Botox for Crow’s Feet: How It Works and Best Tips for Maximizing the Treatment’s Benefits

Crow’s feet are fine lines forming on the outer corners of your eyes. They do not normally pose any serious health risks. But they can make the face look tired and old, prompting people to seek treatment. 

At BHSkin Dermatology, many of our patients ask about getting Botox for crow’s feet in addition to their regular skin care regimen. If you’re curious about the procedure but still unsure about having it, then this article is for you. Here, we discuss how the treatment works and what you can do to get the most out of it. 

To kick things off, we explain the causes of this common skin issue.

What Causes Crow’s Feet?

Crow’s feet form from a combination of different factors.

Repeated Use of Facial Expression Muscles

Years of contracting the facial muscles can crease the overlying skin, forming what are known as “dynamic wrinkles.” Crow’s feet result from the repeated folding of the skin beside the eyes when you smile, squint or frown. Muscular movement is mainly responsible for their presence in young people. But aging and other health-related factors can make them more pronounced the older one gets.

Factors Leading to Skin Structural Changes

The skin loses its elasticity, firmness, and volume over time, giving rise to what we call “static wrinkles.” Primarily responsible for these physical changes are:

• The declining production of the structural skin proteins collagen and elastin
• Subcutaneous fat loss
• Bone loss, making the skin sag

Sun exposure, hormonal and other age-related changes, skin trauma, scarring, poor nutrition, genetics, stress, chronic disease, etc. can all contribute to static wrinkle foWe rmation. These facial lines can occur anywhere, even in areas not affected by moving the muscles of facial expression. But they can worsen the appearance of pre-existing dynamic wrinkles.

It is important to distinguish between these wrinkle types and their causes. Doing so can help you and your doctor figure out your best anti-aging treatment strategy.

How Does Botox Work on Crow’s Feet?

Botox is a drug derived from processing the bacteria-made nerve toxin, botulinum toxin type A. It blocks muscle-stimulating nerve impulses, causing dose-dependent relaxation. Your Botox specialist will inject the drug in key areas near the eyes to smoothen crow’s feet. It is FDA-approved for treating this condition.

If you want to know more about Botox’s actions, we urge you to check out our in-depth Botox treatment guide.

What Are the Side Effects of Botox Crow’s Feet Injection?

The most common reactions to Botox injections are swelling, discomfort and redness. Additionally, the eye area has a rich blood supply, making it bruise-prone. These side effects are normal after piercing the skin and will go away in a few days, even without treatment. However, sensitive patients may relieve inflammatory symptoms by icing the injection sites or taking acetaminophen.

More serious complications may occur, but they are usually due to the provider’s lack of experience performing Botox procedures. They include the following:

• Injection site infection 
• Profuse bleeding
• Severe headache
• Fainting
• Unevenness of facial expressions
• Life-threatening allergy
• Numbness or altered sensation on the injection sites
• Botulinum toxicity

Moreover, compared to other Botox-treatable sites, crow’s feet injection is more likely to produce the following complications:

• Droopy corners of the mouth if the drug is injected too low
• Outward turning of the lower eyelid (ectropion) if the tissues in the area are too lax

Again, these side effects are rare and preventable so long as you’re in the hands of nothing less than a Botox expert.

What Are the Contraindications of Botox Injections?

Botox cosmetic treatment is generally safe. However, some conditions can make the procedure risky for certain patients. They include the following:

• A personal history of botulinum toxin allergy
• Pregnancy and breastfeeding
• Injection or inflammation in the target area
• Systemic infection
• Pre-existing nerve or muscle disorder
• Intake of medications that relax the muscles or block the actions of the muscle-stimulating nerve chemical acetylcholine
• Inborn or acquired blood clotting problems
• Connective tissue disease
• History of severe keloid scarring

So when you consult for crow’s feet treatment, tell your dermatologist if you have a condition that can make Botox injections unsafe for you.

What Can You Expect from Your Crow’s Feet Consultation at BHSkin Dermatology?

At BHSkin Dermatology, we understand that every patient has unique treatment needs.

Your specialist will start the consultation by asking about how your skin issue began and how it has changed over time. They will also take note of parts of your medical and family history that may provide additional clues to the root of the problem.

