It's All About The Eyes! Here's Your Guide To The Best Eye Treatments

Cosmetic Treatments

undereye fillerSource: Sruilk/ Shutterstock

Now that we’re wearing face masks around the clock, our eyes are taking center stage. As a result, not only are we experiencing a wave of bold eye makeup looks, people are turning to in-office treatments and splurging on eye creams more than ever before. In fact, aestheticians are referring to this time as a “Botox boom.”

However, before you invest in a new skincare product or book in an appointment, it’s important to understand the eye concern you’re aiming to address and what the best course of treatment for it is – fillers and Botox are not a cure for everything! For example, are you confusing dark circles with under-eye hollowness? Inserting Botox or filler in the wrong area could do more harm than good!

For the inside scoop, we spoke to N.Y.-based dermatologist, Dr. Doris Day, who specializes in laser, cosmetic, surgical and aesthetic dermatology. She walked us through the most common eye concerns and the best treatments that she applies daily. Consider this your eye treatment 101.

Eye Concern #1: Dark Circles

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According to Dr. Day, dark circles are one of the most common eye concerns that she treats, especially in her younger patients. They can be caused by three things: genetics, poor circulation, and unhealthy lifestyle choices. In the case of genetics, it’s a result of a type of hyperpigmentation in your skin (aka an overproduction of melanin, which is what gives your skin its color). Some people also have thinner skin than others, which makes blood pooling more noticeable. This can also be down to poor circulation.

In fact, even lifestyle choices – like poor sleeping habits, stress, dehydration, unhealthy diet, excess alcohol, and even allergies – can cause your veins to dilate, which can also make dark circles more obvious.

Before you head for an in-office treatment, Dr. Day explains that there are a number of lifestyle improvements you can make that can have a dramatic impact.

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Constant Rubbing: First and foremost, Dr. Day reminds you to be gentle with your eye area, “The lower eyelid skin is the thinnest skin on your body. Every day I see women rubbing and aggressively touching their eyes. It hurts to watch! Rubbing creates a defensive response of the skin which leads to thickening, wrinkling, and dark circles over time.”

Genetics: “While you can’t control your genes, you can take great care of your genetics. This means don’t rub your eyes, wear sunscreen and sunglasses, and use excellent products that will keep the eye area as healthy as possible. I really like eye creams that have ingredients like niacinamide, vitamin C, growth factors, peptides, caffeine, and retinol,” Dr. Day tells us.

Allergies: “Dark circles are often a combination of pigment making the skin darker, and redness from dilated blood vessels. Allergies cause increased redness through the latter effect and rubbing will lead to darkening through increased pigment from the irritation. The solution? Try to stay ahead of allergies. If you know when they start, take allergy medicine a week prior or consult your allergist about how to avoid falling behind and having symptoms that are difficult to control.”

Poor sleeping habits: Prioritizing your sleep is SO important. The recommended amount of sleep for an adult is eight hours. Having trouble sleeping? Dr. Day suggests, “Listening to ocean sounds at bedtime, taking deep breaths and allowing yourself to let go.” Other healthy sleep habits include a hot bath before bed, stepping away from all screens an hour before you sleep, and limiting caffeine from 2 pm.

Dehydration: The solution is easy, drink more water! However, Dr. Day adds, “You can also eat your water as many fruits and vegetables contain up to 90% water.”

Too much alcohol: According to Dr. Day, excessive alcohol consumption can lead to both dark circles and puffiness. She recommends cutting back, and “you’ll see how magical it is for your eyes.”

Treatment Options for Dark Circles

If you’re looking for greater assistance brightening your undereye area, Dr. Day says that “In-office treatments such as peels, lasers, devices that tighten, and fillers can have a lasting effect.” However, she does add, “This is a very sensitive and delicate area, and most of these treatments, especially fillers, should be done or supervised by a trained aesthetic physician.”

Dark circles Source: Dr. Doris Day

“Dark circles and undereye wrinkles can make the face look older and more tired. This 48-year-old patient was treated with five Eyelase sessions, Ultherapy, Botox, and Calecim serum with growth factors to achieve a refreshed look,” says Dr. Day.

Eye Concern #2: Undereye Hollowness and Puffiness

If you’ve tried every concealer and miracle eye cream and are still left with shadows under your eyes, it could be a result of undereye hollowness. Annoyingly, undereye hollowness is a broad category and can be due to a myriad of reasons. Dr. Day begins by explaining it can be a result of genetics, where the shape and structure of the eye creates a natural hollow, which can lead to dark circles. It can also include dark circles that look like a hollow without any actual loss of volume in the area. Finally, it can be caused by redness that can also create a shadow-like effect.

undereye hollownessSource: sruilk/shutterstock

Dr. Day notes that these elements don’t age in a synchronous way, which over time, can lead to “hollows, undereye bags, and crepey skin.” Therefore, if you do opt for an in-office treatment, “The aesthetic physician must carefully investigate the source of each issue before treating, and it’s important to understand it often takes a combination of skincare, devices, and sometimes injectables for optimal, natural, and lasting results.”

Another common issue in this area is puffiness. According to Dr. Day, “Puffiness can have several causes. One cause is fat pad herniation, which is typically a genetic problem.” To determine if this is the cause, Dr. Day explains, “A quick test I use in the office is to press on the upper eyelid. If I see a bulge in the lower lid, then I know it’s a fat pad issue. If I don’t see a change it’s more likely to be fluid. In this case, it helps to control salt intake, and drinking more water helps a lot too.”

