What is the best treatment for fine lines under the eyes? (photo)

Dark eye circles are generally due to a few reasons. Its often a combination of these reasons that result in the dark eye circle.

It is often due to a combination of

1. melanin production under the eyes,

2. the skin in the lower eyelid is thin and therefore blood vessels are easily seen through the skin

3. the sunkeness under the eyes cast a shadow over the lower eyelid

4. the extra loose skin also have a hand in creating lines and more shadows under the eyes.

For more than 10 years, this have been a challanging area to treat. I have used lasers, threads and injectables to treat this layer with varing results. I will the best and most effective treatment from 1 onwards.

1. Fillers: The right fillers is by far the most effective treatment if the doctor has the experience in doing lower eyelids. I have extremely good success using the right fillers for the right lower eyelid and patients are usually very happy compared to other treatments.

2. fine threads seems to have some effect in helping the skin improve in its thickness. However be prepared for possible bruising and swelling compared to the above.

3. Lasers often have variable results because melanin is often not the main problem under the eyes. The sunkeness and shadow seems to play more part in most patients but if patients are prepare to do laser regularlyand their expectations can be managed, then its a possible treatment if injections is not what you want.

At the end of the day, its better to come down for a detailed consultation and for me to examin your tear trough/dark eye circle to decide what is the best course of action.

4. As for HIFU and RF, I am not very convinced. I think its can be a treatment for maintanance but for significant improve, you have to manage your expectations.

There are a number of causes that form fine lines and wrinkles. Two main causes are the loss of elasticity and collagen in the skin and the loss of underlying supportive tissue like fat, muscle, and bone.

Here are various treatments to reduce fine lines and dark eye circles:

a. Botox works by relaxing the muscles that cause wrinkles. Botox can reduce the lines between your eyes and diminish those smile lines near your eyes. Botox will take five to seven days to take effect and usually lasts three to four months.

b. Dermal filler containing hyaluronic acid is a good option to replace lost volume around the eyes. Hyaluronic acid, which is naturally found in the skin, fills the depression under the eyes and hydrates the skin, reducing the appearance of dark eye circles and fine lines. Fillers such as Juvederm and Restylane are US FDA-approved. Each treatment can typically last for about a year.

You can find more information about dermal fillers in my article here

c. Laser treatments can provide longer-term results, but you will need patience and a series of three to five treatments. As we age, collagen production slows down significantly which makes our face appears thinner and more gaunt. Lasers are able to penetrate deep into the skin to treat damaged skin and boost collagen production. One of the most effective lasers is the PicoSure laser.

PicoSure is a picosecond laser treatment approved by the US FDA, which is effective in reducing pigmentation and tightening skin. It reduces fine lines and pigmentation by delivering an ultra-short pulse of energy to the skin in picoseconds (trillionths of a second), shattering the pigment into tiny dust-like particles, which are then absorbed by the lymphatic system and eliminated naturally. PicoSure also has a unique focus lens, which is effective in tightening the skin through stimulation of collagen. It works by creating LIOB or laser-induced optical breakdown though photomechanical disruption. Skin resurfacing lasers like Fraxel Dual laser and ultrasound-based devices like Ultherapy, can also help by renewing and revitalising tired skin.

Hope the above helps!

Cheers,

Dr. Terence Tan

I understand you have a few concerns. I shall answer your concern about fine lines first. Firstly, allow me to clarify a few misconceptions you may have. Fine lines on the under-eye region are usually brought upon by:

1. UV damage caused by sun exposure

2. Loss of intrinsic collagen through aging

3. Static wrinkling of the skin as a result of repeated dynamic wrinkle formation

From the picture, you do have a significant line at the under-eye regions for both eyes. However, strictly speaking, yours are not fine lines, as they do not have their origins from the superficial part of the skin. Your lines are in fact brought upon by the natural muscle anatomy around your eyes. I have attached a photo depicting fine lines at under eye regions. Do appreciate the subtle difference in appearance from yours.

In your case, the lines are not due to your skin losing collagen, but more to do with your pre-tarsal muscle being hyperactive and strong. Over the years, the size of the muscle have grown into a sizeable mass, with a line beneath this ‘mass’, which many individuals would have wrongly describe this appearance as an ‘eyebag’. Can this line be treated? Definitely yes. This line is actually best addressed with small amounts of Botox placed at the correct depth to relax the pretarsal muscle. Doctors who attempt to do this will have to ensure good residual muscle strength, and patient may need additional fillers to improve the general under-eye appearance.

