Four Treatments for Crepey Skin On The Face

crepey_faceThe skin on your face is more exposed to environmental forces such as the sun than other parts of your body.  Therefore, your facial skin is more prone to developing into crepey skin.

As I have discussed in previous blog posts, loss of elastin and collagen in addition to fat loss under the skin accelerates the deflation of the skin.  This deflation leads to the appearance of crepey skin.

Even on the face, the skin on different areas can vary in terms of thickness and, as a result, can require different treatment solutions.  The difference in the skin areas also compounds the difficulty presented by every unique individual, and what bothers them or not about their appearance.

With those provisos above, I will outline broad categories of treatment.  I am taking into account that different patients may require different combinations of treatments to meet their individual needs and desired outcomes.


botox_injection_older_womanFor many places on the face, the thin crepey skin is aggravated by recurrent folding over of the skin by muscle movement.  Botox is unique in that it can improve appearance of the thin skin without changing the skin itself.

This characteristic is particularly helpful around the eyes where the thinnest skin of the face resides.  The relaxation of the offending muscles can soften the appearance of the periorbital skin, making your eyes look less tired and worn out.


The most successful and highest rated dermal fillers are based on hyaluronic acid, which is the main chemical component of human collagen.  Since a major cause of facial skin crepeyness is loss of collagen, replacing your lost collagen with dermal fillers is a logical step.

Juvederm-Ultra-Plus-XcThe commercially available fillers have evolved over the past decade to the point where different fillers are well suited to various needs for varying thicknesses around the face.  The least thick filler that I use here at Maine Laser Skin Care is Juvederm Ultra.

Juvederm Ultra is useful for areas such as the lips and around the mouth.  Just enough filling is needed in these area to improve appearance, but not so much that it looks overfilled and lumpy.

Next in line in terms of thickness is Juvederm Ultra Plus.  This filler is particularly useful for areas of deeper lines such as:

  • the lines that form at the corner of the mouth and extend into the chin (also known as oral commissures or marionette lines)
  • the lines from the nose that go around the mouth (also known as nasolabial folds or parenthese lines).

Juvederm Ultra Plus is the most common one I use.  It addresses so many issues around the face, especially those related to age-related skin changes.

juvederm_voluma_xc_bannerVoluma is the most exciting recent addition to the filler family of products.  This is a much thicker dermal filler which is still hyaluronic acid-based.

It has been specifically designed to be injected and placed in the mid-face and cheek area.  Voluma literally replaces the volume and padding of the cheek area which lifts the overlying skin.

This action basically re-inflates the crucial middle part of the face, making the skin of the area look more full and frankly younger.  Voluma also acts to lift the lower part of the face and essentially contributes to the concept of a “liquid facelift.”


melasma_laserAnother method of treating crepeyness is to stimulate the fibroblast cells within the skin.  This stimulation produces more collagen, as it did when you were younger.

Fractionated lasers treat the surface of the skin that may have been damaged by sun.  They also literally drill down into the skin to stimulate your body to repair the controlled and limited damage caused by the laser itself.

While a number of companies manufacture fractionated lasers, I have chosen the Fraxel Re:store, which is the gold standard for laser in this category of treatment.  I have found Fraxel Re:store to be particularly helpful when the crepeyness of the skin is extensive and the individual does not want or would not even consider plastic surgery.

Fraxel is also excellent for treating facial scars.  After all, old acne scars actually contribute to crepeyness as the skin ages.


crepey_skin_baAnother method of dealing with skin crepeyness is to tighten the existing collagen under the skin.  This method works best when the aging appearance in its earlier stages and not advanced.

Basically, when your existing collagen starts to age under your skin, it loosens and becomes less supportive of the skin.  This loss of foundation allows the skin to start to sag and appear less tight.

There are several methods of skin tightening that are used, but all generally use heat.  Some techniques use laser energy, while others use ultrasound.

pelleve_in_actionThe technique of choice here at Maine Laser Skin Care is called Pelleve, which uses radiofrequency energy to heat up and tighten the collagen layer and therefore the overlying skin.  Over a series of treatment, slow but steady progress can be seen especially in sensitive areas, such around the mouth and the eyes.

If you have any questions about specific methods of treatment for crepey skin, or simply want to make an appointment for a free consultation for your specific needs, call Denise or Emily at (207) 873-2158.


About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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