After that, they will closely examine the skin around your eyes. True crow’s feet are not normally associated with serious health problems. However, if your doctor finds unusual features in the areas of concern, they may ask your permission to inspect other parts of your body. Rest assured that they will proceed with their physical examination with the utmost protection of your privacy.

Once they finish their full assessment, your dermatologist will discuss their findings. They will also explain your treatment options and if Botox is appropriate for you. They will work with you to find you the best age-defying regimen.

What Should You Do to Get Ready for Your Botox Crow’s Feet Treatment?

The pretreatment period is crucial as it helps you avoid potential complications and ensure only the best outcomes. Your doctor may advise you to do the following:

• Refrain from smoking and drinking starting at least a week before your appointment. Cigarettes and alcohol interfere with the skin repair process.
• Avoid blood-thinning medications and supplements, which also delay healing.
• Take bruise-preventing supplements like arnica and bromelain starting 2-4 days before your appointment.
• You may consider doing an extra workout the day before your session. Exercise during the first few hours after injection can ruin Botox’s effects (see below).
• Cleanse your face and keep it free of cosmetics right before your appointment.

We encourage you to read our detailed Botox treatment guide for more great Botox pretreatment prep tips.

What Happens During a Botox Procedure for Crow’s Feet?

During your session, your Botox specialist will first clean up the treatment areas. They may ask you to smile or squint to help them visualize their targets better. They will then inject the medication while applying gentle pressure on your skin. The entire session can be done in a few short minutes, although it takes a bit longer for patients needing topical painkillers.

How Long Does Botox Take to Work on Crow’s Feet?

In the first one to three days after treatment, you will observe gradual weakening of the injected muscles. Expect Botox’s effects to peak by the end of the second week. At that point, you will see a significant reduction of the dynamic wrinkles at the corners of your eyes. Static wrinkles will also smoothen but only to a limited extent.

How Many Times a Year Should You Get Botox for Crow’s Feet?

Three to four months after your session, the treated muscles will slowly recover their strength. Without a repeat Botox injection, the fine lines will return to their untreated state. But you may do as other patients do—getting two to three treatments yearly or as recommended by their dermatologist—to sustain Botox’s effects.

What Are the Dos and Don’ts After Botox Crow’s Feet Injection?

The Botox aftercare regimen is simple, but doing it right prevents many potential problems. We have a full guide on Botox recovery and aftercare, but we will explain it briefly below.

In the first four hours after injection, you must refrain from activities that risk scattering the drug and paralyzing distant muscles. They include:

• Actions that enhance the blood flow to your face, e. g. exercise, suntanning, sauna-bathing, etc.
• Lying on your back
• Scratching or applying heat or heavy pressure on the injection sites

You may resume your normal after this period.

Some patients recover quickly after their Botox session. But if your soreness lingers, you may avoid vigorous activities for a few more days to protect the treated areas from further trauma. Apply makeup only if your skin has no signs of irritation.

The following measures can help clear up bruises fast:

• Ice the treated sites repeatedly during the first 24 hours after your session.
• Continue arnica or bromelain supplementation for a few more days.
• Sleep upright during the first few nights after treatment.
• Refrain from vigorous activities for a few more days.

Your dermatologist may also prescribe an anti-aging skin care regimen to complement your Botox procedure. Follow the instructions religiously.

Good aftercare not only ensures the treatment’s success but also helps you prolong Botox’s cosmetic results. To learn more about making Botox last longer, you may read our article on the subject.

Is Botox the Best Treatment for Wrinkles Around the Eyes?

That depends on many factors. There are times when Botox has distinct advantages as a standalone crow’s feet treatment over other wrinkle remedies. 

Botox vs. Laser Treatment

Laser skin resurfacing is a type of cosmetic surgery that dermatologists perform. It flattens wrinkles by enhancing skin renewal and collagen production. Ablative lasers strip off the skin surface, creating a more dramatic effect than non-ablative lasers and IPL.

The results of these light treatments are superior and longer-lasting than Botox injection. But their downsides include their high costs, long downtimes, time-consuming aftercare regimens and greater scarring and permanent eye damage risk.

Patients are generally happy with light treatments and know they are worth the discomfort. But if you don’t want their drawbacks, you can always choose Botox for crow’s feet.