As for dark eye rings, they are best treated with combination therapies. This is because dark eye rings can be caused by a multitude of factors:

1. Volume loss of the cheeks resulting in hollowing of the under-eye regions

2. Pigmentation formation on skin surface

3. Venous congestion from chronic sinusitis, lack of sleep, stress, or other medical conditions

As you can see, these factors cannot be simply addressed by a single therapy alone. In your case, I do see the beginning of dark eye ring formation. I would recommend:

1. Dermal fillers

• for support of underlying tissues around the eyes and revolumization of cheek areas if needed
• increasing skin elasticity and hydration

if you need further rejuvenation, I would go on to:

2. Eye rejuvenation laser

• improvement of venous congestion under the skin surface
• brightening and reduction of pigment on the skin resurfacing
• mild resurfacing for texture refinement

Hope you find the above helpful.

Finally, do consult your dermatologist or aesthetic doctor to explore different treatment options available.

Take care and all the best!

Best regards,

Dr Heng Wee Soon

Dark eye circles are due to melanin and hemosiderin (from red blood cells breakdown) that are deposited at the thin skin around the eyes.

As we age we also lose skin elasticity ,collagen and volume resulting in eye bags, fine lines and tear troughs. This makes us look tired and fatiqued.

There are many treatments that may help to improve the fine lines and dark circles

1) Q switched laser toning

This can lighten the dark pigmentations around the eyes and improve the fine lines as a result of collagen remodelling

2) HIFU and Radiofrequency

These treatments can tighten the skin by stimulating collagen growth and brighten the skin

3) Fillers

Hyaluronic acid fillers can smooth out the wrinkles and sunkenness around the eyes.

You will probably need a combination of treatments like laser and fillers to improve your dark eye circles and fine lines.

Do consult your Aesthetic doctor or Dermatologist to explore he different treatment options available to you

Take Care and All the Best!

Kind Regards

Dr Lim Heng Wei

Hi,

From a static picture that you have provided alone, I would recommend a combination of 2 types of fillers +/- botulinum toxin under the eyes for the most dramatic results. No swelling and minimal chance of bruising can be achieved with experienced injectors.

That being said, it is better to examine you in person as the way your undereye looks when smiling and expressing yourself is important in determine treatment approach and outcome.

Hope this helps!

Cheers,

Dr David Deng

Hello

From my experience, you will see a visible improvement from a single treatment with a light filler just under the eyes to plump up the hollowness, improve the fine lines and disguise the dark eye circles. I perform this procedure using a blunt cannula to maximise safety and reduce complications such as bruising and pain.

Other less invasive methods will be non-ablative laser, fractional CO2 laser or radiofrequency treatments which all require repeated treatments and will improve things over time, but have a less dramatic result.

I hope you find the best solution for your problem soon!

Warmest regards

Dr Stephanie Ho, Dermatologist

Fine lines and wrinkles around the eyes can be referred to as crow’s feet and the best solution for controlling them is Botox injections every 3 to 4 months. I would not use voluma as it is too thick of a solution and will not look natural.

For under-eye wrinkles, I would recommend improving those with laser therapy or fillers such as Belotero, Restylane, or Volbella.

Sometimes, surgery is required for under the eyes. Be sure to consult with a board-certified dermatologist who will customize a treatment plan specific to you!

Dark eye circles are due to melanin and hemosiderin (from red blood cells breakdown) that are deposited at the thin skin around the eyes.

As we age we also lose skin elasticity ,collagen and volume resulting in eye bags, fine lines and tear troughs. This makes us look tired and fatiqued.

There are many treatments that may help to improve the fine lines and dark circles

1) Q switched laser toning

This can lighten the dark pigmentations around the eyes and improve the fine lines as a result of collagen remodelling

2) HIFU and Radiofrequency

These treatments can tighten the skin by stimulating collagen growth and brighten the skin

3) Fillers

Hyaluronic acid fillers can smooth out the wrinkles and sunkenness around the eyes.

You will probably need a combination of treatments like laser and fillers to improve your dark eye circles and fine lines.

Do consult your Aesthetic doctor or Dermatologist to explore he different treatment options available to you

Take Care and All the Best!

Kind Regards

Dr Lim Heng Wei