I’m beginning to get lines under my eye. They have all appeared in the last 2-3 months. I’m only 20. Should I get Botox?

Dr. Dean Kane Q & A Q. I use my eyes a lot when I talk. I have high dimples below my eyes so constantly cause creases when smiling. New lines seem to be constantly appearing. Mostly on my right eye. I also have milia around my eyes and on my cheeks. I have acne also… mostly comedoneal blackheads. My current routine includes salicylic acid face wash one daily moisturize with a moisturizer that my mum and I made with ingredients including hydralauric acid, rose hip, vitamin a c and e Retina 0.025% once every ten days or so. A. The under eyelid skin wrinkles from the muscles around the eye opening and closing it. ​ Relaxing or weakening this muscle under the eye with Botox may reduce the wrinkle but may also increase puffiness as the muscles do not squeeze the fat and fluid adequately. Over a longer term, it may weaken the lift of the lower lid and sag or “round” the lower eyelid. ​ ​Lines appear when the epidermal skin layers build on either side of the crease and / or the dermis becomes thinner along the crease. Their improvement are best approached with exfoliation of the dry epidermal skin and stimulation of the dermis to create more collagen and structural molecules to resist wrinkling. ​ ​Milia and blackheads develop as the oils from the dermal oil glands are trapped from flowing onto the skin due to non-exfoliated epidermal skin layers. ​ ​My suggestions include:
  1. ​Your mum understands the essentials of good skin care, so continue with this regimen for the moment until you,
  2. ​Consult with a Board Certified Dermatologist or Plastic Surgeon who understand the virtues of ZO (Obagi) Skin Health.
  3. Consider MORE exfoliation of your skin to:
  4. exfoliate the epidermal dead skin layers and reduce skin line height with a glycolic, salicylic or fruit acid
  5. exfoliate the epidermal dead skin layers to release the flow of oils now trapped with a glycolic, salicylic or fruit acid
  6. stimulate and regulate epidermal and dermal skin function with Retin A or other retinoids more frequently or at higher levels
  7. ​Protect your skin with sunblock and hats (which I presume you do living in Australia).
  8. ​Following optimal skin health care, RE-consult with a well experienced Board Certified Plastic Surgeon or Dermatologist to consider dermal fillers.
I hope this has been helpful! All the best!
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