Eye Wrinkles: Why They Appear First — and How to Treat Them

This is an English adaptation of a clinical article Dr. SangYoul Yun — board-certified dermatologist and Medical Director of Delight Dermatology in Gangnam, Seoul — originally published in Korean. Read the Korean original on Naver. It has been restructured and translated for international readers.

The eyes are the first thing people notice about your face. Once past their 30s, many people feel their eyelids suddenly droop and wrinkles set in around the eyes. Today let's look at what causes wrinkles around the eyes and how they are treated.

Of all facial wrinkles, those around the eyes appear earliest — as early as your 20s. Wrinkles generally spread in the order eyes → mouth and glabella → forehead, cheeks and chin. The eye area is especially quick to show them because it has the thinnest skin on the body. Because they fan out like a bird's foot, eye wrinkles are also called crow's feet.

What causes wrinkles around the eyes

• UV exposure — repeated UV exposure reduces dermal collagen and lowers skin elasticity.
• Loss of fat — as the subcutaneous fat volume beneath the dermis shrinks, the skin covering it sags and wrinkles form.
• Dryness — dry skin also reduces elasticity and can drive wrinkles.
• Atopic dermatitis — atopic patients develop a characteristic under-eye crease known as the Dennie-Morgan fold.
• Poor vision and squinting — habitually screwing up or squinting the eyes makes wrinkles deeper. Poor eyesight leads to frequent squinting, which worsens them.

Treatment options

Setting aside surgical treatment, here are the procedures available.

1. Botox around and under the eyes (muscle relaxation)

Wrinkles caused by the movement and contraction of the expressive muscles around the eyes — the crow's feet described above — can be corrected relatively simply. Botox relaxes the muscle and improves them. Because the effect is not permanent, treatment is usually repeated about every 6 months. Under-eye wrinkles can also be corrected to a degree with Botox; where the wrinkle is deep, we combine it with filler placed along the crease.

2. Eye Rejuran (collagen and hydration)

This injects a polynucleotide (PN) component extracted from salmon into the skin. Because it uses a thinner formulation than standard Rejuran, it can be injected around the eyes with less pain. It promotes collagen formation to add firmness and improve wrinkles, and it holds moisture for a hydrating effect.

3. Eye Thermage (collagen regeneration)

A standard Thermage tip is 2 cm square and delivers 600/900 shots, but eye Thermage uses a small 0.5 cm tip for more precise treatment of the eyelids and around the eyes. As collagen regenerates after treatment, wrinkle improvement is visible from about 3 weeks onward.

The most important thing is prevention

Because wrinkles around the eyes begin as early as your 20s, prevention matters most. Apply sunscreen frequently to avoid UV, and once wrinkles start to appear, manage them early with moisturizing and Botox so they do not progress further. If wrinkles are already established, procedures such as Botox, eye Rejuran, eye Thermage and eye Ultherapy can improve them.

Medical disclaimer. This article is general information and does not replace individual consultation. Botox, filler and similar treatments are professional procedures that can carry side effects; the cause of your eye wrinkles and the procedure that suits you should be decided after an in-person consultation with a dermatologist.