Botox vs. Dermal Filler Injection

Dermal fillers produce results instantly, so they work faster than Botox. Their costs depend on the dermal filler type used. Hyaluronic acid-based types like Juvederm and Restylane have comparable prices to Botox.

As the name implies, dermal fillers plump up the skin. Patients who have lost volume around the eyes, e. g. people of advanced age, are good candidates for this treatment. But dermal fillers can make the eyes look puffy if the surrounding tissues have normal volume.

Botox vs. Topical Skin Care Products

Anti-aging topicals typically contain one or more of the following active ingredients:

• Exfoliants like retinol and salicylic acid
• Antioxidants like vitamin E, niacinamide and vitamin C
• Sun-protecting substances like zinc oxide and titanium dioxide
• Moisturizers like ceramides and hyaluronic acid
• Topical treatments alone do not create results as dramatically as Botox. Moreover, they may be less cost-effective over time than getting an occasional in-office cosmetic procedure for the same results. 

If you want to get rid of crow’s feet fast, Botox is preferable over topical skin care products. However, sun protection and a good long-term skin care routine are crucial to prolonging Botox’s effects.

Botox vs. Facial Plastic Surgery

Studies show that Botox creates results comparable to plastic surgery when treating crow’s feet and other dynamic wrinkles. The main advantage of cosmetic surgery done by a plastic surgeon is that its effects last many years. But its downsides are similar to those of laser skin resurfacing: high cost, significant downtime, tedious aftercare and greater side effect risk. 

So if you want a quick-acting crow’s feet remedy without the hassles of plastic surgery, you must seriously consider Botox.

Botox vs. Other Skin Resurfacing Treatments

Other skin-rejuvenating cosmetic procedures that your dermatologist can perform are dermabrasion, chemical peel application, microneedling and PRP injection. These procedures introduce a tiny amount of skin injury that jumpstarts the body’s ability to produce collagen and replenish old skin tissues. They are excellent for smoothening scars and fine lines, though they also have a greater scarring risk than Botox.

As you can see, each wrinkle treatment has advantages and disadvantages that make them more suitable for some patient types but not others. Botox is no different. But many people find their best anti-aging regimen by combining different therapies. 

And here’s the thing: Only a medical professional with profound skin care expertise can help you find the age-reversing formula perfect for you.

Why Is It Best to Entrust Your Wrinkle Treatments to a Board-Certified Dermatologist?

Many people find it hard to ignore the signs of facial aging. Those willing to take action know that this skin issue, though not life-threatening, is complex. And tricky problems need expert solutions.

Among medical professionals, board-certified dermatologists are the most skillful at erasing and delaying the signs of facial aging.  As cosmetic Botox specialists, they can guarantee excellent results and ensure your safety when getting this type of treatment. As skin experts, they are your best information source for scientifically-proven fixes that can go flawlessly well with your Botox injections.

So if you want to get the most out of any anti-aging regimen, trust only a board-certified dermatologist.

Botox for Crow’s Feet Treatment—The Takeaway

Crow’s feet are the wrinkles forming at the outer sides of your eyes. These harmless blemishes stem from repeated facial muscle use, becoming more prominent over time due to aging and other health-related skin changes. Identifying the root causes is key to getting rid of this condition effectively and safely.

Botox is FDA-approved for treating crow’s feet. Its results are comparable to plastic surgery for the same condition. It costs much less, though its effects are temporary. Good pre- and post-treatment care, sun protection, regular maintenance injections and meticulous skin care are just some of the measures that can help prolong its action.

The drug is safe but not 100% risk-free. Further, it can be dangerous when given by unlicensed individuals. To make sure you maximize the benefits of Botox crow’s feet procedures, entrust yours only to a highly experienced board-certified dermatologist.

Want to Smile without the Smile Lines? You’re in the Best Hands at BHSkin Dermatology

Forehead wrinkles, frown lines and crow’s feet are blemishes arising from repeated facial muscle use. They can only get worse as you age as static wrinkles emerge with time. Various wrinkle treatments are available, but how do you know which one is best for you?

Leave that question to LA’s top skin doctors!

At BHSkin Dermatology, our skin care experts work with countless patients everyday to help them delay the signs of facial aging. Visit us at our Glendale or Encino clinic or use our virtual portal for your initial consultation.

Make old friends rave at how stunning you look for your age! Book your appointment today!

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online