You can't ignore the earliest signs of aging-they glare right back at you.

"When we wake up in the morning, the first place we look is in the mirror, into our own eyes," said Dr. Robert Heck of Columbus Aesthetic and Plastic Surgery.

And the eyes-which tend to age quicker than other parts, doctors say-never lie. Instead, they reveal beauty sins from sun damage, daily stress and sleepless nights.

Heck routinely treats patients (women and men) who are unhappy with problems that plague the delicate skin surrounding the eyes-crow's feet, fine lines, puffiness and dark circles.

Some complain of looking perpetually tired, and want to brighten up their appearance.

Many practices like Heck's meet that growing demand by offering an assortment of cosmetic procedures and treatments designed to smooth, firm and lift the eye area.

A mix of environmental and genetic factors influence the aging process, so care should always be individually tailored, said Dr. Jason Lichten of Central Ohio Plastic Surgery.

"I don't think there's a cookie-cutter answer," Lichten said. "It's about having multiple options and being able to let a patient pick what's right for them."

More often than not, doctors say they perform a combination of therapies to achieve the most natural-looking results.

We asked several experts to share a sampling of eye treatment options for women in their 20s, 30s, 40s and up. Here are their recommendations.


20sThis decade is all about prevention.

"The first place you start is with skincare," said Dr. Jeffrey Donaldson of Donaldson Plastic Surgery. "There are good cleansers (and) good moisturizers to help the skin around the eyes. Sun damage can be treated with cosmeceuticals."

The second option he usually offers his youngest patients is Botox injected in small amounts. This remedy, which lessens lines and wrinkles by relaxing isolated facial muscles, works well for women in their late 20s who have noticed traces of lines or wrinkles around the outer eye, Donaldson said. (If your mother and grandmother have crow's feet, chances are you'll share that trait, thanks to genetics.)

Dr. Robert Heck of Columbus Aesthetic and Plastic Surgery said women who start using Botox in their 20s may avoid forming eye wrinkles at all. "The women who are using Botox are aging much, much slower," he said.

The process requires upkeep, though. Botox costs about $400 per treatment and is typically administered every three months.

Other options to perk up the eye area at any age include permanent make-up and Latisse, an eyelash-growth enhancer, Heck said.
30sTo maintain a youthful glow, now is the time to explore a skincare line with aggressive anti-aging ingredients.

Medical-grade brands such as Obagi and SkinMedica are highly recommended by doctors and plastic surgeons but require a consultation-and prescription.

"The difference between an over-the-counter product and the prescription grade is really going to be the depth of the grade that you get," said Jason Lichten of Central Ohio Plastic Surgery. Many over-the-counter eye creams promise impressive results but are essentially just glorified moisturizers, he said.

"It's the equivalent of if you look at your house and the paint is cracking," Lichten said. You can try to patch up the cracks, he said, or fix the foundation.

Botox and other injectable fillers also remain a popular treatment for women in their 30s.

As women age, the skin beneath the eyes loses its supple texture and begins to hollow, creating dark circles. "A lot of people come in complaining of bags under their eyes," said Dr. Jeffrey Donaldson of Donaldson Plastic Surgery.

To fix that problem, he typically uses a filler such as Juvederm to plump the sunken under-eye area or transfers fat from another area into the lower eyelid. The treatment costs about $500 once a year, but the results, he said, are refreshing.
40s+When less-invasive treatments lose their effect, some women consider surgery instead.

Eyelid reshaping surgery-also known as blepharoplasty-can tighten drooping and sagging skin above or below the eye. The process removes fatty deposits around the eyes and gives a more youthful, alert appearance, said Dr. Robert Heck of Columbus Aesthetic and Plastic Surgery.

Dr. Jeffrey Donaldson of Donaldson Plastic Surgery, who also performs this procedure at his office, said the incisions are easily hidden and heal well. Some patients opt to do the lower or upper lid, or both. The risks, he said, are scars and changes to the lid contour, but those can be avoided by choosing a surgeon with the proper training and expertise. The surgery costs roughly $2,000 for upper lids and $2,500 for lower.

If you're looking to target wrinkles and fine lines, lasers also deliver dramatic results, said Dr. Kristen Kenney of Premier Aesthetic and Laser Centre in Delaware. She uses lasers of varying strengths to penetrate deep into the skin, smooth lines and increase elastin. Laser procedures start at about $200 and go up.

"Skincare is going to take years" to produce results, Kenney said. With lasers, she said, you'll see noticeable improvement after one treatment.

Doctors perform a combination of therapies to achieve the most natural-looking results.

BRIGHT EYES: Putting Products to the Test

We tested an array of over-the-counter eye products to see if they delivered on their promises. A few impressed, while others fell short. The best products earned five stars.

LA MER
The Eye Balm Intense
$145 at Saks Fifth Avenue

Key Ingredients: marine algae and peptide complex; vitamins, minerals and other pure elements
The Pitch: "A groundbreaking eye treatment that helps to accelerate skin's natural renewal process to revitalize the fragile eye area."
The Results: After several days of use, I looked forward to applying this mint-green balm in the morning. The light, mousse-like consistency instantly cooled and soothed my sensitive skin and reduced fine wrinkles beneath the lower lash line.

RODIAL
Glamtox Eye Light
$115 at Nordstrom.com

Key ingredients: peptides; wheat protein; pomegranate ellagic tannin; SPF 15
The Pitch: "A quick fix that lets you fake your age without going under the knife. The potent formula reverses damage, reduces wrinkles, firms, lifts and corrects-you won't believe your eyes."
The Results: The thin formula felt greasy when first applied but ultimately plumped fine lines and hydrated the under-eye area all day. It also reduced slight puffiness in the morning, but didn't drastically reduce dark circles.

ZO SKIN HEALTH
Olluminate Intense Eye Repair
$130 at ZoSkinHealth.com

Key ingredients: retinol; glycosaminoglycans (the building blocks of connective tissues); Vitamin E; peptides
The Pitch: "A multi-tasking anti-aging eye treatment with stimulating retinol, optical diffusers and cooling agents that delivers a knock-out punch for crow's feet, deep lines and wrinkles, dark circles, puffiness, loss of tone and elasticity."
The Results: With its silky texture, this product delivers plenty of moisture. But after using for a week, I didn't
notice any drastic changes.

PATRICIA WEXLER M.D. DERMATOLOGY
Intensive 3-in-1 Eye Cream
$32.50 at Bath and Body Works

Key ingredients: Dermal RX Skin Renewal Complex; peptides
The Pitch: The ingredients "work in tandem to do the jobs of three creams-a firming formula, lifting formula and anti-wrinkle formula-simultaneously."
The Results: I love that just
a dab of this buttery cream goes a long way. It wraps the entire eye area in moisture and gives it a dewy look, making skin look and feel satiny smooth.

VICHY LABORATOIRES
Aqualia Thermal Eye Roll-On
$26.50 at VichyUSA.com

Key ingredients: Vichy thermal water; dextran sulphate; escin (a plant extract); hyaluronic acid
The Pitch: "Banishes dark circles and dehydration lines, with visible results: 62 percent of bags diminish after one hour of application, plus 8 hours of hydration."
The Results: Creams sometimes irritate my sensitive eyes, and this gel provided a nice alternative. The roll-on formula minimized the look of fine lines and de-puffed the upper and lower lids.