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Droopy Eyelids | Anti-aging for Dermatochalasis of the upper eyelid

Droopy eyelids, also referred to as heavy eyelids or dermatochalasis of the upper eyelid, is a common change to see in the eyelid skin as we age. It is the result of thinning of the skin and loss of elasticity that causes the skin to sag over the upper outer eye. Although some people may think of this as a cosmetic concern, it is more of a medical concern. Read more...
 

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droopy eyelid

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What is the most common complaint you hear from patients about their upper eyelids as they get older?



Droopy eyelids, also referred to as heavy eyelids or dermatochalasis of the upper eyelid, is a common change to see in the eyelid skin as we age. It is the result of thinning of the skin and loss of elasticity that causes the skin to sag over the upper outer eye.



Video: Techei



Why would patients see their dermatologist about dermatochalasis and not their eye doctor?



This is interesting since one of the most common reasons for patients to present to me is not necessarily for their eyelids but for wrinkles along the lateral forehead above the eyebrows. I have had patients present with concerns about how deep or etched these lines may be and requesting Botox or other neurotoxins to address it. These patients require careful examination to determine the reason for these lines. I have found that in many cases these wrinkles are ironically the result of excess effort placed on raising the eyelids. Many patients do not realize it but they are actually recruiting their forehead muscles to help hold their eyes open. Once I determine this through close evaluation, I must discuss with these patients that injections of neurotoxins such as Botox would run the risk of making the eyelid feel heavier. I often have to refer these patients to their ophthalmologist or oculoplastics for further evaluation and management.



Can an eye cream be used to treat droopy eyelids?



The loss of elasticity in the upper eyelids along with thinning of the skin and excess skin would be challenging for an eye cream to address. Eye creams can hydrate the skin and may have added ingredients that over the long run could potentially reduce collagen breakdown and potentially increase collagen production.


Some eye creams may have ingredients that work by almost "gripping" the skin to make it appear taut while the cream is applied. This is achieved sometimes through the use of silicates such as magnesium aluminum silicate. Waxes and other thickening agents can also achieve a similar result as they tighten once applied to the skin. This is not a long-term benefit for the eyelid skin. It is what I refer to as a "Skincare Cinderella Effect" - a temporary benefit that wears off once the product wears off. This is not necessarily bad for your skin, because there can be a brief cosmetic benefit noted on immediate use.


Aside from creams, however, there is a prescription eye drop called Upneeq that has oxymetazoline as an active ingredient. It works by stimulating an involuntary muscle group in the upper outer eyelid to allow the eyelid to open more with less effort. Again, this is only a temporary effect lasting as long as the product has an effect over the course of a day but wears off without a long-term benefit. This eyedrop is not routinely covered by insurance and can be costly to maintain.


But I have found eye creams that claim to "visibly lift the eyes". How do these work?



Remember that claims to "visibly lift the eyes" are cosmetic claims that do not require proof of actually lifting the eyes. Let's take a look at the products out there.



The first product I found that claims to lift the eyes was Clinique's Repairwear Anti-Gravity Eye Cream. It claims that it "virtually defies gravity". Reviewing the ingredients reveals several hydrating ingredients. The appearance of crepey skin over the upper eyelids will likely appear smoother while using the product, however, it is difficult to say if there is a long-term benefit for this product and it is not at all likely that this product is altering the skin to remove the redundant skin that has developed.



Dermalogica Stress Positive Eye Lift Cream claims that "Fermented Yeast and Hyaluronic Acid: Helps firm and hydrate the skin to generate a lifting effect, as well as protect the moisture barrier". Fermented yeast may have some antioxidant and anti-inflammatory benefits that may support collagen production over time as well as hydrate the skin. Hyaluronic acid is a moisturizer when applied topically. Again, the "lifting effect" may just be that - a visible effect of hydration that is temporary.



I am happy to evaluate other brands you may come across if you leave a comment or request for me to do so and we can update this blog and add videos to review products!



Droopy Eyelid


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