Introduction

The delicate skin beneath the eyes is up to five times thinner than the rest of the face, making it especially prone to fine wrinkling and texture changes. Over time, reduced collagen, repetitive motion, dehydration, and UV exposure lead to the papery, crinkled appearance known as crepey skin. While patients often mistake this for pigmentation or puffiness, its root cause is structural—not cosmetic only.

In this guide, we’ll break down the mechanisms behind under eye crepiness, evidence-based treatment strategies, and combination protocols you can apply in aesthetic practice. To expand your skills in peri-orbital rejuvenation, explore expert-led training modules available on Empire On-Demand.

Understanding Crepey Skin Under the Eyes

Snippet: Crepey under-eye skin is caused by collagen loss, dehydration, and thin dermal structure compounded by constant movement.

Under-eye skin has minimal oil glands and reduced dermal collagen, making it more susceptible to aging and photodamage. Studies published in Dermatologic Surgery confirm that fibroblast activity in periorbital skin declines earlier than in other regions, while repetitive squinting accelerates fine rhytid formation.

Common contributing factors include:

• Intrinsic aging: Collagen, elastin, and hyaluronic acid depletion.

• Photoaging: UV-induced elastosis and oxidative stress.

• Dehydration: Barrier dysfunction and trans-epidermal water loss.

• Genetics: Inherited thin skin and early wrinkle tendency.

• Lifestyle: Smoking, poor sleep, and digital eye strain.

Professional Treatment Options

1. Microneedling and Radiofrequency Microneedling

Snippet: Controlled dermal injury stimulates collagen remodeling to improve thin, wrinkled skin.

Microneedling increases fibroblast activity and collagen production. When combined with radiofrequency (RF), energy penetrates deeper layers to tighten and smooth the skin. Clinical research in Aesthetic Plastic Surgery shows significant improvement in periorbital wrinkles after a series of RF-microneedling sessions spaced four weeks apart.

For in-depth training on safe under-eye needling depth, eye-safety parameters, and post-care, aesthetic providers can learn from Master Eyes Injection Training.

2. Fractional Laser Resurfacing

Snippet: Fractional lasers target texture irregularities and photodamage around the eyes.

Non-ablative fractional lasers (1,550 nm) improve collagen density and fine lines with minimal downtime, while fractional CO₂ offers more dramatic tightening. These are ideal for moderate crepiness and pigmentation around the infraorbital region. Studies show up to 40% improvement in dermal thickness after three fractional sessions.

3. Chemical Peels and Topical Retinoids

Snippet: Chemical exfoliation enhances cell turnover and boosts collagen synthesis.

Low-strength trichloroacetic acid (TCA) peels and retinoid creams gently resurface thin under-eye skin. Topical retinoic acid 0.025–0.05% has demonstrated measurable increases in dermal collagen within 12 weeks of use, according to The Journal of Investigative Dermatology.

4. Injectable Biostimulators and Fillers

Snippet: Restoring support and hydration beneath thin skin reduces the crepey appearance.

Injectable hyaluronic acid fillers provide volume and moisture, improving light reflection and smoothness. For patients with mild hollowness and texture, ultra-soft fillers placed superficially can yield natural results. Alternatively, collagen-stimulating agents like calcium hydroxylapatite or polylactic acid trigger neocollagenesis for longer-term improvement.

Providers mastering safe tear trough injections can elevate outcomes through Treating the Tear Trough Using Belotero — covering anatomy, filler rheology, and complication avoidance.

5. Topical Peptides and Growth Factors

Snippet: Peptides strengthen skin structure and complement procedural treatments.

Topical copper peptides, palmitoyl pentapeptides, and growth-factor serums help rebuild dermal matrix proteins. Recent trials demonstrate increased skin elasticity and density after 8–12 weeks of consistent use. Incorporating peptide-based maintenance between procedures enhances both short- and long-term results.

Clinicians interested in integrating regenerative peptide science into aesthetic protocols can further explore Peptide Therapies Treatment Training.

Combination Treatment Strategy

Snippet: The best outcomes come from layering therapies for collagen induction, hydration, and skin repair.

Example sequence:

1. Phase 1 (Weeks 0–4): Microneedling or RF-microneedling series to rebuild collagen.

2. Phase 2 (Weeks 4–8): Fractional laser for texture refinement.

3. Phase 3 (Weeks 8–12): Superficial filler or biostimulator injection to restore volume and elasticity.

4. Maintenance: Topical retinoids, peptides, and SPF 30+ daily.

This integrative approach targets every layer of under-eye aging—epidermal turnover, dermal remodeling, and volumetric support.

Home Care Recommendations

• Use retinoid cream or serum nightly as tolerated.

• Apply antioxidant eye serum each morning to fight free radicals.

• Maintain hydration and gentle cleansing—avoid harsh scrubbing.

• Always apply SPF 30+ under and around the eyes.

• Encourage adequate sleep and reduce screen time to minimize muscle strain.

Clinical Takeaway

Under-eye crepey skin is a multifactorial challenge requiring layered solutions. Combining collagen-inducing treatments, injectable hydration, and peptide-based maintenance produces visible, lasting rejuvenation. With a sound understanding of anatomy and careful technique, providers can deliver natural results and boost patient confidence.

FAQs

1. What causes crepey skin under the eyes?
   Primarily collagen loss, dehydration, and sun damage leading to thinning skin.

2. Can creams fix crepey skin?
   They improve texture but can’t replace lost collagen; procedures provide stronger results.

3. Is microneedling safe near the eyes?
   Yes, when performed by trained professionals using proper depth and eye protection.

4. How many treatments are needed?
   Usually three to four sessions spaced four weeks apart for optimal results.

5. Can fillers treat crepey skin?
   Yes, soft hyaluronic acid fillers can smooth and hydrate thin under-eye skin.

6. Do peptides really work?
   Clinical studies show measurable increases in firmness and elasticity after 8–12 weeks of peptide use.

7. What’s the downtime?
   Mild redness or flaking for one to three days after microneedling or laser treatment.

8. When should patients start treatment?
   Early signs—fine lines and dryness—respond best to preventative collagen stimulation.

9. Can lifestyle changes help?
   Yes. Hydration, sun protection, and good sleep habits greatly support skin quality.

10. How long do results last?
    With maintenance, results typically persist 12–18 months before touch-ups are needed.

References

• Alam M, et al. “Microneedling and Combination Radiofrequency for Periorbital Wrinkles.” Aesthetic Plast Surg. 2025.

• Carruthers J, et al. “Periorbital Skin Aging: Structural and Functional Changes.” Dermatol Surg. 2023.

• Kim HJ, et al. “Fractional Laser Resurfacing for Infraorbital Wrinkles.” Lasers Surg Med. 2022.

• Varani J, et al. “Retinoic Acid and Collagen Formation.” J Invest Dermatol. 2018.

• Gold MH, et al. “Efficacy of Peptide-Based Skincare for Periorbital Rejuvenation.” J Cosmet Dermatol. 2024.