Whether you call them smile lines or crows feet, the little wrinkles around our eyes are one of the first signs of ageing. And along with dark circles, drooping eyelids and dry eyes, they are all part of reaching mid-life and beyond. But what can you do about it?
Consultant oculoplastic and ophthalmic surgeon Dr Elizabeth Hawkes (https://drelizabethhawkes.com) says the eyes are the first part of the face to show signs of ageing due to the unique nature of the skin around your eyes and on your eyelid.
She explains: “For most parts of the body, you have skin, then a layer of fat and then muscle but around the eyelid, you lack the layer of fat so it’s just skin and muscle.
“On top of this, the eyelid skin is very thin and the muscle under the eyelid skin, called the orbicularis oculi muscle, is one of the most active muscles on the face.
“It controls when we blink. We blink 12 to 14 times a minute so the muscle is constantly working, under very delicate skin, which is why it starts to age first.”
Dr Hawkes said eyelid skin is prone to all the usual signs of ageing, just like other skin, so you start to lose collagen and elastin.
“It loses collagen and elastin, which means it loses strength and is also vulnerable to signs of ageing from the sun due to UV exposure.
“On top of all that, it lacks its cushion of fat so you start to see signs of ageing such as excess folds of skin in the upper eyelid and lower lid and tissues can become very loose as well.”
Does the menopause affect my eyes too?
“Yes, it really does,” says Dr Hawkes. “Many people know about the common menopause symptoms, such as hot sweats, low libido and brain fog, however not many people realise that it can affect your eyes too.
“The hormone changes that occur during the menopause can result in Blepharitis. This is a chronic inflammatory condition of the eyelids, secondary to an overgrowth of bacteria on the eyelashes and eyelids.
'In between eyelashes we have meibomian glands, and they are specialist glands only in eyelids, which secrete the oily layer of our tear film and lock in our tears. They are highly susceptive to hormonal changes in body and if the quality is reduced, it can lead to dry eye syndrome.
“Many people actually suffer with watery eyes when their eyes are dry, as your eye’s reflex is to make more tears to lubricate the surface of the eye.”
How to prevent eyes from ageing
The big villain for your eyelids - UV Exposure
“The number one cause of damage to our delicate eyelid skin is the sun,” says Dr Hawkes.
“Lots of people don’t realise the eye area is a high risk area for small skin cancers. It’s easy to forget the eye area, especially as all the sunscreen bottles say avoid eye areas but you should be applying all around the eye in a circular motion and, particularly, the inner corner by the nose as that is a very common spot for a small basal cell carcinoma.”
Use mineral based make-up in summer marks to protect your eye area
“Using a mineral based make-up will help cover up the skin around your eyes and protect them even further,’ says Dr Hawkes. “And never forget your sunglasses. They are not just a fashion statement and must have UV protection. Look for UV 400 protection. It is extremely important for sunglasses (of any type) to have UV protection because UV radiation from the sun can damage the delicate skin of your eyelid, as well as the skin surrounding the eye area. It can also damage the cornea, lenses and other parts of the eye. UV exposure can also contribute to some types of cataracts, solar retinopathy and pterygium. Protecting the eyes from this is essential for eye health reasons and also to prevent premature ageing.”
Do eye creams really work?
“I’m definitely pro-eye cream,” says Dr Hawkes. “The skin around the eye area is unique and needs special care. You do need to be very delicate when applying it. If you are aggressive, you could actually cause puffiness. The eyeball is cushioned in fat in a bony socket and when it prolapses forward, you get eye bags.
“Use light serums and light creams, which don’t clog up glands and put you at risk of milia. “Hyaluronic acid locks in moisture and that’s what I use around my eyes.”
What about dark circles?
“We all get dark circles under the eyes when we are tired, stressed or ill. The skin is so thin so the blood vessels are more visible. They are really useful tools to predict your general health,” says Dr Hawkes. “Volume loss in the tear trough area can also cause extra shadowing.
“A quick tip in the morning is to splash eyelids with cold water or add an ice cube as this will help with constricting the blood vessels.”
Your diet can affect your eye health too
“Omega 3 is very good for your eyes and very important in your diet,” says Dr Hawkes. “Also Lutein & Zeaxanthin supplements, which delay the onset of macular degeneration. These aren’t found in your diet and need to be taken as a supplement.
“Vitamin C is also beneficial for your eyes as well as your whole body. I recommend following a Mediterranean diet, with virgin olive oil, no processed food, fresh fruit and vegetables and lots of fish.”
Take screen breaks
“It’s really important to remember to take screen breaks for your eye health as you tend not to blink as much, which can cause dry eyes and fasten the ageing process. With each blink, you sweep tears across the eyes and it keeps them healthy. So I always recommend the 20-20-20 rule so that every 20 minutes you look out of the window at something 20 metres away for 20 seconds.” What treatments are there for my eyes? Botox “Botox - or anti-wrinkles injections - are a sure-fire way to reduce the wrinkles around your eyes,” says Dr Hawkes. “‘Botulinum Toxin temporarily paralyses the muscles that make you squint which in turn causes your wrinkles and fine lines to relax and soften in appearance. Anti-wrinkle injections are effective and results can be seen just a few days after the treatment.” Tear trough (under eye) fillers? One of the most effective treatments to combat tired-looking or aged eyes is to use tear trough fillers, says Dr Hawkes
“They are a hyaluronic acid-based injectable used to reduce dark circles, eye bags and a tired looking appearance. With minimal to no downtime, they are an effective treatment to combat tired-looking or aged eyes.
“The natural ageing process and various lifestyle aspects can contribute to an aged appearance around the eyes. But, careful administration of fillers under the eyes helps replace lost volume, conceal dark circles and smooth the skin. This results in a more youthful appearance overall. “After tear trough fillers, patients feel an increased sense of confidence in their appearance - no longer worrying that they 'look tired all the time'.”
“If you’re still worried about your eyes and feel you need more help, you can consider blepharoplasty. Blepharoplasty surgery is performed to improve the appearance of the eyelids by remodeling their structure,” says Dr Hawkes.
“This can involve complex combinations of skin removal, muscle tightening, and fat repositioning or removal. Every eyelid is unique, meaning the surgical plan and procedure is a highly bespoke process.
“Surgery can be performed under local anaesthetic, or with ‘twilight’ general anaesthesia. Depending on the number of eyelids requiring surgery, the procedural time varies from 45 minutes to 2 hours.
“The benefit of blepharoplasty is that we can achieve a beautiful and very natural look. This isn’t facelift surgery - you won’t come out looking like an entirely different version of yourself - but you will look a lot brighter, less tired, and refreshed.
“Normal recovery is two weeks, however, I would advise having this done six weeks before spending extended periods in the sun or a big event.”
This article is a promotional advertorial by Dr Elizabeth Hawkes.
Dr Elizabeth Hawkes, MBBS, BSc, FRCOphth, is a Consultant Ophthalmic Surgeon, Oculoplastic Surgeon & Aesthetic Practitioner specialising in blepharoplasty, eye surgery &advanced facial aesthetics.
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