Board-certified dermatologist Dr. Adam Wallach talks to us about this common dermatology concern.
At their earliest stage of development, around the age of 30, crow’s feet happen because of repetitive squinting.
How to treat crow’s feet must be one of the most asked cosmetic dermatology questions in our practice. Let’s start with what they are. Crow’s feet are the fine lines and wrinkles that fan out to the side of the lateral corner of your eyes. They are so named because of their likeness to a crow’s foot or footprint. At their earliest stage of development, around the age of 30, they happen because of repetitive squinting. At this stage I like to treat them with the simple use of botulinum toxins (such as BOTOX® Cosmetic, Xeomin®, and Dysport®). Cosmetic neurotoxin injections alone can soften dynamic wrinkles so much so that sometimes they disappear completely — at least while the botulinum toxin is active, which can be for up to three to four months.
As we age, our crow’s feet become more numerous, deepen, and begin to appear even when we are expressionless. In other words, the wrinkles go from being present only during moments of facial expression to being present even while the face is still or expressionless. In this more evolved stage of crow’s feet, which often starts to happen between the ages of 40 to 50 years old, we may use a small amount of hyaluronic acid (HA) filler in addition to botulinum toxin to help soften the area. You may be more familiar with the brand name forms of these cosmetic injectables such as the collection of fillers from JUVÉDERM®, Restylane® and BELOTERO BALANCE®.
Treating crow’s feet with cosmetic injectables involves little downtime, is an approachable cost point for many, and generally our patients enjoy instant gratification.
As the depth and number of crow’s feet develop further, dermatologists pivot to other cosmetic tools. Lasers are incredibly popular tools of our trade because of their effectiveness in treating so many dermatological concerns. Ablative lasers like CO2 or erbium, can help to soften the crow’s feet tremendously by smoothing the skin where those lines exist. With ablative lasers patients will experience 5-10 days of downtime with some redness, slight crusting, and swelling; however, the effect can be dramatic and long lasting, depending on how this procedure is performed.
For patients who prefer a more gradual approach coupled with less downtime, there are other non-injurious devicessuch as Ultherapy®, Sofwave™, or Fraxel® RESTORE that can help soften crow’s feet. Along with a more gradual effect, these require repetitive treatments to reap benefits.
On a final note, I cannot emphasize enough the importance of avoiding sun damage, not only for helping prevent skin cancer, but for its added benefit of avoiding photo-aging. Remember to limit your sun exposure, wear sunscreen with a sun protection factor (SPF) of at least 30 every day, wear polarized sunglasses and an ultraviolet protection factor (UPF) hat when outdoors.
With the advances in laser technology and the variety of treatments available, there are many options that we can offer our patients depending on their unique situation. To learn more about how to treat crow’s feet, schedule a consultation with one of Skin Cancer & Dermatology Institute’s medical providers or cosmetic specialists.
Originally published, “A medical expert’s perspective on how to treat crow’s feet”
(July 16, 2021) Sierra Sun