Crow's feet

Crow's feet

Overview

Crow's feet are the fine lines and creases that appear at the outer corners of your eyes. These wrinkles come in two types: dynamic and static. Facial expressions are thought to be the primary cause of dynamic wrinkles. Every smile, frown, and raise of the brow has led to the formation of small wrinkles around the corners of the eyes.

Natural causes of static wrinkles include gravity and aging. Our skin begins to lose elastin as we age, a protein found in our skin that is crucial for keeping our skin firm. When it starts to fade, our skin becomes loose, allowing us to manipulate it without returning to normal. As the skin continues to wrinkle and elasticity disappears, the consequence is seemingly permanent lines.

The treatment you choose will be determined by the degree of your crow's feet as well as your desired outcome. In certain circumstances, a combination of therapies may be recommended (e.g, topical cream, Botox).

Because crow's feet emerge naturally as we age, they are very hard to entirely avoid. However, by making a few lifestyle changes, you can reduce their intensity.Maintain your overall health by exercising on a regular basis and eating a well-balanced diet. Wear sunscreen to protect your skin from the sun's damaging rays, which cause wrinkles, especially crow's feet. Wear sunglasses even on cloudy days to avoid squinting. Also, moisturize your face in the morning and at night.

Eye wrinkles classification

Eye wrinkles classification

Static wrinkles and dynamic wrinkles are the two forms of wrinkles. Facial mimics caused by emotion changes such as fear, shock, frowning, and laughing cause dynamic wrinkling. They arise and disappear quickly. Dynamic wrinkles prefer the periorbital, forehead, and glabellar regions.

Static wrinkles, on the other hand, do not fade quickly and can be observed even when the facial muscles are relaxed. The perioral, neck, and malar regions are more prone to static wrinkling. Because of the loss of collagen with age, dynamic wrinkles can develop to static wrinkles. According to the Glogau Scale, facial wrinkling is classified into four stages: stage 1 has no wrinkles, stage 2 has minor wrinkling, stage 3 has moderate wrinkling, and stage 4 has severe wrinkling.

What causes eye wrinkles (crow's feet)?

Crow's feet treatment

Before we explore the reasons why wrinkles and fine lines appear, let's first take a look at the structure of eye- periorbital skin.

The skin around your eyes is extremely thin. As you get older, your skin loses collagen. This is a natural occurrence. However, that effect is especially prominent on the delicate skin surrounding your eyes, resulting in the first appearance of fine lines or wrinkles you may spot on your face. Loss of elasticity in the skin surrounding the eyes can also contribute to other unwanted features like puffiness and dark circles. So why do you have fine lines or deep wrinkles around your eyes?

These are the most common reasons:

1. Sun Exposure:

Sun exposure can lead to wrinkles, particularly around the eyes. If you are frequently outside during peak sunshine hours without sufficient UVA ray protection, sun damage will eventually begin to accumulate in the form of fine lines and wrinkles.

2. Facial Expressions:

Repetitive facial expressions can also result in lines and wrinkles around the eyes. A groove develops beneath the skin every time you squint – for example, when you smile or try to see something more clearly. Because collagen synthesis decreases with age, the skin around the eyes loses its capacity to bounce back into place. As a result, creases begin to form.

3. Smoking and Vaping:

The term "smoker's lips" refers to the tiny lines that form around the mouth of someone who vapes or smokes. This behavior, however, adds to wrinkles beneath the eyes. In addition to blocking blood flow to the skin, squinting to keep smoke out of your eyes can result in premature aging.

4. Rubbing Your Eyes:

If you have a habit of rubbing your eyes when you're tired, make an effort to quit. Keep in mind that the skin around the eyes is thin and sensitive. Rubbing the region around your eyes on a regular basis can stretch the skin too much, causing elastin breakdown and the creation of wrinkles.

5. Not Sleeping on Your Back:

For those of you who sleep on your side or stomach, you may be introducing wrinkles to your skin sooner than you'd like. A 2012 study in the Journal of Cosmetic and Laser Therapy found that sleeping with your face against the pillow can lead to facial imperfections such as crow's feet.

6. Dehydrated Skin:

Dehydrated skin is a temporary condition that’s due to a lack of water. Along with flakiness and a feeling of tightness, another common symptom of dehydrated skin is more pronounced lines, particularly around the eyes.

7. Genetics:

Your genes have the ability to influence the start and severity of physical aging. However, it is crucial to note that skin that is frequently exposed to the outside world (such as your face) is often more impacted by extrinsic and environmental variables.

Methods of treatment of Crow's feet

The periorbital region is one of the most prominent indicators of chronological age and hence a key target in skin rejuvenation, although it presents certain therapeutic challenges. Because the skin on the eyelids is the thinnest in the body and has a crucial functional purpose in protecting the eyes, this region presents a therapeutic challenge. Traditional surgical techniques, such as blepharoplasty and rhytidectomy, can result in extensive downtime and the potential of adverse effects, making them unsuitable for many patients.

