Under-eye wrinkles are fine lines and creases in the thin skin beneath the eyes, caused by a mix of repeated muscle movement, sun exposure, loss of collagen with age and changes in the fat and skin of the lower lid. Mild lines often respond to good skincare and sun protection; deeper creases, loose skin or bags may need a medical treatment or lower eyelid surgery, depending on the underlying cause.
Why the skin under the eyes creases so easily
The skin of the lower eyelid is among the thinnest on the body, with very few oil glands and little underlying support. Beneath it sits the orbicularis oculi, a ring-shaped muscle that contracts every time you blink, smile or squint. Over years, that constant movement folds the skin in the same places, and fine lines gradually become fixed creases.
Because there is so little padding here, even small changes in hydration, collagen or fat volume show quickly. That is why under-eye lines are often one of the first signs of ageing people notice, sometimes as early as the late twenties.
The main causes
- Intrinsic ageing: collagen and elastin production slows, so the skin becomes thinner and less springy.
- Sun damage: ultraviolet light breaks down collagen and is a major driver of crepey texture under the eyes.
- Expression lines: smiling and squinting create radiating lines at the outer corners, often called crow’s feet.
- Smoking: reduces blood supply to the skin and accelerates collagen loss.
- Volume change: loss or descent of fat in the cheek and lid can leave skin loose and folded.
- Excess skin: some people develop redundant lower-lid skin that pleats when they smile.
Most people have a combination of these factors, which is why an accurate assessment matters before choosing a treatment.
Fine lines, crepey skin or bags: telling them apart
It helps to separate three different problems. Fine lines are shallow creases that are mostly visible when you smile. Crepey skin is thin, finely wrinkled skin that looks like tissue paper even at rest. Bags are bulges caused by fat pushing forward from behind the eyelid, sometimes with a groove beneath them.
Each responds to different approaches. Treating bags with skincare alone will not help, and adding filler to crepey skin can make it look heavier. Mr Nassab examines the lower lid at rest and in movement, checks skin laxity and lid tone, and considers the cheek and brow before recommending anything.
Skincare and non-surgical options
For early lines, consistent daily care can make a visible difference over months:
- Sun protection: a broad-spectrum SPF and good sunglasses reduce further damage and squinting.
- Retinoids: a gentle eye-area retinoid, introduced slowly, can improve texture over time.
- Moisturisers: hydrating products plump the surface temporarily and reduce the look of fine lines.
- Anti-wrinkle injections: small doses at the outer corner can soften crow’s feet; treatment directly beneath the lower lid needs care to avoid affecting lid support.
- Dermal fillers: may help a hollow tear trough in carefully selected patients, but are not a treatment for wrinkles in thin skin.
Non-surgical results are temporary, and some treatments need repeating. You can read more about dermal fillers on their own page.
When lower eyelid surgery is worth considering
Where lines are caused mainly by loose skin, bulging fat or a deep groove at the lid-cheek junction, a lower blepharoplasty may be more effective than repeated non-surgical treatment. Depending on the findings, surgery can remove or reposition fat, trim a small amount of excess skin through a fine incision just beneath the lashes, and tighten the lower lid so it sits well.
Surgery does not remove every fine line. Crepey texture often improves only partly, and expression lines at the outer corners may persist. Mr Nassab will explain which parts of the problem surgery can address and which are better managed with skincare or other treatments afterwards.
Recovery and realistic expectations
Lower eyelid surgery is usually carried out as a day case. Swelling and bruising are common for one to two weeks, and most people return to desk work after about ten to fourteen days. The final result settles over several months as swelling resolves and the incision fades.
The aim is a smoother, fresher lower lid that still looks natural, not a stretched or altered appearance. Ageing continues after any treatment, so protecting the skin from the sun remains important. Lower blepharoplasty is priced from £7,500 and a full breakdown is available on the prices page.
Frequently Asked Questions
Can eye cream get rid of under-eye wrinkles?
Eye creams can improve hydration and, with ingredients such as retinoids, gradually refine texture. They cannot remove deep creases, loose skin or bags.
At what age do under-eye wrinkles start?
It varies widely with genetics, sun exposure and smoking. Many people notice fine lines in their late twenties or thirties, with more obvious changes later.
Is filler good for under-eye wrinkles?
Filler is designed to restore volume, not treat wrinkled skin. In thin, crepey skin it can look lumpy or puffy, so it is used selectively after careful assessment.
Will blepharoplasty remove all my under-eye lines?
It can improve lines caused by loose skin and bags, but fine surface lines and crow’s feet may remain. Mr Nassab will discuss what is realistic in your case.
Is lower eyelid surgery painful?
Most people describe discomfort rather than pain, managed with simple painkillers and cold compresses for the first few days.
