The appearance of crepey skin under the eyes can be one of the most distressing features of aging. It happens as we age and our skin loses collagen and elasticity. As a result, our skin develops fine wrinkles. Fortunately, there are treatments that can help.
The least invasive treatments available are creams. A good skincare routine is critical. Many eye creams contain peptides and antioxidants to improve the firmness of the delicate skin of the eye area. It is critical that your eye cream also contain retinol or that you use prescription Retin-A if you can tolerate it, even if you only use it a few nights per week. Even more important is to protect your skin from the sun by using a high quality sunscreen, wearing sunglasses, and avoiding unnecessary exposure.
As far as procedures go, there are several to consider. The first are chemical peels. Phenol peels can provide nice improvement. However, not everyone is a candidate for phenol. Phenol can lighten the skin, so only patients with light skin to begin with are good candidates. Other peels, like trichloracetic acid (TCA), can be used, but they do not give nearly as much improvement.
Another procedure that can help is fractional resurfacing. Fractional resurfacing uses a laser to blast away small dots in the skin. It is a controlled injury, and the skin tightens during the healing process.
A minimally invasive option that works is the combination of Botox and fillers. I have found that a few drops of Botox in the lower eyelid area can help reduce wrinkling. I have also used Belotero to fill very superficial, shallow wrinkles.
Lastly, one may consider eyelid surgery. Using surgery, a portion of the crepey skin is removed and the rest of the skin is pulled tighter.