With age, eye area skin tends do develop a number of characteristic problems we discuss below.
Crow's feet
Crow's feet are wrinkles near the outer corner of the eye caused mainly by frequent skin movement in that area (due to squinting, laughing, etc.). Sun damage and skin dryness also contribute. For mild crow's feet, avoidance of squinting and the topical treatments discussed above may suffice. Deep crow's feet may respond to Botox injections. Also, fractional skin resurfacing seems to be showing promise in treating moderate crows feet by inducing reparative collagen synthesis.
Dark circles
The most common cause of dark circles under the eyes is the proliferation of blood vessels combined with thinning of the fat layer. There is some evidence, more anecdotal than clinical, that topical vitamin K may produce a modest improvement in dark circles. Common vitamin K creams contain 2-5% of vitamin K (e.g. a popular cream Dermal K contains 5%). However, despite promotional hype, vitamin K rarely brings about a quick and complete disappearance of dark circles.
Theoretically, agents that strengthen veins and capillaries might reduce dark circles of vascular origin. A number of standardized plant extracts (such as grape seed, butcher's broom and horse chestnut extracts) have been shown to improve venous insufficiency by strengthening venous walls. Unfortunately, the effectiveness of these agents for dark circles has not been studied.
Sometimes dark circles are simply result of fatigue and lack of sleep. Try to get plenty of rest and see if it helps.
In rare cases, dark circles are due to irregular skin pigmentation. This can be treated with bleaching agents such as hydroquinone or kojic acid. However, vascular dark circles are often mistaken for those caused by excess pigmentation. Bleaching agents are potential irritants and should only be used if there is a clear indication. Do not bleach your skin unless your dermatologist approves it and determines what bleaching agent is optimal for your skin type.
Bags
Under eye bags are caused by puffiness, loss of skin tone and general skin aging. All of the above steps, particularly those to firm the skin and reduce puffiness can help prevent bags under eyes or even partly reverse the existing ones.
Unfortunately, pronounced under eye bags cannot be completely eliminated by topical treatments and lifestyle changes. A surgical option (blepharoplasty) is usually effective. However, it is expensive and, like any surgery, carries a risk of scarring, infection and other complications.
A relatively new procedure for lifting sagging skin called ThermaCool (a.k.a. Thermage) is rapidly gaining popularity. ThermaCool is based on heating of deep skin layers with a burst of radiofrequency waves. This controlled thermal injury triggers a healing response, which eventually results in skin tightening. ThermaCool does not require skin incisions like surgery or causes extensive skin burns like ablative laser. It may be a viewed as an intermediate choice for moderate eye bags. The price ranges between $500 and $2,000 depending on the area treated. Even though the science behind radiofrequency treatment is theoretically sound, not enough data is available to clearly determine the degree of its effectiveness, reliability and risk. In fact, a significant number of people report side effects, especially when treated by inexperienced providers and/or early versions of the technique and/or equipment. It may be wise to wait till radiofrequency technology matures and reliable, large-scale statistics is available on both benefits and side effects. However, for those reluctant to wait, it is paramount to find a board certified provider who has performed hundreds of ThermaCool (Thermage) procedures. See also our article on radiofrequency treatment as well as user reviews of ThermaCool (Thermage).
