For lower eyelid wrinkles, the best option is “Thermismooth.” It is a noninvasive radio frequency treatment of the skin that takes 10 mins and about 4 sessions to soften those lines. It does not require any special preparation and is not painful. The hand piece looks like a pen and the metal wand feels like a hard stone. Soft gel is applied and the hand piece is rolled all over the skin as it starts heating the skin slowly and gradually. At the end of the treatment, the skin appears to be pink and this does not last longer than a few hours. The treatment can been repeated no earlier than 3 weeks and most individuals notice improvement after every session.

It is well known that any modality that is used to create the under eye wrinkles will have a better result if Botox or any similar botulinum toxin has been used to paralyze the underlying muscle orbicularis oculi. If possible, you should consider getting Botox treatment prior to undergoing Thermismooth treatments. If Thermismooth is not available in your area, you can definitely consider other modalities such as Microdermabrasion, dermal pens, chemical peel and also laser resurfacing.

Microdermabrasion is vacuum cleaning of the skin, which removes dead cells and improves the superficial skin.

Dermal pens, such as Rejuvapen, perform needling and vertical holes in the superficial skin. As those tiny areas heal, they produce collagen leading to tightening of the skin. This will help with the wrinkles in the lower eyelid to some degree.

Chemical peels cause tightening by producing new collagen with the help of different chemicals such as TCA or phenol. However, it also leads to a change in color and can cause the mismatch between the lower eyelid skin and the surrounding cheek area.

Laser resurfacing works well if it is fractional and does not cause any peeling of the skin. ResurFx by Lumenis is a good laser that does not lead to any scabbing or peeling.