- Lines under the eyes are a natural result of aging, although external factors such as sun damage or smoking can accelerate their formation.
- Fine lines under the eyes are treatable by various means including lasers, Retin-A or chemical peels.
- Deeper lines under the eyes may benefit from treatment with a dermal filler.
Contents
Understanding the Lines Under the Eyes
Our eyes rest in an area called the periorbital hollow, where the skin is very thin and delicate. Due to this fragility, the skin under the eyes is more prone to developing lines and wrinkles than skin elsewhere on the body.
The body produces natural proteins such as collagen and elastin, which help maintain the structure and elasticity of our skin. However, collagen and elastin production eventually becomes depleted due to age and other factors.
Because under-eye skin is so thin, it can lose elasticity and structure very quickly, leading to the gradual formation of lines and wrinkles.
Age 20
From the age of 20 onward, collagen production starts to decline. The ability of the skin to slough away dead skin cells also begins to decrease. However, at this age, the presence of lines or wrinkles under the eyes is uncommon, and likely due to environmental factors or genetic predisposition.
Age 30
During the 30s, the skin starts to lose its ability to transport moisture between layers. The skin may appear thinner or duller as fat cells begin to shrink. Age-related lines or wrinkles will begin to form.
Age 40
After the age of 40, collagen production is significantly reduced and ultimately stops altogether. The skin starts to lose elasticity, and lines under the eyes are likely to be deeper and more visible.
In later years, menopause will also affect the sensitivity and elasticity of the skin in women.
Causes of Lines Under the Eyes
Natural aging process
Starting in our 20s, we produce 1% less collagen each year. This means that skin begins to progressively lose structure and elasticity over the years, resulting in lines and wrinkles which will become deeper and more pronounced over time.
This is referred to as “intrinsic aging” because it happens to everyone regardless of any other factors which may accelerate the aging process.
Facial expressions
Repetitive facial expressions such as smiling, frowning, squinting or furrowing the brow can also cause fine lines to develop around the eyes.
Furthermore, years of sleeping with the face buried in a pillow have also been found to cause wrinkles in the under eye region.
External factors
“Extrinsic aging” is the accelerated aging of the skin due to external factors:
- UV exposure is proven to age the skin, and will therefore inevitably contribute to earlier and deeper wrinkles under the eyes.
- Smoking is also a significant risk factor in skin aging. The longer you smoke, the more prone you’ll be to skin damage, including lines and wrinkles.
- Lack of sleep and inadequate hydration can also cause the skin to look dull. If prolonged, both will ultimately contribute to the aging process.
How to Get Rid of Lines Under The Eyes
There are various treatments for lines and wrinkles dedicated to under the eyes. These include neurotoxin injections, microneedling, and chemical peels, among others. Which one is best for you will depend on whether you have fine lines or deeper wrinkles under the eyes.
Best Treatments for Fine Lines
Neurotoxins
Neurotoxins, such as Botox, Dysport, and Xeomin, injected in the under eye area (targeting the pretarsal muscle) can help widen the eye and give the illusion of a smoother under-eye contour.
A very low unit volume of neurotoxin is injected by a trained professional in the area of the lower eyelid just below the eyelashes to the pretarsal muscle, superficially, to weaken its ability to keep the eye more closed when at rest.
Relaxing this muscle could impact individuals who suffer from dry eye, and should therefore be discussed completely with your healthcare provider before undergoing this treatment..
As with other neurotoxin treatments, repeat injections are needed every six months or so.
Retin-A
Retin-A is a synthetic form of Vitamin A, applied as a topical treatment to the skin.
Tretinoin, the active ingredient, is effective in treating fine lines and wrinkles under the eyes. It can also help brighten the complexion and reduce the appearance of dark circles.
Lasers
Laser treatment involves putting microscopic holes into the skin to promote the production of collagen and elastin. Laser treatment is permanent and requires minimal recovery time.
Microneedling
Microneedling, also called dermarolling, works similarly to laser treatments.
A device with thousands of tiny needles is rolled over the surface of the skin to create microscopic punctures that promote collagen production.
Chemical peels
Chemical peels use alpha hydroxy acid, such as glycolic acid or trichloroacetic acid, to peel away the top layers of the skin.
Trichloroacetic acid is the “deepest” treatment, peeling away more layers than other treatments and producing the most effective reduction of lines under the eyes. However, the recovery period is longer than using glycolic acid.
Microdermabrasion
Microdermabrasion involves spraying microcrystals onto the skin to achieve a similar peeling effect as chemical peels.