Traditional treatments that are more conservative include retinoic acid, chemical peels, botulinum toxin, dermal fillers, and dermabrasion, however these have been mostly supplanted by modern technology. Ablative and nonablative lasers have changed the world of facial rejuvenation since the 1990s. While ablative therapies have demonstrated considerable improvement in periorbital rhytids from the beginning, nonablative skin resurfacing was first met with skepticism owing to its mild and slow results.

1. Retinoids:

Topical retinoids are the cornerstone of photo-damaged skin therapy. Retinoids are vitamin A compounds that occur naturally as well as those that are synthesized. The benefits of retinoic acid on patchy hyperpigmentation, fine wrinkles, and skin texture are widely recognized; however, cosmeceutical retinoids have received less clinical investigation. Similar to retinoic acid, retinol 1.6% generated reduced erythema while generating epidermal thickening and boosting production of cellular retinoic acid-binding protein (CRABP-II mRNA) and cellular retinol binding protein (CRBP mRNA). When compared to retinoic acid, retinaldehyde has been demonstrated to be much more effective in eliminating fine wrinkles and improving skin roughness.

The most commonly used alpha hydroxy acids (AHA) are glycolic 20% and lactic acid 15% which reduce periorbital pigmentation. Most researchers reported an improvement of up to 90% in dark circles following treatment with 3.75% trichloroacetic acid and 15% lactic acid. Segmental chemical peel with phenol-croton oil (27.5% phenol and 0.1% croton oil) has been used successfully for periorbital wrinkles. This cost-effective modality has been associated with long-lasting neocollagenesis, and cardiac monitoring is not required when treating 1 or 2 facial units.

2. Neuromodulators:

Botulinum toxin type A has transformed nonsurgical esthetic treatment of the upper face. Botulinum neurotoxins function by preventing the release of acetylcholine from vesicles on presynaptic nerve terminals. Botulinum neurotoxins have become an essential element of the plastic surgery for the treatment of cosmetic concerns such as glabellar and periorbital wrinkles. This blockade causes reversible but long-lasting denervation that inhibits muscle function; on the other hand, non-depolarizing muscle relaxants cause a particular competitive pre- and post-synaptic neuromuscular block that is fast reversible.

3. Mechanical Resurfacing (dermo abrasion):

Mechanical resurfacing involves creating small abrasions in the skin's most basal layers. This can involve the use of a motorized equipment that releases crystals of aluminum oxide, known as microdermabrasion, or the use of sandpaper that is repeatedly rubbed over the periorbital region with changing power using one's hand, known as manual dermabrasion or motorized dermabrasion.

Because the skin in that area is very thin and controlling eyelid movement might be difficult, motorized dermabrasion is the least recommended form to be utilized in the periorbital region owing to the risk of harm. On the other hand, manual dermabrasion is the most suitable method for the periorbital area since it allows very specific control of the depth of tissue involved and the force being applied to the area.

4. Radiofrequency:

Radiofrequency (RF) skin rejuvenation devices have also been introduced. Volumetric heating is produced via tissue impedance and subsequent heat diffusion in this technique, which impacts deeper tissue layers than laser-based technologies. As with laser treatment, fractional RF devices have been created to increase efficacy and tolerability. Because the skin remodeling occurs deep below the minimum epidermal ablation and at a sublative degree of heating, one of the fractional RF devices has adopted the name "sublative rejuvenation."

5. Microplasma radiofrequency:

Micro-plasma radiofrequency (RF) has been presented as a novel dermatological technique. Ablative microplasma RF is a non-laser, non-light technique that can cause epidermal resurfacing and dermal coagulation. Micro-plasma radiofrequency uses a discharge of radiofrequency energy that works on nitrogen molecules in the air near the skin's surface, causing ionization of a part of the atoms to generate high-energy foci known as plasma sparks. When the gas ions return to their previous steady state, energy is released.

When these sparks are uniformly delivered to the skin, they generate several regulated channel-like holes in the epidermis. It creates micro-ablative epidermal thermal zones in the skin that are made up of coagulated and thermally denatured columns, with the surrounding viable tissue functioning as a reservoir of stem cells, growth factors, and inflammatory cells, allowing for fast reepithelialization. When compared to other ablative resurfacing methods, this rapid epithelialization results in significantly less downtime and morbidity.

6. The DAS (Dermo Ablation Surgery):

A plasma blade is an electrocautery device that creates a plasma voltaic arc, causing the epidermis and superficial dermis to tighten. The DAS Medical device generates direct voltage current, which raises the skin's temperature. The method of direct voltage current fulguration differs from that of controlled delivery of voltage current accomplished discharge with AC in that it affects a much smaller region of skin and does not harm adjacent tissues.

When the device's tip is put to the skin at a 2 mm distance, electrons in the atmosphere tend to sequester some of the energy given. When air is carried, it ceases to be an insulator; ionized air is led: this ionization is known as "plasma."

7. Platelet-rich plasma:

The past decade has also seen the emergence of platelet-rich plasma (PRP) as a treatment optionfor rejuvenating the skin’s appearance. Early clinical trials examining PRP for treatment of periocular wrinkles from 2010 to 2016 lacked control groups but demonstrated that both PRP and PRGF provide statistically significant improvements in overall skin appearance, wrinkles, firmness/sagginess, and color homogeneity.

