Wrinkles

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Wrinkles are creases in the skin. The medical term for wrinkles is rhytids. Most wrinkles come from aging changes in skin. Aging of the skin, hair and nails is a natural process. There is little you can do to slow the rate of skin aging, but many things in the environment will speed it up.

Frequent exposure to sunlight results in early skin wrinkles and dark areas or liver spots. It also increases the chances of getting skin cancer. Exposure to cigarette smoke can also make the skin wrinkle sooner. Your skin changes as you age. You might notice wrinkles, age spots and dryness. Your skin also becomes thinner and loses fat, making it less plump and smooth. It might take longer to heal, too.

Sunlight is a major cause of skin aging. You can protect yourself by staying out of the sun when it is strongest, using sunscreen with an SPF of 15 or higher, wearing protective clothing, and avoiding sunlamps and tanning beds. Cigarette smoking also contributes to wrinkles. The wrinkling increases with the amount of cigarettes and number of years a person has smoked.

Wrinkles and age

Elastin and collagen fibres give the skin suppleness and strength. The numbers of these fibres in the skin are reduced as we age, causing wrinkles. Our skin has a layer of fat just below the surface (subcutaneous layer), which gives form and structure. This layer of fat thins out as we age, causing the skin to sag.

Wrinkles and sun exposure

Sun exposure is the most common cause of skin damage and wrinkling. Exposure to the ultraviolet (UV) radiation in sunlight causes changes to the skin. In addition to fine lines and wrinkles, UV damage causes brown spots and pigment irregularity, as well as broken capillaries and red blotches. All of these changes make the skin look older.

UV rays prompt the formation of free radicals within the skin, which damage elastin fibres in the skin, and contribute to wrinkling and skin cancer. People with fair skin have less protection against UV-induced skin changes and tend to develop more wrinkles than people with dark skin.

The best way to prevent wrinkling caused by sun exposure is to:

  • Wear protective clothing.
  • Avoid the sun around the middle of the day.
  • Use sunscreen for the parts of skin that can’t be protected by clothing.

Smoking and wrinkles

As well as all the other health risks associated with smoking, smokers will have more wrinkles. These changes may not show up till you are in your 30s or 40s. Fine lines around the mouth are most common. Research has shown that people who have never smoked have less wrinkles than smokers.

Frowning and squinting and wrinkles

Squinting is the most common cause of crow’s feet around the eyes. Frowning, especially when done frequently, may cause deep wrinkles, especially on the forehead. Many products claim to revitalize aging skin or reduce wrinkles, but the Food and Drug Administration has approved only a few for sun-damaged or aging skin. Various treatments soothe dry skin and reduce the appearance of age spots.

Causes

Common causes of wrinkles include:

Smoking and wrinkles

As well as all the other health risks associated with smoking, smokers will have more wrinkles. These changes may not show up till you are in your 30s or 40s. Fine lines around the mouth are most common. Research has shown that people who have never smoked have less wrinkles than smokers.

Frowning and squinting and wrinkles

Squinting is the most common cause of crow’s feet around the eyes. Frowning, especially when done frequently, may cause deep wrinkles, especially on the forehead.

Treatment for wrinkles

Daily use of a high SPF sunscreen (SPF 15 plus or SPF 30 plus) is the most effective thing you can do to prevent wrinkles. There are a number of cosmetic creams that help conceal wrinkles and disguise age-related changes. The effects of these creams are temporary and only last for a day or so.

Other treatments include:

  • Injection of botulinum toxin paralyses the muscles under the skin responsible for deep wrinkles, as well as fine lines around the eyes and mouth. The effects of a single injection may last six to nine months. Experience is required by the doctor performing the procedure to make sure there is no loss of power to the muscles responsible for facial expression.
  • Injection of filler into the base of the wrinkle can elevate the skin and flatten the wrinkle. The effects generally last six to nine months, depending on the site, the product and the volume of the product injected.
  • Fractionated laser is a walk-in walk-out procedure that causes multiple tiny invisible wounds in the skin. The wound healing promotes collagen regeneration and gradually fades wrinkles. Four to six treatments spaced four to six weeks apart are generally required.
  • Laser resurfacing and threading are specialised cosmetic procedures that are also used for fine lines and wrinkles.
  • Face lifting and threading are procedures performed by plastic surgeons for facial rejuvenation.

Home Care

Stay out of the sun as much as possible to limit skin wrinkles. Wear hats and clothing that protect your skin and use sunscreen daily. Avoid smoking and secondhand smoke.

Questions to ask

  • When did you first notice that your skin seemed more wrinkled than normal?
  • Has it changed in any way?
  • Has a skin spot become painful or does it bleed?
  • What other symptoms are you having?

Your provider will examine your skin. You may need a skin lesion biopsy if you have any abnormal growths or skin changes.

Treatments for aging wrinkles

Current evidence suggests that tretinoin decreases cohesiveness of follicular epithelial cells, although the exact mode of action is unknown. Additionally, tretinoin stimulates mitotic activity and increased turnover of follicular epithelial cells. Tretinoin is better known by the brand name Retin-A.

Topical glycosaminoglycans supplements can help to provide temporary restoration of enzyme balance to slow or prevent matrix breakdown and consequent onset of wrinkle formation. Glycosaminoglycans (GAGs) are produced by the body to maintain structural integrity in tissues and to maintain fluid balance. Hyaluronic acid is a type of GAG that promotes collagen synthesis, repair, and hydration. GAGs serve as a natural moisturizer and lubricant between epidermal cells to inhibit the production of matrix metalloproteinases (MMPs).

Dermal fillers are injectable products frequently used to correct wrinkles, and other depressions in the skin. They are often a kind of soft tissue designed to enable injection into the skin for purposes of improving the appearance. The most common products are based on hyaluronic acid and calcium hydroxylapatite.

Botulinum toxin is a neurotoxin protein produced by the bacterium Clostridium botulinum. Botox is a specific form of botulinum toxin manufactured by Allergan for both therapeutic and cosmetic use. Besides its cosmetic application, Botox is used in the treatment of other conditions including migraine headache and cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving the head and neck).

Dysport, manufactured by Ipsen, received FDA approval and is now used to treat cervical dystonia as well as glabellar lines in adults. In 2010, another form of botulinum toxin, one free of complexing proteins, became available to Americans. Xeomin received FDA approval for medical indications in 2010 and cosmetic indications in 2011.

Botulinum toxin treats wrinkles by immobilizing the muscles which cause wrinkles. It is not appropriate for the treatment of all wrinkles; it is indicated for the treatment of glabellar lines (between the eyebrows) in adults. Any other usage is not approved by the FDA and is considered off-label use.

Laser skin resurfacing is FDA-cleared skin resurfacing procedure in which lasers are used to improve the condition of the skin. Two types of lasers are used to reduce the appearance of fine lines and wrinkles on the face; an ablative laser that removes thin layers of skin and a nonablative laser that stimulates collagen production. Nonablative lasers are less effective than ablative ones but they are less invasive and recovery time is short. After the procedure people experience temporary redness, itching and swelling.

These are some treatments for wrinkles:

Wrinkles and sagging are age-related skin changes. Lifestyle has a major effect on the skin’s tendency to wrinkle. Sun exposure and smoking are the most common causes of premature skin wrinkling. If you limit sun exposure and avoid smoking, you can reduce the amount of wrinkles you develop.

Alternative Names

Rhytid

External resources

W8MD wrinkle and skin treatment options

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