Crow’s Feet

Where the periorbital skin has become thin or has begun to show static lines, treatments aimed at improving skin quality often give a natural-looking result. There are three related but distinct groups here.

Polynucleotides (PN) are long-chain, highly purified DNA fragments derived from wild salmon (Oncorhynchus keta). Once injected superficially into the skin, they are understood to act as a “repair signal” — supporting your fibroblasts to produce more collagen and elastin, helping the skin hold moisture, and gradually improving its thickness and resilience. They are not fillers and do not add volume. A widely-used brand example in the UK is Rejuran®, a CE-marked Class III medical device made by PharmaResearch using their patented DOT™ (DNA Optimizing Technology) process. A specific formulation, sometimes referred to as Rejuran Eye, is designed for the very delicate skin around the eye. Treatment is typically a course of three sessions about a month apart, with results commonly lasting around 6–12 months, though this varies between individuals.

PDRN (polydeoxyribonucleotide) is a related compound from the same family but with a shorter chain length and lower molecular weight. It acts mainly on the skin’s repair processes — supporting cell turnover, reducing inflammation, and aiding healing — which makes it useful where skin is sensitive or recovering. Polynucleotides and PDRN have meaningfully different molecular profiles and clinical roles.

Multi-ingredient skinboosters such as Profhilo, Sunekos, NCTF, and klardie deliver hyaluronic acid alongside amino acids, peptides, vitamins, and — in some formulations — DNA-derived components, supporting hydration, the skin barrier, and overall skin quality. Specific eye-area formulations within this group are often used very gently around the periorbital skin.

These treatments are usually given as a short course of 2–3 sessions a few weeks apart, with occasional maintenance.

Platelet-Rich Plasma (PRP) is prepared by taking a small sample of your own blood and concentrating the platelets, which carry growth factors that signal nearby cells to repair and regenerate. Platelet-derived exosomes are a distinct treatment from PRP, though also derived from the patient’s own platelets — they are tiny extracellular vesicles that carry signalling molecules, and like PRP they are autologous and may be administered by injection. Both can support the quality of periorbital skin, particularly where the skin has lost its repair capacity. PRP and platelet-derived exosomes are not the same as “advanced PRP” — they are distinct treatments with different mechanisms, and Dr Garara will discuss which is appropriate at consultation.

When static crow’s feet have changed the surface texture of the skin itself, energy-based devices can resurface and remodel it. These fall into two groups. Laser resurfacing includes UltraClear, a 2910nm fibre laser marketed as a “cold ablative” fractional system, designed to stimulate collagen renewal with shorter recovery than traditional CO₂ lasers; and MultiFrax, a dual-wavelength non-ablative fractional laser used for fine lines and overall skin refinement. Separately, radiofrequency microneedling with Sylfirm X delivers controlled radiofrequency energy into the dermis through fine needles, rather than light, to encourage tightening and remodelling of the lateral eye area. Which is appropriate depends on the depth of the lines, your skin type, and how much downtime you can accommodate.

Treatment for higher Fitzpatrick skin types (IV–VI) requires careful device selection and conservative settings to reduce the risk of post-inflammatory hyperpigmentation or, in some cases, keloid scarring. Dr Garara has particular experience in aesthetic medicine for skin of colour and tailors device choice, energy levels, and treatment intervals accordingly.

Sometimes crow’s feet that extend further down the cheek look more pronounced because of a loss of structural support over the upper cheekbone. In selected cases, collagen biostimulators placed high on the cheekbone can gradually rebuild the foundation that holds the lateral eye area in place, easing the way the skin drapes. The two main classes used at the clinic are poly-L-lactic acid (PLLA) biostimulators, which work primarily by signalling your fibroblasts to produce new collagen over a course of months, and calcium hydroxyapatite (CaHA) preparations — including hybrid formulations that combine hyaluronic acid with CaHA. Specific product choice is determined at consultation. This is a mid-face treatment, not a treatment of the eye area itself; the eye area benefits indirectly.