Crepey Skin Under the Eyes: Causes and Treatments

Crepey skin under the eyes is a common concern because the skin in this area is naturally thinner, more delicate, and constantly in motion. Over time, factors like ageing, sun exposure, and lifestyle habits can make it appear finely wrinkled or loose. Many people begin searching for solutions when they notice makeup settling into lines, or when textural changes make the eye area appear tired. Understanding why this happens is the first step toward exploring treatment options that may support healthier, smoother-looking skin.

Why the Thinnest Skin Is the Toughest to Treat

The skin beneath the eyes holds a fascinating paradox.

It’s the thinnest skin on the human body – delicate, expressive, and constantly in motion. That very combination makes it one of the first areas to show signs of ageing: fine lines, skin laxity, and the distinctive “crepey” texture that so many people notice long before wrinkles appear elsewhere.

Patients often ask: “Can you fix the fine lines under my eyes?”
The question seems simple. The answer rarely is.

Because here’s the conundrum – the thinner the skin, the harder it is to treat safely.

Improving under-eye laxity or wrinkles requires stimulating new collagen – yet to do that, we must deliver energy or controlled injury into some of the body’s most fragile tissue.

Too gentle, and nothing changes. Too strong, and we risk damage. It’s a delicate dance between transformation and tolerance.

What causes crepey skin under the eyes

The lower-eyelid area isn’t just thin – it’s structurally unique. Here are some examples of what what causes crepey skin under the eyes:

• Minimal collagen and elastin: The dermis is sparse, giving little structural support.
• Little subcutaneous fat: There’s almost no cushioning between the skin and underlying muscle.
• Constant movement: Every blink, squint, and smile pulls at the skin thousands of times each day.
• High exposure: UV light and environmental stressors impact the area directly, yet it lacks the natural defences of thicker skin.
• Lifestyle factors: sleep quality, hydration, nutrition, and smoking all amplify the effect, while genetics decides how soon it shows.

Over time, these factors combine to create laxity, fine wrinkling, and surface crepiness.

How to Treat Crepey Under Eye Skin

To rejuvenate ageing skin, including how to treat crepey under eye skin, we must trigger collagen regeneration – typically through heat, light, or micro-injury. But under the eye, the margin for error is razor thin.

Mild treatments offer a higher degree of safety but limited results. Aggressive ones can tighten beautifully but there are greater risks of scarring, pigment change, or even ectropion (outward turning of the eyelid).

So every decision – depth, density, temperature – must balance efficacy against fragility. That’s what makes this small patch of skin one of the most technically demanding areas in aesthetic medicine.

Fractional Co2 Laser

Among all technologies, fractional Co2 laser resurfacing remains the most powerful option for tightening and smoothing under-eye skin. It delivers controlled micro-ablations in a grid-like pattern, vaporising tiny columns of skin while leaving bridges of intact tissue to speed healing. This stimulates intense collagen remodelling and dermal tightening over the following months.

When performed carefully, Co2 resurfacing can dramatically improve crepey skin, fine lines, and textural irregularities. But its power is also its danger. Too much energy or overlap can cause scarring, prolonged redness, pigment change, or eyelid contraction.

That’s why periocular Co2 laser requires advanced anatomical understanding, conservative settings, and precise eye protection.

Done properly, results are long-lasting and transformative. Done carelessly, they can be catastrophic.

Other Energy-Based and Minimally Invasive Options

While Co2 laser remains the gold standard, it’s not the only path forward. For those wanting conservative rejuvenation or shorter downtime, a range of non-ablative or minimally invasive treatments can improve the under-eye area more gradually.

Non-Ablative and Fractional Lasers

These devices – such as Er:YAG, 1550 nm, or 1927 nm lasers – heat the dermis without removing the surface layer. They stimulate collagen renewal with less recovery and minimal risk, though results are milder.

Ideal for early under eye crepiness or maintenance, they suit patients seeking subtle improvement rather than dramatic tightening.

Radiofrequency (RF) and RF Microneedling

RF energy heats deeper dermal layers to contract collagen and trigger new fibre formation. Microneedling RF combines this with precise mechanical penetration, targeting tissue beneath the surface.

When used carefully, RF can soften mild laxity and texture irregularities. However, over-treatment may risk fat atrophy or swelling – especially in those with already thin skin.

Biocompatible Injectables

Treatments like polynucleotides, or other biocompatible agents work by enhancing hydration and fibroblast activity rather than removing tissue. They don’t physically tighten the skin, but can make it appear smoother, stronger, and more luminous, particularly when combined with light-based therapies. They are often used between device sessions to support long-term dermal health.

