Crow's Feet: Lines at the Corners of the Eyes and How to Treat Them

In a photo where you are smiling, or in the mirror in the morning daylight, you notice fine lines fanning out from the outer corner of your eyes: these are crow's feet, the lines at the corners of the eyes that show mostly when you smile. They form when the muscle around the eye contracts. A muscle-relaxing injection acts on this movement; it is one of the cosmetic injections offered by CARE MD.

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Face of a fictional woman smiling broadly, in a tight crop of the upper face: the fine lines fanning out from the outer corners of the eyes are visible as they naturally appear, with no marking or retouching of the skin.

At a glance

Six things to know before deciding

What forms them: the repeated folding of the muscle around the eye when you smile, then age and skin condition, which eventually set the lines even at rest.
What an injection can do: relax this muscle so the skin creases less when you smile; it does not fill a line that is already etched in and does not guarantee that it will disappear.
Duration: temporary, several months, varies from person to person, with no guarantee.
Risk specific to this area: a drooping eyelid or eyebrow, sometimes double vision, when the product spreads too close to the eye.
Before any treatment: a medical assessment, which may lead to postponing or changing the injection, or deciding not to perform it.
Eyelids, dark circles and under-eye bags: CARE MD treats dark circles and under-eye bags; an eyelid that droops after the injection should be reported as soon as it appears.

Where the lines at the corners of the eyes come from

Each time you smile, laugh or squint in the sun, the muscle around the eye contracts and the skin at the outer corner creases in a fan shape. At first, the lines show only when you smile. Over time, these wrinkles can stay visible at rest. This does not happen at the same age for everyone.

Smiling face of a fictional man, the lines at the corners of his eyes naturally visible when he smiles, with no marking or retouching of the skin.

Skin condition matters too. With age, skin loses elasticity, muscles become more active, and the amount of collagen and fat decreases. The sun is the factor that damages skin the most and can etch fine or deep lines into it. Smoking and heredity also contribute, to a degree that varies from person to person.

Dynamic wrinkle: Visible only when the muscle is working, when you smile or squint.
Static wrinkle: Visible at rest too, because the skin has kept the mark of the movement.
What adds to them: The sun, smoking, heredity and the loss of skin elasticity with age.

What a muscle-relaxing injection changes in crow's feet, and what it leaves in place

A muscle-relaxing injection keeps a muscle from contracting, to soften the wrinkles already there. It is also called a neuromodulator, with brand names such as Botox^® or Dysport^®. At the corner of the eye, the aim is to relax the muscle that folds the skin when you smile: if it pulls less, the fan of lines creases less deeply. This injection is used mostly to soften dynamic wrinkles: crow's feet, but also the frown line, the crease between the eyebrows, and forehead lines.

Its limit is clear: the injection acts on movement, not on a line that is already etched in. It is less effective at softening lines that are pronounced even at rest. Deep creases call for other treatments, such as filler or laser. It does not tighten the skin or restore volume. It does not guarantee that wrinkles will disappear, or an identical result from one person to the next. It does not treat the eyelid itself, dark circles or under-eye bags either.

This type of injection can relax the muscles of a clenching jaw, with masseter injection, or those that form bands in the neck, with the Nefertiti lift, and reduce excessive underarm sweating; precautions differ depending on the area treated.

CARE MD offers this injection for crow's feet. A physician, or a nurse injector supervised by a physician, performs the injection. At the assessment, the physician specifies the product and the limits of treatment for this area.

Acts on: The movement of the muscle that folds the skin when you smile, not a line that is already set in.
Who it is for: An adult whose lines deepen mainly when they smile, after assessment by a physician.
What it does not guarantee: That marked lines at rest will disappear, or an identical result from one person to the next.
Who performs it: A physician, or a nurse injector supervised by a physician.
Product and limits for this area: To be specified at the assessment.

When to postpone or skip it

Inflamed or infected skin, hypersensitivity to an ingredient in the product; extreme caution is needed with neurological conditions, difficulty swallowing or breathing problems.

