Crow's Feet: Why They Form and How They're Treated

Crow's feet are the fan of fine lines at the outer corners of the eyes. They form because a ring-shaped muscle around the eye squeezes the thin skin there every time you smile or squint, and that skin gradually loses its ability to bounce back. Depending on whether the lines come mostly from movement or from skin quality, a neuromodulator, laser treatment, skincare, or a combination may help.

A muscle shaped like a ring

The orbicularis oculi is a flat, circular muscle that surrounds each eye. Its main job is to close the eyelids, from a gentle blink to a tight squeeze. The outer part of this muscle also contracts strongly when you smile genuinely or squint against bright light.

Because the muscle runs in a circle, its pull at the outer corner creates lines that radiate outward, rather like spokes. That is where the name comes from. These lines are a normal part of a warm, expressive smile, and many people have no wish to change them.

Why the skin around the eyes shows lines early

The skin of the eyelids and surrounding area is among the thinnest on the body. It has fewer oil glands and less supporting fat beneath it than skin on the cheeks or forehead. That makes it more prone to dryness and fine creasing.

Several factors speed this up:

• Sun exposure, which breaks down collagen and elastic fibres. The eye area is often missed when applying sunscreen.
• Squinting in bright conditions, including glare from water and snow, or from uncorrected vision.
• Smoking, which reduces blood flow and accelerates skin ageing.
• Natural ageing, as collagen production slows and skin becomes thinner.

Lines that appear only when you smile are dynamic. Lines still visible with the face at rest, often with a crinkled or crepey texture, reflect changes in the skin itself.

Option one: neuromodulator injections

A neuromodulator, such as botulinum toxin type A, relaxes the outer portion of the orbicularis oculi so it squeezes the skin less forcefully. Usually a few small injections are placed just under the skin at the outer edge of each eye, kept a safe distance from the eye itself.

Movement typically softens within 3 to 14 days, and the effect commonly lasts about three months. Some people find the eye area wears off slightly sooner than the frown or forehead, as these muscles are used constantly.

The goal for most people is softening, not removing the smile. Because the muscle is also involved in your expression, too much relaxation can make a smile look less natural. It can also change how the cheek moves in some cases. A conservative plan is usually sensible, especially for a first treatment.

Option two: laser treatment

When crow's feet are visible at rest, or when the skin looks thin and crepey, laser treatment may address the skin rather than the muscle. Resurfacing lasers remove or heat very fine layers of skin in a controlled way, prompting the skin to renew itself and produce new collagen over the following months.

The eye area needs careful, gentle settings because the skin is so thin, and eye protection is essential throughout. Several sessions may be needed, and results build gradually. Laser does not stop the muscle from squeezing, so some people choose to combine it with a neuromodulator. Our article on laser for fine lines and wrinkles explains how this works in more depth.

Option three: skincare and prevention

Skincare will not relax a muscle, but it plays a real role in skin quality, and for mild lines it may be all that is needed. Helpful habits include:

• Applying a broad-spectrum sunscreen daily, including the outer eye area, all year round.
• Wearing sunglasses that block UV light, especially near water or snow.
• Using a gentle moisturiser to support the skin barrier.
• Introducing a retinoid slowly at night, if your skin tolerates it, while keeping it away from the eyelid margin.
• Having your eyes checked if you find yourself squinting often.

Who should not have treatment, or should wait

Neuromodulator treatment is generally avoided during pregnancy and breastfeeding, in people with neuromuscular disorders such as myasthenia gravis, and in anyone with a previous reaction to a botulinum toxin product. Active infection, cold sores or inflamed skin near the eyes should be cleared first. People with dry eye, recent eye surgery or a history of eyelid problems should mention this, since treatment near the eye may not be suitable.

Laser treatment near the eyes may need to be postponed if you have a recent tan, active skin infection, or a history of poor healing or abnormal scarring. Certain medications, including past use of isotretinoin, need to be discussed beforehand. Never stop a prescribed medication on your own.

Possible side effects

For injections, the common effects are small bruises, which show more easily in this thin skin, along with redness and brief tenderness. Less often, people notice a smile that looks uneven, a change in how the lower eyelid or cheek moves, dry or watery eyes, or temporary double vision if product affects muscles that move the eye. These effects are temporary.

For laser, expect redness, swelling and some flaking for a few days, depending on the depth of treatment. Risks include changes in skin colour, infection and, rarely, scarring.

Frequently asked questions

Will crow's feet treatment affect my smile?

It can change it slightly, which is why a light approach is often used. The aim is to soften the lines while keeping your smile looking like your own.

Are crow's feet the same as under-eye creases?

Not exactly. Lines directly under the eye often relate to skin thinness, hollowness or puffiness, and a neuromodulator is used cautiously there, if at all.

When should I see my family doctor instead?

If you notice new swelling, a lump, a change in eyelid position or a spot that is growing, changing or bleeding near the eye, see your family doctor for assessment first.

If crow's feet are on your mind, consider booking a consultation at HealthPark Medical Aesthetics. A physician can look at whether your lines come mainly from movement or from skin changes, and help you decide whether injections, laser, skincare or simply waiting suits you.