Tixel – Thermo-Mechanical Fractional Rejuvenation

Tixel is a relatively new technology that uses a heated titanium tip to deliver short bursts of thermal energy directly onto the skin’s surface. Unlike a laser, it relies on thermal contact, not light, to create tiny micro-zones of coagulation that stimulate collagen production.

Because there’s no optical energy, Tixel has a lower risk of pigmentary change or scarring and can be safely performed close to the lash line with simpler eye protection requirements. Downtime is typically mild – redness and slight swelling for one to two days.

However, results are also gentler. Tixel provides modest tightening and textural improvement, not the deeper structural change of Co2 laser. It’s often positioned as a “middle-ground”: a more conservative option for subtle rejuvenation and maintenance.

Fotona SmoothEye – Non-Ablative Er:YAG Tightening

Fotona SmoothEye is a non-ablative treatment using Fotona’s Er:YAG laser in Smooth Mode. It delivers gentle, bulk heating to the dermis without disrupting the surface, promoting neocollagenesis and gradual tissue tightening. The SmoothEye protocol is particularly suited for the delicate periocular area because it balances efficacy with exceptional safety.

Typically performed in a series of sessions, SmoothEye causes only temporary warmth or redness – no peeling, no wound care, and no extended downtime. The risk of scarring or ectropion is minimal.

Results develop progressively over several months, offering a low-risk path to firmer, more elastic under-eye skin. While not as dramatic as Co2 laser, it provides a valuable maintenance and early-intervention option, especially for patients preferring conservative treatment.

Surgery: Effective but Not Complete

When excess skin or prominent fat pads dominate the concern, lower-eyelid surgery (blepharoplasty) becomes the logical consideration. Surgery can remove redundant skin or reposition herniated orbital fat pads, which are commonly mistaken for “under-eye bags.”

However, surgery addresses quantity, not quality. While it removes tissue, it doesn’t correct the thin, crepey texture of the skin that remains. Many patients find they still benefit from resurfacing treatments after healing to refine texture and tone.

Blepharoplasty also carries its own risks – most notably ectropion if too much skin is excised or if postoperative healing affects eyelid support. It’s a reminder that precision and moderation apply just as much in surgery as in laser treatments.

A Clinical Observation – When Surgery Isn’t the Final Step

It’s not uncommon to see patients who’ve had technically successful lower-eyelid surgery but remain troubled by fine wrinkling. The fat pads may be gone, and excess skin removed, yet the remaining tissue still looks aged.

That’s because surgery can’t rebuild collagen.

To restore texture, we must still rely on controlled regeneration – often through fractional Co2, Tixel, or SmoothEye laser treatments performed months after surgical healing. This synergy – surgery for structure, laser for skin quality – delivers the most complete rejuvenation.

A Regenerative Step Forward – Combining Co2 Laser and Rejuran

In recent years, regenerative aesthetics has added an entirely new dimension to under-eye rejuvenation. One of the most promising advances is the combination of Co2 laser resurfacing with Rejuran – a polynucleotide-based injectable derived from salmon DNA fragments.

Rejuran works by stimulating fibroblast activity, reducing inflammation, and improving the extracellular matrix. In simpler terms, it helps the skin heal itself – not by filling or stretching it, but by encouraging natural repair processes.

When applied immediately after Co2 laser, Rejuran can:

• Accelerate healing: Patients often experience faster recovery, reduced redness, and less downtime.
• Enhance dermal regeneration: The polynucleotides act as a scaffold for new collagen and elastin formation.
  
• Reduce inflammation: Its soothing, bioactive properties help stabilise the healing response and reduce post-laser erythema or irritation.
  
• Improve long-term results: Over time, the skin not only looks smoother but also becomes structurally healthier – thicker, stronger, and more elastic.
  

Think of it as supporting the repair phase rather than just the treatment phase. The Co2 laser creates the stimulus; Rejuran guides and accelerates the regeneration.

For under-eye skin – where safety margins are small and recovery is critical – this synergy can be transformative. It represents a new philosophy of treatment: not just resurfacing the skin, but restoring its function and vitality.

The Art of Delicate Renewal

The lower eyelid is where science meets artistry. It challenges every assumption about “stronger is better” and rewards a conservative, evidence-based approach.

Whether through Co2 laser, Tixel, Fotona SmoothEye, Rejuran, or surgery, success lies in balancing stimulation with safety.

True rejuvenation doesn’t mean erasing every line – it means restoring the harmony of expression while preserving the skin’s natural delicacy. In that sense, the thinnest skin often teaches us the deepest respect for our craft.