Dear Beauty Editor,
I need eye help. My lids are crepey, so I’ve been putting those eye patches over my eyes instead of under them — with middling results. But when I’ve tried eye cream it causes milia. What should I do?
—Ryan
I’ve never heard of anyone wearing eye patches — which are typically designed to go beneath your eyes — on their lids, so let me start by saying I am delighted by your ingenuity. But I’m not surprised your clever hack didn’t change your skin all that much. Most of the things that will improve the appearance of crepey lids, like in-office radiofrequency treatments or plastic surgery, are going to be more invasive (and costly) than silicone patches.
Before we get to those, I want to make sure that anyone who is inspired by your experiment only tries it with patches made of medical-grade silicone sheeting, like the Dieux Skin Forever Eye Mask or Wrinkles Schminkles Eye Wrinkle Patches. Silicone is occlusive, so the patches allow your skin to luxuriate in a more hydrated environment, which may temporarily plump the skin underneath. (Key words being may and temporarily — which it sounds like you’ve already realized.) Please don’t try this with patches that are pre-soaked in skin care; the occlusive material ups the potency of any ingredients on the patches, and that could irritate the thin skin of your eyelids, says board-certified dermatologist Ranella Hirsch, MD.
If you’re prone to milia, those little white bumps caused by a buildup of keratin, you could switch to an eye cream with a lighter consistency, since heavy moisturizers are known to exacerbate the condition. I’ve found a few that are pretty good at brightening under-eye discoloration and softening lines (Skinceuticals A.G.E. Eye Complex for Dark Circles is currently in rotation), but I have yet to find an eye cream that smoothes or tightens crepey skin significantly.
So what will improve your lids? Hirsch offered two suggestions: Thermage, a skin-tightening radiofrequency treatment, and blepharoplasty, a surgical procedure that improves the appearance of your eyelids by trimming and tightening the skin (with either a scalpel or, increasingly, a laser). Hirsch says Thermage can be painful and expensive (on average, the procedure costs about $3,000, according to patients who self-reported their costs to the website RealSelf). And this is not some low-stakes tweakment you should get from a facialist or at a drop-in med clinic. “Make damn sure your provider knows what they are doing,” says Hirsch, who adds that some of the worst burns she’s seen in her practice are from patients who went to improperly trained Thermage providers. Of course, eyelid surgery isn’t cheap either (RealSelf reports an average cost of $5,400). But there are multiple types of eyelid surgery now available, and some can happen without anesthesia or much downtime at all. It can be “far less invasive than people think,” Hirsch says.
If you’re intrigued by either of the options above, I suggest you book consultations with a dermatologist (ideally one whose practice is focused on cosmetic dermatology) and a plastic surgeon or ophthalmologist who specializes in oculoplastics to discuss your options. Depending on your bone structure, your eye shape, how lax your skin is, and the quality of your skin and the fat beneath it, it might make more sense to skip over the treatment and go right for the surgery. I’m not saying that’s always the case or even trying to push you in that direction. But I’ve noticed that a lot of people who are ready to try anti-aging procedures for the first time approach their decision with the notion that a “treatment” is always less invasive than the “surgery,” and that they should try the treatment first and then, eventually (or if they’re not happy with the treatment results), they can have surgery. But loose or crepey eyelids are a special case, and no good doctor (or self-respecting beauty editor) would give you a recommendation or advice without seeing your face first.
As you contemplate your next step, please remember there’s one other option to consider: You can do nothing at all. Will crepey eyelids make you look older than you did ten years ago? Sure. Does crinkly skin make applying eyeliner more difficult? Absolutely. But textured lids are also a sign that you’ve smiled and laughed and spent days in the warm sun and nights with your face pressed against a cool pillow. In my opinion, that’s nothing to hide — but you pull an Anna Wintour and start wearing sunglasses indoors if you disagree.
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