8. Injectables (Fillers):

Hyaluronic acid is the most often utilized ingredient for achieving appropriate aesthetic outcomes and combating the aging process. It is very beneficial in the periorbital area and, in the hands of a skilled physician, may provide remarkable results. The glycosaminoglycan disaccharide hyaluronic acid is present in human skin, synovial fluid, and vitreous fluid. It is a molecule that attaches to water very strongly and stays attached to it until it is destroyed. This permits the molecule to continue providing volume to the face until it totally evaporates.

The brow, upper eyelid, and tear trough are all common injection sites. It is critical to inject only little amounts of the substance and prevent overcorrecting the fault, which might result in patient displeasure. Furthermore, if the midface area is to be injected, it should be done before the periorbital area since the former might lower the depth of the tear trough, resulting in less product required in the latter.

Ecchymosis, erythema, and mild edema are common adverse effects that can occur with any face injection. Inadvertent injection of material into blood vessels can result in necrosis of the injection site, as well as embolization of the substance and blockage of arteries. This is especially concerning in the periorbital area since the ocular artery might be damaged, resulting in irreversible vision loss. Fortunately, these adverse effects are uncommon and even more so in expert hands.

9. Plasma skin resurfacing:

Plasma skin resurfacing (PSR) is a new technique that uses the state of matter known as plasma to create a thermal impact on the skin by using positively ionized gases. A gaseous nitrogen source is utilized in PSR to produce a plasma. This modality, unlike ablative lasers, is not chromophore-dependent and so does not evaporate tissue. This method may work by generating a layer of dried epidermis, which acts as a natural barrier, allowing for quicker healing and the development of new epidermis.

Plasma resurfacing has been used safely in skin types I-IV and may have a better safety profile than ablative laser. This modality has been used with good results in full- facial resurfacing. In a recent study, the use of this technology has shown good response to treat periorbital area for dermatochalasis and wrinkles.

How to prevent wrinkles and fine lines around eyes?

wrinkles and fine lines prevention

If you don't want to increase the number of under-eye wrinkles and fine lines, take the following precautions to keep the delicate skin in that area smooth and supple.

1. Protect Yourself with Sunscreen and Other Accessories:

Sunscreen is arguably the most effective anti-aging skincare product you can wear every day. Don't reserve it for hot summer days on the beach. UV rays are present year-round, even on cloudy days. Apply sunscreen gently on and around your eyelids, avoiding direct contact with your eyes. Remember to reapply SPF every two to three hours. On especially sunny days, supplement your efforts with a pair of UV protection sunglasses and a wide-brimmed hat.

2. Keep Your Skin Hydrated:

To avoid dryness and fine wrinkles associated with dehydrated skin, use a good moisturizer, especially around your eyes. A separate eye cream can give additional moisture, but for some people, a properly-formulated moisturizer containing ceramides can perform just as well in preventing fine lines and wrinkles.

3. Rest Your Eyes:

If you find yourself staring at a screen for extended periods of time, make sure to take a break for the health of your eyes. This may be as easy as taking brief breaks from the internet, television, or smartphone throughout the day. Pamper yourself with cooling eye masks to relieve puffiness and inflammation caused by eye strain.

4. Adopt Good Habits:

Whether your smoke or rub your eyes constantly, be mindful of the effects these habits can have on your eyes and the rest of your skin. Sometimes, small changes can lead to significant results over time.

Conclusion

Crow's feet

It's no secret that our eyes are one of the first areas to show the signs of ageing. The skin here is 40 per cent thinner than the rest of our face, making it more delicate. “Crow’s feet” is the term given to those fine lines around the eye area. These tiny wrinkles might also be known as “smile lines” since they’re the ones that form when we grin. While these little wrinkles may not trouble you much when you’re smiling, they’re definitely bothersome when they become permanent features of your face.

Most people seek dermatological treatment for crow’s feet when they become noticeable when the face is at rest. These are known as "static wrinkles," as they are constantly visible. If these fine lines emerge just when you smile, they are referred to as "dynamic wrinkles" and do not require treatment at this time.

Crow's feet are caused by the aging process. Collagen and elastin, two proteins present in the skin's supporting structure, produce less as you get older. These proteins are principally responsible for the lush, firm look of skin.

Skin also thins with age, and nowhere is this more noticeable than around the eyes. Because the skin around the eyes is already tissue-paper thin, rubbing your eyes or pushing on the skin while applying makeup might harm your appearance in the long term. When the sensitive skin around the eyes thins, it becomes more prone to wrinkle formation.

Whatever new products, procedures, or technology are introduced, there is one alternative that continuously rates first in the treatment of crow's feet: Botox. This injection is simple (it takes around 15 minutes each treatment and there is no downtime) and safe (it is the only FDA-approved wrinkle treatment). It is quite successful, but maintenance will need recurring treatments.

Other popular options for getting rid of those little lines around the eyes are dermal fillers. These injectables, like Juvederm and Restylane, use hyaluronic acid to plump the skin through hydration and lubrication, softening the appearance of wrinkles. Touch-up treatments are also necessary with dermal fillers.