Removing layers of skin promotes collagen production, helping to produce a smoother look.
Results of microdermabrasion can last for 6–12 months.
Before and afters
Effective Treatments for Deeper Lines Under the Eyes
Fillers
If you have deeper lines under your eyes, then a dermal filler injection may be a more effective treatment. A filler substance, with ingredients such as hyaluronic acid or calcium hydroxylapatite, is injected into the under-eye area. The results of these treatments typically last about one year.
Brands used for the under eye area include Juvéderm and Restylane. Costs vary between brands and clinics, but on average you can expect to pay around $700 per syringe.
Before and afters
Controversial Treatments
The treatments listed above are proven to be effective in reducing the appearance of lines under the eyes. Other treatments are also sometimes recommended, but may not produce results.
Facial exercises
A routine of facial exercises has been found to be beneficial in reducing some visible signs of aging around the cheeks. However, there is no concrete evidence that these kinds of exercises specifically help to reduce the appearance of lines under the eyes.
At-home treatments
Online searches will yield many at-home remedies for under-eye wrinkles, ranging from egg whites to watermelon to rice flour masks. Cucumbers are also often thought to help.
However, none of these treatments are clinically proven.
Prevention
Limiting facial expressions
Try to avoid excessive frowning or squinting, for example when you’re concentrating or working at a computer screen. This will help to prevent dynamic wrinkles that result from holding the same facial expression for a prolonged period.
Hydration
Make sure you drink plenty of water to keep your skin hydrated and reduce the appearance of aging.
Water binds to the outer layer of your skin but external factors such as extreme temperatures can cause this layer to lose moisture. When this occurs, your skin may appear dry and give the impression of prematurely aged skin.
Hydration reduces the appearance of aging by replenishing the moisture in your skin’s outer protective layer, thereby mitigating dryness.
Sleep
Getting enough sleep is important, as lack of sleep can accelerate the aging process. The National Sleep Foundation recommends that adults between the ages of 18 and 64 sleep 7–9 hours every night.
Smoking
Consider quitting or at least cutting down the number of cigarettes you smoke. This will help to delay the appearance of lines and wrinkles on the face, including under the eyes.
Diet
Maintaining a healthy diet rich in vitamins A, C, and E is shown to keep skin healthy and can help to offset the extrinsic effects of skin aging.
Sun protection
UV exposure causes the skin to age more quickly. Use a day face cream that contains sun protection, or if the sun is out, wear a hat that provides shade for the eyes.
Serums and creams
A wide range of serums and creams are available to help prevent lines from developing under the eyes.
Active ingredients include retinol, a derivative of vitamin A and a milder form of Retin-A, vitamin C, as well as peptides. All are meant to help promote collagen production.
Exfoliation
The skin around the eyes is delicate and should be treated with care, but gentle exfoliation can promote the growth of new skin cells.
Takeaway
Lines under the eyes are an inevitable result of aging and external factors such as UV exposure or smoking. However, they are easily treatable by various safe and noninvasive methods.
Consider factors such as the extent of the condition, how long you want the results to last, the length of the recovery period, as well as the cost to determine the appropriate treatment.
Sources
- Nedim Sarιfakιoğlu, Ahmet Terzioğlu, Levent Ateş & Gürcan Aslan (2004) A new phenomenon: “sleep lines” on the face, Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 38:4, 244-247. doi: 10.1080/02844310410027257
- Amaro-Ortiz, A., Yan, B., & D’Orazio, J. A. (2014). Ultraviolet radiation, aging and the skin: prevention of damage by topical cAMP manipulation. Molecules (Basel, Switzerland), 19(5), 6202–6219. doi:10.3390/molecules19056202
- Flynn, T. C., Carruthers, J. A., Carruthers, J. A. and Clark, R. E. (2003), Botulinum A Toxin (BOTOX) in the Lower Eyelid: Dose‐Finding Study. Dermatologic Surgery, 29: 943-951. doi:10.1046/j.1524-4725.2003.29257.x
- Alam M, Walter AJ, Geisler A, et al. Association of Facial Exercise With the Appearance of Aging. JAMA Dermatol. 2018;154(3):365–367. doi:10.1001/jamadermatol.2017.5142
- Wendy W. Lee, Alexandra E. Levitt (2018). Periocular rejuvenation with neurotoxin and dermal filler. Plast Aesthet Res 2018;5:43. doi:10.20517/2347-9264.2018.39