How long the effect lasts

The effect does not appear the same day: the muscle relaxes fully within a few days, up to about two weeks. The effect is then temporary and fades over several months. A single treatment can be enough to maintain the effect for several months on lines that are marked when you smile. The result and how long it lasts vary from person to person.

To maintain the effect, the injection has to be repeated. The timing is discussed at the assessment, based on your lines and what you want. Pain or a bruise may appear at the injection site.

The risks of an injection this close to the eye

Near the eye, the first risk to know about is ptosis: a drooping eyelid. It is associated with an injection placed incorrectly in the forehead or around the eyes. The injection softens wrinkles, but it can cause an eyelid to droop: this is the main serious complication in this area. If the product spreads around the injection site, an eyebrow can also droop or vision can become double. A headache or a change in eyelid sensation may also appear. These effects are uncommon.

The most common effects are a bruise or hematoma at the injection site, and a headache. Facial pain, eye swelling, a rash or allergic reaction, or localized facial muscle weakness can also occur. These effects are usually temporary, but they can last several months.

These risks are why the injection must be entrusted to a qualified, experienced health care professional, and why you need to understand the benefits as well as the risks before starting.

Signs that require medical attention

After an injection, most effects are mild and short-lived. Call CARE MD if an eyelid or eyebrow droops, if your vision becomes double, if an eye swells, if a rash appears, or if an unusual effect persists or worries you. Only a physician can make a diagnosis.

Are there other treatments for the lines at the corners of the eyes

Against the signs of skin aging, options include surgery, laser, microdermabrasion, chemical peels, filler and the muscle-relaxing injection. Treating crow's feet depends mostly on what you see in the mirror: peels and resurfacing lasers can improve fine lines and static creases, but have no effect on dynamic wrinkles. Lines that show only when you smile therefore come from muscle movement. For creases already etched in at rest, filler, another type of cosmetic injection, or laser serve a different goal.

For crow's feet, hyaluronic acid does not pursue the same goal as a muscle-relaxing injection: it targets creases already etched in, not the movement. At the assessment, the physician determines whether it is appropriate for this area, without promising a result. CARE MD also offers laser and focused ultrasound, with no needle; at the assessment, the physician will tell you whether either is appropriate for your lines.

Lines visible mainly when you smile: The muscle-relaxing injection targets these dynamic wrinkles.
Creases visible at rest: Other treatments come into play, such as filler or laser.
Hyaluronic acid: A different goal from relaxing a muscle; whether to use it for crow's feet is discussed at the assessment.
Offered by CARE MD: The muscle-relaxing injection, laser and focused ultrasound; whether to use hyaluronic acid for crow's feet is discussed at the assessment.

Why a medical assessment comes first

Before proposing a treatment, the physician needs to know your situation. During the assessment, they look at your lines at rest and when you smile, as well as the position of your eyebrows and eyelids. They also take the time to listen to what you expect. The assessment may also lead to postponing the injection, changing it or deciding not to perform it: inflamed or infected skin, hypersensitivity to an ingredient in the product, a history of neurological conditions, difficulty swallowing or breathing problems can justify this decision.

Bring the information that could change the decision: your medical history, allergies, medications and supplements, and previous treatments. Tell the physician if you are pregnant or breastfeeding. Ask how these injections may interact with other products, other procedures or medications you take for other conditions. Write down your questions about how much your lines could improve, the risks specific to this area, how long the effect lasts and what happens if you are not happy with the result.

Eyelids, dark circles and under-eye bags

If an eyelid droops after the injection, tell CARE MD as soon as it appears: this effect of the injection is different from an eyelid weighed down by age. CARE MD also treats dark circles and under-eye bags, and offers aesthetic care for the face.

Ask us your questions about the lines at the corners of your eyes

Frequently asked questions

Where do crow's feet come from and why do they set in?

They come mainly from the muscle around the eye, which folds the skin at the outer corner each time you smile or squint. Over the years, the skin loses elasticity, the sun and tobacco damage it, and a wrinkle visible only in motion can become visible at rest too. This does not happen at the same age for everyone.

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