Crow's feet why they form, and which treatment fits which line

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What crow's feet are

Crow's feet, which doctors call lateral canthal lines, are the lines that radiate from the outer corner of each eye towards the temple and cheek. They are among the first lines to appear, often in the late twenties, because the skin around the eyes is among the thinnest on the face and is folded thousands of times a day.

They are made by the orbicularis oculi, a ring-shaped muscle that closes the eye and tightens when you smile, laugh or squint. A genuine smile pulls this muscle, which is why crow's feet are sometimes called laughter lines. Some people find them friendly; others feel they look tired or older in photos.

Crow's feet are related to, but different from, lines under the lower lashes, crepey under-eye skin and eye bags. Each needs a different approach, so it helps to know which you are looking at.

Causes

Why crow's feet form, and why early in Singapore

Most people have a combination. A doctor or your Aesthetic Specialist will look at the area at rest and while you smile before suggesting anything.

• Smiling and squinting: every contraction of the orbicularis oculi folds the skin in the same fan pattern.
• Sun: ultraviolet light breaks down collagen and elastin. Singapore's UV index is high all year, and squinting in bright light adds more folding.
• Thin skin: the skin beside the eye has little fat underneath and few oil glands, so it shows creases early and dries easily.
• Collagen loss with age: the dermis thins and becomes less elastic, so lines that once disappeared after a smile start to stay.
• Habits: rubbing the eyes, smoking, poor sleep and dehydration all make lines look deeper.
• Volume changes: as the cheek and temple lose some fullness with age, the skin beside the eye has less support and can crease more.

Self-check

Smile lines, lines at rest, or crepey skin?

In good daylight, a few simple checks give a useful first idea of what is driving your crow's feet. They are not a diagnosis.

• Relax your face and look straight ahead. If no lines show, and they appear only when you smile, they are dynamic lines made by muscle.
• If faint lines remain with the face relaxed, they are partly static, meaning collagen loss has etched them into the skin.
• Gently press and slide the skin at the outer corner. Fine crinkling like tissue paper points to crepey, thin or dehydrated skin.
• Look below the eye. Puffiness or a bulge is usually fat or fluid, not a line, and needs a different assessment.

Matching the treatment

Crow's feet type, what helps, and where

SkinRev Lab prices are per session, before GST. Medical treatments at IN Eternity Clinic are performed by Dr Sin Yong and priced at consultation by the clinic.

Injectables

Wrinkle-relaxing injections for smile-driven crow's feet

Wrinkle-relaxing injections are a prescription treatment that reduces the pull of the outer part of the orbicularis oculi. A few small amounts are placed beside the outer corner of each eye. The effect appears over a few days, peaks at about two weeks and wears off gradually over the following months, commonly after about three to four months.

In a multicentre randomised trial of 445 people with moderate to severe crow's feet, 66.7% of treated people reached none or mild lines at full smile on day 30, by investigator assessment, compared with 6.7% on placebo. In a 13-month trial in Japanese adults treated repeatedly for crow's feet and frown lines, between 85% and 90% were responders for crow's feet at day 30, with responses holding steady across repeated treatments.

Placement matters around the eye. Too much, or placement too low or too far in, can flatten the smile, change how the cheek lifts, or make under-eye bags look more obvious. A careful doctor aims to soften the lines while keeping a natural, warm smile, and may advise against treating the lower lid at all if you have puffiness there.

Collagen and skin quality

RF microneedling, lasers and skin boosters for etched lines

Relaxing the muscle does little for lines made by thin, sun-damaged skin. For those, the aim is to rebuild collagen or improve hydration in the dermis. At IN Eternity Clinic, Dr Sin Yong uses RF microneedling, where fine needles deliver radiofrequency heat inside the skin at a shallow depth suited to the eye area. In a small study of 11 Korean adults, all showed improvement in lateral periorbital wrinkles after microneedle fractional RF, with better skin hydration; it is promising but small.

Non-ablative lasers heat the dermis beneath an intact surface, so recovery is quicker than with ablative resurfacing. IN Eternity Clinic's FSX Laser is a multi-pass thulium and erbium-glass protocol used for fine lines and skin quality. Ablative resurfacing can make bigger changes to deeper etched lines but needs about a week of recovery and carries more risk. In Asian skin, post-inflammatory hyperpigmentation (PIH) after fractional laser is a real risk; a study of Chinese patients found energy, density and cooling all affected it, so settings are deliberately cautious.

