Cosmetic Dermatology Conditions - Wrinkles / Lines

The main causes of aging skin are due to two primary sources: the natural decreasing elasticity of the skin with increasing age, and sun exposure.

In regards to the natural decreasing elasticity of the skin with increasing age, collagen formation and elastic tissue formation is decreased as a person age. This may be primary due to the decreased ability of collagen / elastin producing cells to reproduce as they themselves age. The result is less viable collagen and elastin production leading to saggy, thin skin tissue clinically seen as wrinkles.

Sun exposure dramatically decreases the time needed to age skin and lead to wrinkles. The harmful ultraviolet radiation in sun exposure destroys normal elastic tissue and renders it useless. The result is sagging skin clinically seen as wrinkles. Also, the skin tends to thicken and become somewhat “leathery” with greater degrees of exposure as a method of protection.

The baseline treatment for prevention of aging / wrinkles / photodamage is the use of sun-protective clothing, sunscreen, and retinoid products. A suitable sunscreen should be applied in generous amounts several times a day to the face and exposed body. An SPF of 15 or higher should be used on the face and 30 or more to the body. Persons should avoid the sun during the times of 10am – 3pm (peak intensity). In addition, the use of a retinoid has been scientifically shown to prevent or reverse aging. The best retinoids are obtained with a prescription from a dermatologist knowledgeable about treatment regimens and side effects, although suitable retinoids may be found in many over-the-counter products (e.g. ROC). Other topical products that may be used include those containing Vitamin C or Vitamin E antioxidants.

Laser treatments may also lessen the effects of aging and reduce fine lines / wrinkles. The non-ablative lasers (do not peel off the skin) have variable results while the ablative lasers (peel off the top layer of skin) are the gold standard for all types of wrinkles, but have significant downtime. Newer laser treatments include the use of fractional resurfacing laser technology (Fraxel®, Starlux®) which combine excellent efficacy with minimal downtime.

Chemical peels and dermabrasion have also been used to treat wrinkles and photoaging with great success. In regards to treating wrinkles specifically, BOTOX® and Restylane®, Juvederm® (and similar collagen treatments) are very widely used in both treatment and prevention of wrinkles in a variety of locations. Over-the-counter BOTOX® alternative creams exist that are thought to enhance collagen production and promote thicker, fuller, and healthier skin.