The Best Treatment For Undereye Hollowness and Puffiness

Dr. Day insists that the easiest way to resolve undereye hollowness is by using filler. “One technique I use to fix this is to use a cannula (soft needle) to disrupt that ligament and then place very small amounts of hyaluronic acid filler to blend the area. I never use a sharp needle to inject this area since the filler can move and it can look lumpy and bluish, which can occur even months after the injection,” Dr. Day says. You will feel a minor pinch like plucking an eyebrow hair. She adds that “You should expect to have more than one treatment with the goal of restoring a normal tear trough rather than over-filling the area.”

As with all cosmetic procedures, Dr. Days reminds us that you must also consider the midface, “It’s important to evaluate this area as it often helps to add volume in specific areas of the midface to improve under the eyes.” Although Dr. Day warns that the midface should be addressed by an advanced injector as if you overfill the area, the lower lid can merge with the cheek and look unnatural. In some cases, it can also make the eyes look smaller because the filler can push the lower eyelid upwards.

Due to the level of expertise this treatment requires, it can cost anywhere between $300 to $800 depending on your location, your doctor, and how much filler you require. As always, when you’re looking for an aesthetician, ask for recommendations, read the reviews, and ask for pictures from previous procedures. And remember, every doctor has their preference for technique. For more deets, check out our full guide on undereye hollowness.

Below, Dr. Day provides an example of a natural-looking result with filler: Left is before, and the right is after treatment.

undereye hollowness Source: Dr. Doris Day

“This beautiful patient in her 30s came in complaining of “bubbling” under the eyes from filler that was injected too superficially. I dissolved the filler to erase the lumps, swelling, and visibility of the original filler and then used small amounts of hyaluronic acid filler with a cannula to restore the area!”

Eye Concern #3: Crepey Skin and Wrinkles

Everyone will experience undereye wrinkles as they occur naturally as we age. However, if you want to, you can soften their appearance with a consistent skincare regimen that includes active ingredients like niacinamide, vitamin C, growth factors, peptides, caffeine, and retinol. Dr. Day also recommends in-office treatments such as Botox, Dysport, or Xeomin (other neurotoxins that block muscle contractions, similar to Botox) for gently smoothing the lines and preventing fine lines from deepening.

eye wrinklesSource: Dr. Doris Day

Above, Dr. Day provides a successful case of a lady who wanted to soften existing wrinkles: “This 57-year-old patient wanted to address the undereye wrinkles. A combination of Botox and six Eyelase sessions led to a softer, more rejuvenated undereye appearance.”

Not into Botox? You could also consider “Fractional laser to rejuvenate the skin, as well as fillers discretely placed around the eyes, under the brows, the temples, and lower eyelids,” says Dr. Day. Finally, she also suggests “Devices that use radiofrequency or ultrasound energy to tighten and lift the skin and address the skin’s deeper layers. The result is beautiful, youthful, natural eyes that maintain their shape and are a true reflection of you.” However, Dr. Day warns against PRP and microneedling around the undereye as the skin is too thin and sensitive.

Eye Concern #4: Droopy Eyelids

Another common issue people face around the eye area is droopy skin or heaviness, which is typically a result of genetics or lifestyle. According to Dr. Day, it can start as early as your 30s but the good news is there are excellent non-surgical options, especially if you start early!

The main issue with heavy eyelids and excess drooping is it can lead to fine lines and wrinkles, as the normal response is to raise the brows. While many people turn to Botox as a quick fix, Dr. Day explains that this can lead to further complications.

Dr. Day begins, “If we add Botox to the forehead, we can easily eliminate the lines there,” however, she continues to explain that this can make the eyelids look heavier as the forehead muscles are weakened and therefore, can’t lift the lids as effectively. Furthermore, “If you have too much filler in the lower eyelid, you get smaller eyes from heaviness from above and even smaller eyes from the pushing up of filler from below,” says Dr. Day. This changes the shape of your eyes, making them look smaller and less awake.

Treatment Solution for Droopy Eyelids

“The best non-surgical solution for drooping or heaviness is to lift the brows with a tightening or lifting device like Ultherapy, Thermage, Fotona Eyelase or Endymed Tightening,” explains Dr. Day. And while Botox is not the sole fix, Dr. Day does add that “A little Botox works well to soften the forehead movement without creating a negative effect on the eyelids.”

Eye Concern #5: Thinning and Sagging Brows

brow products Source: Presley Ann/Getty Images

Words to live by: never forget your brows! After all, as Dr. Day reminds us, they frame the face and create a structural balance. However, what a lot of people don’t realize about their brows is they can thin and, even sag as you age. Alternately, “for a good number of women, the brows go up not down as they age,” said Dr. Day Day.

Treatment Solution for Thinning and Sagging Brows

When it comes to brows, there are a number of treatments, from superficial options like microblading to cosmetic treatments to tone and lift the skin. In general, for thinning brows, Dr. Day recommends minoxidil to encourage hair growth. If you’re wanting to address sagging, she advises, “Strategically placed neuromodulators, which can help make the brows even in height and, give them a nice arch. Tightening and lifting devices help situate them just where they need to be to help your eyes look their best.”

Are you considering any eye treatments right now? Let us know in the comments below.