Injectable skin boosters place tiny amounts of soft hyaluronic acid, polynucleotides or similar materials into the skin to improve hydration, texture and crepiness. A 2024 review described them as a growing option for skin quality, with evidence still developing. They do not relax muscles or add shape, and injections near the eye still need careful technique.

SkinRev Lab · Non-invasive

SKINTIGHT and HydraFacial Perk Eye at SkinRev Lab

SKINTIGHT is a microplasma resurfacing and tightening session on the Alma PrimeX. A pin-tip applicator forms fine micro-channels in the skin surface while warming the dermis, prompting collagen renewal over the following weeks. Settings are adjusted for the delicate eye area, and the upper and lower eyes are treated together as one zone at S$588, before GST. Mild redness for a few hours is usual at tightening settings. It suits fine crepiness and mild laxity; it does not relax the muscle that makes smile lines.

HydraFacial Perk Eye is a short, roughly 15-minute treatment on the HydraFacial Syndeo, using a roller-flex applicator worked gently around the orbital bone with an antioxidant serum, finished with a take-home eye product. It can make dry, tired-looking skin look smoother and fresher for a while, which is why people book it before an event. It does not rebuild collagen or change crow's feet made by movement. It can be booked alone or added to any HydraFacial tier; ask the price at the counter.

If your crow's feet are mainly smile lines, your Aesthetic Specialist will say so and can pass your enquiry to IN Eternity Clinic. Dr Sin Yong, SkinRev Lab's Medical Adviser, trains the team hands-on on the treatment machines in the centre.

Prevention

Slowing crow's feet down

• Use a broad-spectrum sunscreen every day, right up to the outer eye, and reapply outdoors. In a randomised trial of 903 adults over four and a half years, daily sunscreen users showed no detectable increase in skin ageing.
• Wear sunglasses with UV protection so you squint less in Singapore's bright light.
• Moisturise the eye area morning and night; dehydrated skin creases more visibly.
• Introduce a retinoid eye-area product slowly if your skin tolerates it, and stop if it stings or flakes.
• Avoid rubbing your eyes, and treat itchy, allergic eyes with your doctor.
• Do not smoke, and protect your sleep; both affect how the skin repairs.

Safety

Risks, and when to see a doctor first

After wrinkle-relaxing injections around the eyes, small bumps that settle within half an hour and pinpoint bruising are common. Less often, the smile can look flatter, the eyes can feel dry, or under-eye puffiness can look more obvious for a few weeks until the effect wears off. RF microneedling and lasers cause redness and swelling for a few days, and in darker or Asian skin can leave temporary darkening, which is why sun protection around each session matters.

Wrinkle-relaxing injections are not given during pregnancy or breastfeeding, or to people with neuromuscular conditions such as myasthenia gravis. See a doctor rather than booking a cosmetic treatment if you have a growth or spot near the eye that is new or changing, eyelid swelling that comes and goes, or a rash around the eyes.

Where to go

Crow's feet treatment in our network

Wrinkle-relaxing injections, RF microneedling, FSX Laser and injectable skin boosters are performed by Dr Sin Yong at IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, beside Orchard MRT. He looks at the eye area at rest and while smiling before advising, and treatment is priced at consultation by the clinic; WhatsApp +65 8815 3008.

SKINTIGHT and HydraFacial Perk Eye are at SkinRev Lab, #B1-28 CityLink Mall, on the underground link between City Hall and Esplanade MRT, open daily 11am to 8pm. Results vary between people, and for many, combining approaches works better than any one treatment.

Sources

References & sources

1. Carruthers A, Bruce S, de Coninck A, et al. Efficacy and safety of onabotulinumtoxinA for the treatment of crows feet lines: a multicenter, randomized, controlled trial. Dermatol Surg. 2014;40(11):1181-1190.
2. Kawashima M, Harii K, Horiuchi Y, et al. Safety, efficacy, and patient satisfaction with onabotulinumtoxinA for the treatment of upper facial lines in Japanese subjects. Dermatol Surg. 2020;46(4):483-490.
3. Kim KE, Park JH, Seul TW, Kim IH, Ryu HJ. Periorbital skin rejuvenation of Asian skin using microneedle fractional radiofrequency. Ann Dermatol. 2023;35(5):360-366.
4. Chan HH, Manstein D, Yu CS, Shek S, Kono T, Wei WI. The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians. Lasers Surg Med. 2007;39(5):381-385.
5. Rho NK, Kim HS, Kim SY, Lee W. Injectable skin boosters in aging skin rejuvenation: a current overview. Arch Plast Surg. 2024;51(6):528-541.
6. Hughes MC, Williams GM, Baker P, Green AC. Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med. 2013;158(11):781-790.

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