The skin around the eye area is very delicate and much thinner than in other areas of the face especially under the eyes. As we age the skin becomes even thinner and supporting structures around our eyes change and this Periorbital (around the eye) area is a very common concern for many patients. Topical products are useful around the eye but care must be taken that they are not inadvertently applied to the eye itself. Laser based treatments similarly must be used with great caution near the eye to avoid any potential damage to the eye and also realising the skin is more sensitive and reactive can swell and react more after any heat based treatments.
The commonest conditions that we treat in the Eye area are
The lines on the outer eye are called Crows feet. These can appear at a younger age if people spend a lot of time outside in the sun and are often more severe on the side that people sleep on. Fortunately these respond very nicely to wrinkle injections. The range of dose required varies from 6-15 units of Product B on each side. As a guide expect around 10 units per side which will cost around $300 to give a result that will last 4 months.
The lines on the inner eye on the side of the nose are called Bunny or Wolf lines and these can be softened by the use of wrinkle injections. Typically requires about 6 units in total of Product B.
Fine lines under the eyes are more difficult to treat. Very low dose Product B can help in certain people. Topical treatments such as ELASTIDERM can be beneficial. Skin needling and PRP treatments are also worth considering.
The effects of ageing that result in increasing skin elasticity and loss of muscle tone combined with gravity results in the progressive drop in the height of the eyebrows. In certain skin types there can be genetic factors that result in these changes occurring at a much younger age. The resultant Brow Droop makes the eyes appear smaller and can give a tired and older appearance. When Brow Droop becomes more severe the resultant hooding of the eyelids can start to compromise vision and require surgery (called a Blepharoplasty)
The simplest non surgical option to try and reverse Brow Droop is through the use of Cosmetic Injections with both anti wrinkle injections and Dermal fillers having a place. Wrinkle injections can target the muscles that pull the brow down (called depressors) which then allows the opposing muscles that lift the brow (called elevators) to work more effectively. Often the Frown lines are also treated to give a more balanced effect. Dermal fillers can be injected just under the outer brow to lift the skin in this area.
By understanding the anatomy of the eyebrow it is possible to make subtle changes to the shape of the eyebrow by using low dose anti wrinkle injections. Commonly opening up the outermost part of the brow (Flared Brow) is requested. Lifting the central part of the brow is less commonly requested (Arched Brow).
Many people complain about Dark circles under the eyes. The difficulty is that many different factors can cause Dark Circles and that several factors may coexist in the one patient. The appropriate treatment for dark circles under the eyes will of course depend on the cause. As there may be several factors involved a combination approach may be necessary.
Avoidance of aggravating lifestyle factors is also important. Fatigue and tiredness are recognised aggravating factors as well as smoking, high caffeine intake, sun exposure, pregnancy and menstruation. Allergies and nasal congestion can cause the veins that drain from your eyes into your nose to dilate and darken. Advice on appropriate skin care in the under eye area is also very important.
Some patients develop dark circles at an early age and there can be a family history with genetic factors being important.
Treatment options for dark circles include:
- Topical creams which can help with skin hydration, reducing irritation and cosmeceuticals can help target pigmentation.
- Prescription skin creams containing Hydroquinone (a bleaching agent) can lessen hyperpigmentation, when this is the factor in causing dark circles under the eyes.
- Dermal Fillers into the “tear troughs” will make the circles less obvious when they are caused by loss of volume which has generated a shadow effect.
- Skin Needling can help with fine lines and facilitate the effectiveness of topical products
- Lasers can target superficial blood vessels and pigmentation
- Cover makeup in some circumstances may be the best option
For more Information on Dark Circles go to this page.
Prominent Blue Veins can occur around the eye. These are termed Periorbital Veins. Whilst blue veins in the legs are typically treated by injecting a sclerosant solution this is regarded as potentially too dangerous close to the eyes. The Periorbital veins drain to an area behind the eye and there is a potential risk of damage to vision so we strongly advise avoiding injecting these Periorbital veins.
The blue veins can however be treated by Laser treatment. The laser of choice is the long pulse YAG laser. Special shields may be needed over the eyes for this treatment but results can be very satisfying. As a guide we avoid treating any blue veins under the eyes by Laser unless we are treating over the cheekbone.