Wrinkles

Overview

Wrinkles, a natural part of aging, are most prominent on sun-exposed skin, such as the face, neck, hands and forearms.

Although genetics mainly determine skin structure and texture, sun exposure is a major cause of wrinkles, especially for people with light skin. Pollutants and smoking also contribute to wrinkling.

If your wrinkles bother you, you have more options than ever to help smooth them or make them less visible. Medications, skin-resurfacing techniques, fillers and surgery top the list of effective wrinkle treatments.

Symptoms

Wrinkles are the lines and creases that form in your skin. Some wrinkles can become deep crevices or furrows and may be especially noticeable around your eyes, mouth and neck.

When to see a doctor

If you’re concerned about the appearance of your skin, see a dermatologist. He or she can assess your skin and help you create a personalized skin care plan. A dermatologist can also recommend medical wrinkle treatments.

Causes

Wrinkles are caused by a combination of factors — some you can control, others you can’t:

• Age. As you get older, your skin naturally becomes less elastic and more fragile. Decreased production of natural oils dries your skin and makes it appear more wrinkled.

Fat in the deeper layers of your skin diminishes. This causes loose, saggy skin and more-pronounced lines and crevices.

• Exposure to ultraviolet (UV) light. Ultraviolet radiation, which speeds the natural aging process, is the primary cause of early wrinkling. Exposure to UV light breaks down your skin’s connective tissue — collagen and elastin fibers, which lie in the deeper layer of skin (dermis).

Without the supportive connective tissue, your skin loses strength and flexibility. Skin then begins to sag and wrinkle prematurely.

• Smoking. Smoking can accelerate the normal aging process of your skin, contributing to wrinkles. This may be due to smoking’s effect on collagen.
• Repeated facial expressions. Facial movements and expressions, such as squinting or smiling, lead to fine lines and wrinkles. Each time you use a facial muscle, a groove forms beneath the surface of the skin. And as skin ages, it loses its flexibility and is no longer able to spring back in place. These grooves then become permanent features on your face.

Prevention

Here are some tips for protecting your skin and minimizing the appearance of wrinkles:

• Protect your skin from the sun. Limit the time you spend in the sun, especially midday, and always wear protective clothing, such as wide-brimmed hats, long-sleeved shirts and sunglasses. Also, use sunscreen year-round when outdoors.

Choose a skin-care product with a built-in sun protection factor (SPF) of at least 15. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or more. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.

• Use products with built-in sunscreen. When selecting skin care products, choose those with a broad-spectrum sunscreen — meaning it blocks both UVA and UVB rays.
• Moisturize. Dry skin shrivels plump skin cells, which can lead to premature fine lines and wrinkles. Moisturizing traps water in your skin, which helps mask tiny lines and creases. It may take a few weeks of regular use of the product before you notice any improvement in your skin.
• Don’t smoke. Even if you’ve smoked for years or smoke heavily, you can still improve your skin tone and texture and prevent wrinkles by quitting smoking.
• Eat a healthy diet. There is some evidence that certain vitamins in your diet help protect your skin. More study is needed on the role of nutrition, but it’s good to eat plenty of fruits and vegetables.

Treatment

Surgical procedures and non-surgical techniques

A variety of procedures are used to smooth out wrinkles. Some studies indicate that a combination of treatments may yield the most satisfying results. Talk with your doctor about what’s important to you and which approach would best meet your needs and expectations as far as recovery time and results.

• Laser resurfacing. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis). This stimulates the growth of new collagen fibers. As the wound heals, smoother, tighter skin forms. Laser resurfacing can’t eliminate excessive or sagging skin.

Laser resurfacing may be done as an outpatient procedure, usually with a local anesthetic. You may be fully sedated for extensive resurfacing. It can take several months to fully heal from ablative laser resurfacing. A newer method using fractional lasers has a shorter recovery time. Risks include scarring and lightening or darkening of skin color.

A technique called nonablative laser fractional resurfacing has a shorter healing time and fewer risks than does the ablative technique. Nonablative lasers are better suited to people with moderate wrinkles because results are subtle. This treatment needs to be repeated more often than does ablative treatment. This method also can be done with a fractional laser.

• Micro-needling. Micro-needling, or skin needling, is a facial rejuvenation procedure that uses a device with several tiny needles that poke you to create a miniature wound in the top layer of your skin (epidermis). This wound heals within minutes and causes new collagen and elastin to form as your skin heals. Micro-needling is effective at improving wrinkles or fine lines in your skin.

• Chemical peel. Your doctor applies a chemical solution to the skin to remove the top layers. The skin that grows back after a chemical peel is smoother. Depending on the depth of the peel, you may need several treatments before you see a difference in your skin. Redness lasts up to several weeks. Possible side effects include scarring, infection, and lightening or darkening of skin color.

• Dermabrasion. Dermabrasion sands down the surface layer of skin with a rapidly rotating brush. New skin grows in its place. You may need to undergo the procedure more than once.

Possible side effects include temporary redness, scabbing and swelling. It may take several months for pinkness to fade and for you to see results.

• Microdermabrasion. Similar to dermabrasion, this technique removes only a fine layer of skin. You’ll need a series of treatments over months to produce modest, temporary results. If you have rosacea or tiny red veins on your face, this technique could make the condition worse.

You may notice a slight redness or stinging sensation on the treated areas.

• Botulinum toxin type A (Botox). When injected in small doses into specific muscles, Botox keeps the muscles from contracting. When the muscles can’t tighten, the skin appears smoother and less wrinkled.

Botox works well on frown lines between the eyebrows and across the forehead and on crow’s-feet at the eye corners. It takes one to three days to see results. The effect typically lasts a few months. Repeat injections are needed to maintain results.

• Soft tissue fillers. Soft tissue fillers, which include fat, collagen and hyaluronic acid (Restylane, Juvederm, others), can be injected into wrinkles on your face. They plump and smooth wrinkles and furrows. You may experience temporary swelling, redness and bruising in the treated area. The effect of most products is temporary.

• Face-lift. The face-lift procedure involves tightening the underlying muscle and tissues. It may be done in a hospital or an outpatient surgical facility, with a local anesthetic, sedation or general anesthesia. Healing times can be lengthy after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.

Face-lift results are not permanent. You may choose to undergo another face-lift several years later.

Keep in mind that results vary depending on the location and depth of your wrinkles. Nothing stops the aging process of skin, so you’ll likely need repeated treatments to maintain benefits.

References

• American Academy of Dermatology. Skin conditions by the numbers. www.aad.org.
• Goesel Anson, MD, FACS and others, Sleep Wrinkles: Facial Aging and Facial Distortion During Sleep, Aesthetic Surgery Journal, Volume 36, Issue 8, September 2016

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.