How to Get Rid of Crow's Feet (and Prevent Them in the First Place)

An Interview With Dr. Neal Schultz of DermTV.com

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Crow's feet—wrinkles around the eyes—are a very common skin issue that usually starts showing up in your 30s. Lotions, supplements, questionable tinctures and other remedies abound, and many call for a healthy dose of skepticism. The best approach is to consult a trusted medical professional.

In a recent interview, New York City dermatologist Neal Schultz, M.D., founder of BeautyRX skin care and frequent contributor on DermTV.com, offered a few tips on both preventing and reducing crow's feet.

Are all lines on the sides of the eyes considered crow's feet?

When you smile, you’ll see small lines going from the corners of your eyes out toward your temple. When you stop smiling, if the lines go away, those are simply smile lines. If the lines stay, those are crow's feet.

Typically, when do men and women start showing signs of crow's feet?

The age is highly variable, but we see many people in their mid-30s starting to see small lines that don’t go away. People could fall into this category in their 20s or not until their 40s, of course, but mid-30s is the average.

What are the main causes of crow's feet?

The three Ss: smiling, squinting, and sleeping, in that order. Smiling is the biggest instigator of crows feet, then squinting, then sleeping.

To get an idea of how wrinkles form, picture a paperclip. When you bend that paperclip back and forth and back and forth, after a while, the paperclip will break.

This is the same with your skin. Repetitive motions that cause creases in your skin can break the collagen and elastic fibers in your skin and cause wrinkles anywhere on the face, not just around the eyes.

Smiling: Smiling is a repetitive movement, and chances are good you smile many times every day.

Everyone smiles a bit differently, but those people who use the muscles next to their eyes when they smile obviously will get crow's feet earlier than people who don’t.

Squinting: You should wear sunglasses every single day, all year round. This is because squinting from the sun is a repetitive movement, and just as in that paper clip analogy, continuous squinting causes the collagen and elastic fibers to break down and wrinkles to form.

Sleeping: The ideal way to sleep to avoid wrinkles is on your back, using one of the u-shaped travel pillows. This is obviously not something that most people can do, so using a silk pillowcase can help.

Here’s why: When you wake up, do you notice sleep lines? Sometimes, your skin gets pulled on the pillowcase when you are sleeping, and that causes creases in your skin. When you use a silk pillowcase, your skin is able to slide more easily and won’t get tugged or pulled.

What do you recommend for people who don’t yet have deep crow's feet and want to prolong the inevitable?

If preventing crow's feet is important to you, you need to be doing whatever you can at this age to keep the fine lines from getting deeper.

On top of wearing sunglasses daily, I recommend exfoliating daily.

The gold standard in exfoliation is glycolic acid, and I recommend it for anti-aging all the way down to anti-acne. Chemical exfoliants such as glycolic acid work better than physical exfoliants.

Exfoliating works by taking away the dead skin cells on the top layer of your skin, called the epidermis. On top of forcing fresh skin to the surface, this also adds volume to the epidermis, helping to smooth out lines.

Under the epidermis is the dermis, where the collagen is formed. Using glycolic acid to exfoliate helps promote new collagen growth, which also adds volume to the dermis. This easy step can help smooth out the early lines.

I also recommend using peptides. Peptides are tiny particles that the body thinks are little pieces of broken collagen. The body “sees” those broken collagen pieces and, in turn, the dermis makes more collagen to replace the broken collagen.

This helps smooth fine lines.

Speaking of products and ingredients, what do you think about products like Furlesse, with which you literally tape the lines in your skin? Do they really help with wrinkles?

They won’t really smooth the lines unless they have peptides in them. If you use them continuously, you may see a very minimal improvement of maybe 5 percent, but 5 percent is 5 percent!

What can you do in-office that does not involve injections?

In-office glycolic acid peels are a great first start. We use a higher percentage of glycolic acid than you can get at home, and it takes less than 10 minutes for the entire procedure. The acid actually works in two to three minutes.

Also, laser treatments are available. They work by making your body believe there is a small wound. The body reacts by building more collagen to heal the wound.

When do injectable medications come into play?

You can start using preventative botulinum toxin (for example, Botox and Dysport) even before crow's feet are an issue. This helps keep the collagen from breaking down completely, like in the paperclip analogy above. This is a great step that I recommend anyone start when they are noticing those early static lines.

If you’re afraid of the needle, topical botulinum toxin is available in your dermatologist’s office. It has the exact same results as the injectable form with no pain. It will take about 30 minutes in the office, and just like the injectable form, results will last for three to four months.

What about side effects of injectables?

When you use botulinum toxin on your crow's feet, there are no concerns for “frozen face” because the muscles used there are not muscles that you need for most expressions.

Do you ever recommend against injectables?

Botulinum toxin isn’t recommended for those who are pregnant or those who have had facial paralysis such as Bell's palsy until the effects of the palsy are gone. And even then, choose a provider with experience in using injectables on people with a history of facial paralysis.

Any final words of advice about crow's feet?

Preventative care is key. Do what you can early in life to prevent crow’s feet. Also, pass these tips on to your teenage daughters; they'll thank you one day.