Age-Proof Your Eyes

Concerned about dark circles, puffiness, sunken sockets or fine lines? We’ve got nonsurgical solutions to the most common, most complained-about eye problems

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Eye Problem #1: Dark Circles

Cause: “Over the years, you lose collagen and elastin in the under-eye area, which thins the skin, allowing blood vessels to show through and create a blue cast,” explains Elizabeth K. Hale, MD, associate professor of dermatology at NYU Langone MedicalCenter. Other contributors: excess pigment, which people with darker skin (often of Middle Eastern, Arabic, Indian, Latin or African descent) are at greater risk for developing, and allergies, which can congest blood vessels around the eyes and give skin a bluish tint. Exacerbating the allergy situation, says Hale, is the fact that congestion makes you want to rub your eyes, creating a state of chronic inflammation and pigment buildup.

At-Home Strategies for Dark Circles

For dark circles caused by thinning skin, “retinoids, either over the counter or prescription, can build collagen and thicken skin,” says Los Angeles–based dermatologist Jessica Wu. Start by taking a teardrop-size amount of a product such as Glow by Dr. Brandt Revitalizing Retinol Eye Cream ($55; and apply every other day to avoid irritation.


Eye creams that contain hyaluronic acid (the gel-like liquid that keeps skin firm) can also plump under-eye skin and make it seem less translucent, while creams that contain caffeine constrict blood vessels, says Hale. You can get both hyaluronic acid and caffeine in Hydroxatone Hydrolyze Intensive Under Eye Treatment ($80;


If you have hyperpigmentation, your best bets are lightening products that contain kojic acid, mushroom extract or hydroquinone, says dermatologist Elizabeth Tanzi, codirector of the Washington Institute of Dermatologic Laser Surgery in Washington, D.C. One with kojic acid: Peter Thomas Roth Power K Eye Rescue ($100;


For allergy-related circles, an over-the-counter antihistamine is an obvious antidote, or “for use directly in the eye, an over-the-counter ocular decongestant may reduce symptoms but is not recommended for long-term use,” says Cristina Schnider, OD, senior director of professional communications at Vistakon, a division of Johnson & Johnson Vision Care Inc. One to try: Visine A Eye Allergy Relief ($7;


In-Office and Rx Solutions for Dark Circles

Careful placement of a hyaluronic acid filler like Restylane, Juvéderm or Belotero can plump the skin under the eye and make the blood vessels there less apparent. “This layer of filler camouflages dark areas, kind of like wearing a slip underneath a white skirt,” says Wu. Excess pigmentation can be lightened with low-energy lasers, light treatments or in-office chemical peels. And for allergy-related irritation, Hale suggests talking to your doctor about a mild hydrocortisone cream or an Rx cream like Elidel or Protopic. Just take care applying these products close to the eye, Schnider warns.


Eye Problem #2: Under-Eye Bags/Puffiness

Cause: As you age, skin’s connective tissue weakens, causing fat pads under the eye to slip out of place and bulge, says Rosemarie Ingleton, MD, assistant clinical professor of dermatology at the Mount Sinai School of Medicine in Manhattan. Other causes of puffiness: fluid buildup from allergies or sinus congestion; too little sleep; and too much salt.


At-Home Strategies for Under-Eye Bags/Puffiness

Though there’s no do-it-yourself answer for protruding fat, you can deflate puffiness caused by fatigue or fluid retention. Apply cotton balls soaked in cold soy-milk to the area for two minutes, says Wu. “The soymilk’s proteins combined with the coldness soothe inflammation,” she says. Not into kitchen remedies? A product with anti-inflammatory ingredients such as Yes to Cucumbers Soothing Eye Gel ($15;, packed with green tea extract and cucumber, works similarly. Finally, “a skin-tightening cream with caffeine, which constricts blood vessels, noticeably deflates puffiness,” says dermatologist Fredric Brandt, who is based in New York and Miami. Try Strivectin-EV Get Even Dark Circle Corrector ($59;

In-Office and RX Solutions for Under-Eye Bags/Puffiness

“Fillers injected around bags can make them seem smaller,” says Brandt. Because perfect placement of fillers like Restylane and Juvéderm is key to diminishing bags, it’s imperative that you see a board-certified physician who has experience using fillers for this specific purpose. Find a qualified doctor through the American Society for Dermatologic Surgery or the American Society for Aesthetic Plastic Surgery, then “cross-reference with the list of doctors on the website for the company that makes the filler,” suggests Tanzi. When you consult the doctor, ask how often he or she performs the procedure. “You want someone who does it on a nearly daily basis,”says Brandt. A second option is a tightening ultrasound or radio frequency procedure (e.g., Thermage or Ulthera) that lifts (and flattens) the skin over the fat pad. “Results last two to three years,” says Tanzi. 


Eye Problem #3: Sunken Sockets

Cause: “A hollowed-out appearance around the eyes is usually caused by fat loss and/or a shift of fat under the eye socket, as well as changes in the bone under the eyes. All of the above is age related,” explains Brandt.


At-Home Strategies for Sunken Sockets

There’s not much you can do at home, but “hyaluronic acid creams help boost volume,” says Brandt. Try Shiseido Bio-Performance Super Corrective Eye Cream ($60;


In-Office and RX Solutions for Sunken Sockets

Hyaluronic acid fillers like Restylane and Belotero can help fill in the concave areas, says Brandt. Fat grafting is another option ($3,000 and up). “A plastic surgeon does liposuction to remove fat elsewhere on your body and injects it around the eyes,” Wu says. Some people prefer using a substance from their own body to do the filling, and the results tend to last longer (potentially forever) than those of hyaluronic acid, which typically last nine to 12 months. One advantage of fillers, though: If you don’t like the way they make you look, a solution injected into the skin will dissolve them. If you use fat and then are unhappy, there is no easy fix.


Eye Problem #3: Fine Lines/Crepeyness

Cause: “The breakdown of collagen and elastin from sun exposure, combined with the natural aging process—and a lifetime of smiling and squinting—is the primary cause of fine lines and crinkly skin,” says Tanzi. Add to this the fact that the eye area loses fat and hyaluronic acid, and it’s no surprise that fine lines are the most common sign of aging.


At-Home Strategies for Fine Lines/Crepeyness

Moisturize, moisturize, moisturize, says Hale. “Lines are more exaggerated when your skin is dehydrated,” she explains. You lose hyaluronic acid as you age, so look for a product chock-full of it, like Estée Lauder Advanced Night Repair Eye Serum Infusion ($62; To stimulate collagen production and make skin plumper, you have a variety of options: retinoids, stem cell extracts, peptides and at-home lasers like the PaloVia Skin Renewing Laser ($499; Or try Lifeline Skincare Eye Firming Complex with HSC-X ($97;; it contains human stem cell extracts.


In-Office and RX Solutions for Fine Lines/Crepeyness

Your MD can use fractional laser resurfacing (e.g., Fraxel) to boost collagen production and tighten skin. Most devices require three to five sessions spaced a month apart, at an average cost of $750 to $1,200 a session. Post treatment downtime is minimal. More aggressive lasers known as ablatives require fewer treatments (one or two) but closer to a week of downtime, and the cost per treatment starts at about $1,000. For crow’s-feet and forehead wrinkles, injecting Botox or Dysport inhibits the muscle contractions that cause these lines. Results last three to four months, with little downtime.


Next: Skin Picks of Top Docs


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First published in the April 2013 issue

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