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One of the first places to reveal visible signs of aging is around the eyes. The delicate skin in this area is extremely thin and contains little subcutaneous fat tissue.
During the aging process, skin cells divide more slowly, and the dermis begins to thin. Networks of collagen and elastin fibers loosen and unravel, causing depressions on the surface. The skin also loses its elasticity, is less able to retain moisture, oil-secreting glands are less efficient and the skin is slower to heal. These combined factors contribute to the development of wrinkles.
In addition, during aging, the orbicularis oculi muscle surrounding the eyes becomes weak and loses its retaining effect. The fat pads below the eyes herniate, resulting in the appearance of under-eye bags.
Currently there are a wide range of procedures and products that claim to treat the skin around the eyes.
Fine wrinkles can be treated with dermal therapies that result in collagen contraction. However, because these types of therapies focus on the skin factor only, they typically do not achieve satisfactory results.
The other well-known treatment is blepharoplasty. While this procedure effectively removes fat below the eye, it comes with longer downtime.
Combining radiofrequency (RF)-based microneedling and CO2 fractional technology, the Fraxis DUO from Ilooda Co., Ltd. (Suwon-si, Gyoenggi-do, South Korea), delivers a new treatment option for periorbital aging.
RF microneedling allows the practitioner to reach the musculus orbicularis oculi layer where the heat can stimulate strengthening of the muscle. The addition of fractional CO2 stimulates the collagen in the deep dermis for improved results.
Results of this treatment can be seen in the case of a 60-year-old Asian woman with signs of periorbital aging who received three passes of RF microneedling, which was applied at 10% intensity with a 60-70 ms pulse length and 1.5 mm depth, using a circular motion. Subsequently, she received a more superficial treatment with the fractional CO2 at 0.6 mJ, I-Stack of 5-6 and distance of 0.5 mm. The treatment was repeated for 14 consecutive days. See Figure 1.
While there were no severe adverse effects in this patient, light erythema may occur. This typically disappears in three to five hours.
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