How to Prevent and Treat Crows Feet
Crow’s feet, or laugh lines around the eyes, can be a challenging area to treat from a cosmetic perspective: on the one hand, expressions of joy transmitted through the eyes are beautiful in their own right, but deeper lines and creases in this area can often draw attention to the changes associated with aging and loose skin.
My personal approach is to attempt as much as possible to prevent the lines from becoming deep or in some cases even forming to begin with. There are two main methods to achieve this: skincare to plump and stimulate collagen (such as tretinoin or Retin-A©, and Botox© (or equivalent Xeomin© or Dysport©) to reduce the muscle movement in the area and thereby reduce the creasing patterns. These options can be started at any time-even in the early 30s- before real creases have begun. In this way, a combination of treatments early can prevent the formation of obvious deeper creases. Botox can even be performed as little as twice a year when patients begin before creases have actually formed.
Once the creases are present, the above combinations of skincare and Botox can still make a significant impact and can lessen the appearance of lines in this area. Often, that is all patients are interested in so that they can still appear to have movement while improving their appearance overall. If a more drastic improvement is needed, a series of peels or even fractionated laser treatments can be undertaken. The choice of intervention depends on the comfort level of the surgeon and the amount of downtime or recovery the patient is able to give.
If a week of downtime is tolerable, facial laser resurfacing can be performed relatively aggressively to treat the area around the eyes specifically. Makeup can typically be worn to reduce the appearance of redness during the period of recovery, but a significant amount of collagen and plumpness can be gained with a single treatment. Because we usually cannot be aggressive enough with one treatment to wipe out lines in the crow’s feet region, a repeated treatment may be needed 3-6 months later. During that period of recovery, Botox can be used to give the skin a continued break from creasing as well.
Peels can be performed, often at varying depths, depending on the amount of recovery or downtime afforded if laser resurfacing is not an option. Often, a peel will have 3 days of recovery and can be repeated every month to 6 weeks for 3-4 treatments to allow improvement in this area in a slower, but less intensive treatment plan. Continuing skincare and Botox through this period will also boost results.
All in all, a multi-pronged approach is often needed to treat this area. The good news is, crow’s feet respond to treatment quite well if all options are utilized! Other treatments, such as fillers, can be used as well if indicated, but are not routine as they can be fraught with unexpected complications. With judicious use of Botox and a rigorous skincare routine early, an ounce of prevention is definitely worth a pound of cure!
