Wrinkles are creases, folds, or ridges in the skin. They normally appear as people get older, but they can also develop after spending a long time in water.
The first wrinkles to appear on a person's face tend to occur as a result of facial expressions.
Sun damage, smoking, dehydration, some medications, and environmental and genetic factors affect when and where people will develop wrinkles.
Most wrinkles tend to appear in the parts of the body which receive the most sun exposure, especially the face and neck, the back of the hands, and the arms.
Most people do not welcome wrinkles, and billions of dollars are spent globally on treatments to remove or delay them.
Some of these therapies make great claims but have no effect, while others may have moderate, significant, or very considerable success.
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What causes wrinkles?
Wrinkles are a natural part of the aging process. As people get older, their skin gets thinner, drier, and less elastic, and less able to protect itself from damage. This leads to wrinkles, creases, and lines on the skin.
Environmental factors such as smoking can accelerate the development of wrinkles.
Facial expressions, for example, repeatedly smiling, frowning, or squinting can lead to fine lines and wrinkles at a younger age.
According to the Mayo Clinic, each time a person uses a facial muscle, a groove forms under the surface of the skin.
When a person is young, the skin springs back, but as they get older, the skin loses its flexibility. Springing back becomes harder and less frequent, resulting in more permanent grooves.
A number of avoidable, environmental factors also contribute.
Exposure to ultraviolet (UV) light, for example, through sunbathing, tanning booths, and outdoor sports increases the chance of developing wrinkles earlier.
UV light breaks down the collagen and elastin fibers in the skin. These fibers form the skin's connective tissue. They are located under the surface of the skin, and they support the skin. Breaking down this layer causes the skin to become weaker and less flexible. The skin starts to droop, and wrinkles appear.
Clothes that cover the body, such as hats and long sleeves, may delay the development of wrinkles.
People who work in the sunlight have a higher chance of early wrinkles. Jobs that involve this type of exposure include fishing and farming. Sailors, golfers, beach lifeguards, and gardeners may also be more prone to skin aging.
Regular smoking accelerates the aging process of skin, because of the reduced blood supply to the skin. Alcohol dehydrates the skin, and dry skin is more likely to wrinkle.
What are the treatment options for wrinkles?
The two main types of wrinkles are surface lines and deep furrows.
Most basic wrinkle treatments, if they have any effect, tend to help reduce the fine lines. For deeper creases, there are more aggressive techniques, such as plastic surgery or injections of fillers.
Topical retinoids are derived from vitamin A, and they are said to reduce fine wrinkles, some pigmentations, and skin roughness.
This type of medication can make it easier for the skin to burn sunlight, so the patient needs to use it with a skin-care program to protect the skin. Possible adverse effects include dryness, itching, a burning sensation, tingling, and redness.
Over-the-counter (OTC) wrinkle creams vary considerably in active ingredients and therefore, also, in effectiveness.
Slight to modest results may sometimes be obtained from retinol, alpha hydroxy acids, kinetin, coenzyme Q10, copper peptides, and antioxidants. The active ingredient concentration in an OTC wrinkle cream will be significantly lower than a prescription one.
In most cases, if there are results, they do not usually last long.
Cosmetic surgery and other medical procedures
A number of surgical options are available.
Dermabrasion is a surgical procedure that involves the controlled wearing away, or abrasion, of the upper layers of skin with sandpaper or some other mechanical means.
Wrinkles are a natural part of aging, but treatments like Botox can put them off for a while.
Dermabrasion is used to remove fine wrinkles, tattoos, nevi, or moles, acne scars, and other types of scar.
It may cause scabbing, swelling, and redness. These generally fade after 2 weeks, but some pinkness may remain for several months. The desired results are not immediate, and may take several months.
Microdermabrasion uses a powerful vacuum to spray microcrystals of aluminum oxide across the surface of the skin. The procedure removes the outermost layers of skin cells, and it stimulates cell growth in the underlying layers of skin.
This type of treatment is said to help give a fresher and smoother appearance to the skin, as well as diminishing the appearance of lines and wrinkles, enlarged pores, coarse skin, and sun damage. The patient may have slight redness in the areas of treated skin.
Repeated treatments are required because results are temporary.
Laser, light source, and radiofrequency (RF) treatments destroy the outer layer of skin with a laser beam, while the dermis, or underlying skin, is heated up. This stimulates the development of new collagen fibers.
In 2013, a study reported over 90 percent satisfaction one month after undergoing RF, and up to 75 percent satisfaction after 6 months, but the researchers called for further investigations into safety and effectiveness.
When the wound heals, the new skin is smoother and tighter, but ablative laser resurfacing can take several months to heal.
Newer therapies using laser technology may heal more quickly.
Non-ablative lasers, radiofrequency devices and pulsed light sources do not damage the epidermis. The underlying skin is heated, triggering the formation of new collagen and elastin.
The skin feels firmer and appears refreshed after several treatments, and recovery times are faster, but more treatments are needed and results are more subtle.
Botulinum toxin type A, commonly known as Botox, blocks the chemical signals that cause muscles to contract. It is used to treat a number of medical conditions, as well as wrinkles.
It is injected in small doses into targeted muscles. If the muscles can no longer tighten, the skin flattens, giving a less wrinkled and smoother appearance.
Botox can decrease the lines on the forehead, the frown lines between the eyes, and "crow's feet," around the corners of the eyes.
Treatments generally last 3 months, so repeated injections are needed.
A chemical peel involves applying a chemical solution to wrinkly areas, causing the dead skin to shed and eventually peel off. The regenerated skin tends to be smoother and less wrinkled than the old skin.
Some types of chemical peels can be bought and used without a medical license, but it is advisable to consult a medical health care professional for the treatment.
A facelift, also known as a rhytidectomy, is a type of cosmetic surgery that aims to make people look younger. It usually involves removing excess facial skin and fat, with or without tightening the underlying tissues.
The skin of the face, neck, or both is redraped. Research suggests that after 5 1/2 years, a facelift is still effective, but that the neck starts to relapse. Healing times may be lengthy, and the patient will experience bruising and swelling for a few weeks after surgery.
Soft tissue fillers include collagen, hyaluronic acid, or fat. They are injected into deeper face wrinkles, plumping and smoothing them out and giving the skin more volume.
Patients may sometimes experience swelling, redness, and bruising in the treated areas for a short period. As with Botox treatment, for lasting results, the treatments will need to be repeated every few months.
The results are dependent on several factors, including where the wrinkles are and their depth.
Preventing wrinkles and lines
Aging is a natural process, and eventually, everybody has wrinkles and lines that become more prominent over time.
Moisturizing creams may help to reduce the appearance of wrinkles.
The following steps may help slow the process down:
Avoiding excessive sun exposure reduces skin damage, because the sun causes the skin to age faster. Hats, protective clothing, and sun screens can protect the skin from wrinkles by reducing sunlight damage.
Zero exposure to sunlight totally is not recommended, however, because it is a vital source of vitamin D, and vitamin D is essential for bone strength and other aspects of health. Some sunscreens can protect the skin while allowing vitamin D to be synthesized.
Moisturizers do not prevent wrinkles, but they may help temporarily make tiny lines and creases less evident.
Quitting smoking can prevent the accelerated aging of skin. Even a long-term heavy smoker can slow down the process by giving up.
Avoid alcohol because it dehydrates the body and the skin.
Sleeping at least 7 hours a night, eating healthily and exercising regularly help to maintain overall health, and this may include skin quality, although this has not been extensively proven by research.