Treating crow's feet

The skin around the eye is the thinnest on the face — a fraction of the thickness of the cheek — with very few oil glands and a muscle underneath that contracts constantly. Every smile, every squint, every bright day folds it in the same place.

Add sun exposure, which is concentrated here because we squint against it, and you have the conditions for early lines regardless of how well you look after your skin.

The eyes carry most of what people read as warmth in a face. A genuine smile — a Duchenne smile — involves the muscle around the eye, and that crinkle is a large part of how sincerity is recognised.

A face that smiles with the mouth and not the eyes reads as flat or insincere, even when the viewer cannot articulate why. This is the area where I most often recommend less than the person asks for, and where softening rather than erasing gives the better-looking result.

Fine crepey lines under the eye, visible when your face is completely still, are usually skin quality rather than movement — thin, sun-damaged, dehydrated skin. Muscle relaxation will not do much for those, and treating them that way is a common source of disappointment.

Polynucleotides are usually the better answer under the eye, because they improve the density and quality of the skin rather than stopping it moving. Skin boosters and gentle microneedling also help.

Distinguishing the two is straightforward in clinic: lines that only appear on smiling are muscle, lines present at rest are skin. Most people have some of each.

The outer eye is close to the muscles that support the brow tail. Product placed too high or too medially can drop the outer brow, which reads as a heavy or slightly sad expression.

This is why the treatment is placed laterally and why the dose is modest. It is also why I review at two weeks: adding a small amount is easy, and removing it is not possible.

Sunglasses, genuinely. A great deal of the squinting that etches these lines is avoidable.

Daily SPF around the eye, which most people skip. A retinoid formulated for the eye area, used carefully. And treating the skin quality directly, which is what makes the result hold rather than needing ever more frequent treatment.

Relax your face completely in front of a mirror and look at the outer corner of your eye. Whether the lines are still there decides what will actually help.

Most people past forty have some of both, which is why a plan aimed at only one of them disappoints. It is also why the honest answer to “can you get rid of these” is usually “we can soften them considerably”.

Ultraviolet exposure, by a distance

The skin around the eye is the thinnest on the face and it takes the most sun. Cumulative UV damages the collagen and elastin that let skin recover from being folded — which is precisely what turns a dynamic line into a static one. Daily protection and sunglasses do more for this area across a decade than any single appointment.

Squinting you have stopped noticing

An out-of-date glasses prescription, screens without a break, driving into low sun. All of it is repeated forceful contraction of exactly the muscle that creases this skin, and none of it registers as squinting at the time. An eye test is an unglamorous but genuinely effective intervention here.

Smoking, and sleeping on one side

Smoking damages dermal collagen and adds a pursing movement on top of it. Consistently sleeping on the same side compresses one eye area for hours every night, which is a common reason these lines are asymmetric and the fold on that side is deeper.

The eyes carry most of the information in a smile. Whether a smile reads as genuine is judged largely at the outer eye — it is why a smile that involves only the mouth reads as polite rather than warm. Remove that movement entirely and the face becomes harder to read, in a way people notice without being able to name.

There is a mechanical reason too: the muscle around the eye also helps hold the area up, and over-treating it can make the lower lid look heavier or worsen under-eye puffiness. Softening the fold while leaving the smile intact is the harder skill and the better result.