June 30, 2015
With the start of the summer season, most Floridians are planning to be outside significantly more than they were in the winter and spring. What comes along with the sunshine of the beach, barbecues and afternoons at the ball field? Squinting.
So what. Why is squinting a big issue?
Squinting is a physiologic reflex to bright environments that decreases the size of the opening of the eyelid in order to allow less light to reach the eye. Let’s examine exactly what happens during a squint. Three important facial muscle groups contract. This creates radial wrinkling of the skin and soft tissue around the eye. People will commonly call these by the nickname “crow’s feet,” or “smile lines.” The space between the eyes is narrowed creating both vertical wrinkles many call “11 lines” or “frown lines” as well as one or more horizontal lines at the top of the nose. Besides the extra wrinkles it creates, the act of squinting also lowers the position of the eyebrow.
So what does all this mean?
Over time, the pattern of repeated squinting can result in an increased number and increased depth of wrinkles between the eyes and to the sides of the eyes. This is simply the effect of creasing the skin over and over, similar to what one sees when they fold a sheet of paper in the same place many times. Squinting also encourages a lower brow position.
Of course, the sun can’t take all the blame. As we age, the skin gets progressively thinner, and changes in vision, such as need for reading glasses, can be responsible for many of the squints performed throughout the day even if one is not out in the sun.
Unfortunately, squinting from the sun is a double whammy, as it has been scientifically proven that harmful UV rays independently cause the skin to become even thinner and less elastic, in addition to increasing the risk of skin cancer.Folding skin that is thinner with less ability to stretch will result in deeper, more etched in creases over time. By now, everyone knows that sunscreen will help protect against thinning of the skin, but it doesn’t keep us from squinting. Even after applying sun protection, younger patients may notice that they get specific patterns of tan lines where they have been over using the muscles around the eyes while out in the sun.
So, does Botox® help with squinting?
Yes. Botox® helps to decrease squinting. Botox® treatments by your doctor involve placing small amounts of medicine into specific areas of these key muscles to strategically weaken the contraction in a favorable manner. This requires precision and skill to positively affect both the aesthetics and the function of the muscles around the eye. The benefit is that it significantly reverses these signs of aging. Numerous studies have proven Botox® can decrease the depth and number of wrinkles around the eyes, as well as can slightly raise the position of the brow. It can slightly open or widen the space between the eyes to give a more youthful or rested appearance.
Does that mean that if I get Botox® I shouldn’t wear sunglasses?
No way. Sunglasses are important too, as they protect the actual globe from harmful UV rays. This can potentially lower the chance of developing cataracts, macular degeneration and other eye diseases whose risk specifically increases with increased exposure.
If you have tried Botox® in the past, but didn’t like it, or didn’t see a difference, ask about other FDA approved neuromodulator medications that may work better for you, called Xeomin® and Dysport®.
Dr. Scott Asher, Tallahassee Democrat