is causing the "wrinkle". If you analyze the problem, it will be much clearer what the best solution is for you.

Eye wrinkles can be caused by various factors, or a combination of factors. The two most common causes are skin laxity and muscle contraction.

Skin laxity is loosening of the skin and stretching or breakdown of collagen and elastin, typically from sun exposure, smoking, or eyelid rubbing (which is common if you have environmental allergies). Skin laxity can be addressed with a range of treatments from over the counter creams (containing retinol or glycolic acids) which can offer some benefit to chemical peels or laser skin resurfacing to surgery (if there is a lot of excess skin to remove).

Over the counter creams don't offer dramatic results typically but they are relatively inexpensive and easy to do yourself at home. Chemical peels, laser resurfacing, and surgery can dramatically reduce wrinkles but they are more costly, not without risk and do require recovery time.

If, on the other hand, your eye wrinkles are caused from your skin bunching up when your muscles contract (smiling), then Botox injections to relax those muscles may be a better option. There is no downtime, but the treatment must be repeated every 3-4 months to maintain the effect.

You may need a combination of skin treatments or surgery plus Botox. So, to answer your questions, the best eye wrinkle treatment is the one that's tailored to address the cause of the problem and that meets your needs in terms of cost, risk and recovery time.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 39 reviews

Lower Eyelid Bags, Fine Lines, and Wrinkles: Instantly Ageless Cream

The lower eyelid/cheek junction is one of the first places to show gravitational aging in the face.  Weakened support in the lower eyelid causes eyelid fat to protrude outward causing the bag, sharp transitions in the lower lid cheek junction accentuate this aging effect, and skin damage and dynamic wrinkling of the skin cause fine lines and wrinkles around the eyes.
These problems are very difficult to address non surgically but there are some options.  Botox can help with the dynamic wrinkling caused by muscles of facial expression:  crow's feet.  Carefully placed appropriate fillers can smooth the lower lid/cheek transition.  Laser treatments such as the Fraxel Re:Store can improve the skin, diminish wrinkles, and tighten the skin.  
One popular product I use in my practice is Instantly Ageless eye cream which acts somewhat differently than most products.  This cream is applied and dries to tighten the skin and eliminate fine lines and wrinkles.  After application, the skin feels tight and the results are immediate.  The product is applied in the morning or before the desired effect and will last until it is removed.  Web reference included below

John Burns, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 28 reviews

There are many solutions for wrinkles around the eye area

Once wrinkles have developed, there aren’t any over-the-counter solutions that will make a difference, and only a few prescription-grade creams will help plump skin enough to minimize fine lines. I have found that a great approach for signs of aging around the eyes is BOTOX® Cosmetic, which temporarily relaxes the muscles that are responsible for causing those wrinkles in the first place. Resurfacing treatments with lasers or microdermabrasion can also make an improvement. To slow down the progression of wrinkles, be sure to use a high-quality moisturizer for this delicate are, and never skip the sunscreen.

Botox and laser for eyelid wrinkles

Botox works very well for dynamic lines or lines around the eyes which occur with expression.  Laser resurfacing works well for static lines, especially the fractional Co2.

Prevent eye wrinkles with sunscreen

Whereas I do generally agree with my colleagues' answers, I am quite surprised that sun screen is rarely mentioned. If ever there is a "magic pill" in our arsenal against aging, it has to be avoiding sun damage. Use sunscreen every day, especially on our most delicate skin areas that are exposed to daily sun. Of course, good sunglasses are also essential.

Now, if the damage is done, there are of course an arsenal of solutions. It is, as I am sure you have read, an individual approach. Every patient is different and has different needs. In my practice, they include Botox, Erbium Laser resurfacing, Microdermabrasion, Retinol, light acid peels, and Blepharoplasty.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 58 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.