Wrinkles

Overview

Wrinkles are a natural part of aging, often manifesting as lines and creases on sun-exposed areas like the face, neck, hands, and forearms. Factors such as pollution and smoking can speed up this aging process. To help prevent wrinkles, it’s advisable to use sunscreen daily and avoid smoking. If wrinkles are a concern, there are several treatments available to diminish their appearance, including topical medications, skin resurfacing procedures, fillers, and surgical options.

Symptoms

The lines and creases that develop on your skin are known as wrinkles, with deep wrinkles often being most noticeable around the mouth, eyes, and neck. 

If you’re concerned about your skin’s appearance, consider consulting a dermatologist—an expert in skin care. They can assess your skin, recommend treatment options for wrinkles, and help you create an effective skin care routine.

Causes

Many variables contribute to wrinkles, some of which you can control and others of which you cannot:

• Aging: As you age, your skin naturally becomes less elastic, drier, and loses fat and collagen in the deeper layers. This leads to the formation of lines, wrinkles, and sagging skin.
• Ultraviolet (UV) radiation: UV rays from sunlight and other sources accelerate skin aging, especially in people prone to sunburn. UV exposure damages elastin fibers and collagen, the connective tissues that give skin its strength and flexibility.
• Smoking and pollution: Both smoking and environmental pollutants contribute to faster skin aging.  
• Repeated facial expressions: Movements like squinting, smiling, and frowning create grooves beneath the skin’s surface. Over time, as the skin loses flexibility with age, these grooves develop into permanent lines and wrinkles.  
• Genetics: Your inherited genes significantly influence your skin’s appearance and texture.  

Diagnosis

A diagnosis of wrinkles is examining the skin to determine the presence of creases and lines as well as potential causes. Your medical history and personal priorities are also discussed with your doctor. The choice of treatments that may best suit your needs and objectives for outcomes, side effects, and recovery time is aided by this conversation.

Treatment

Many wrinkle-reduction techniques are available to help minimize wrinkles. Your doctor may prescribe one or more treatments in order to achieve the greatest results.

• Prescription creams and serums: Your doctor may recommend anti-wrinkle creams containing prescription-strength retinoids, which are derived from vitamin A. These products, such as tretinoin, tazarotene, and adapalene, help reduce fine lines and uneven skin tone. Results may take a few weeks or months to appear. Retinoids can cause skin rashes, dryness, or burning and should not be used during pregnancy. Retinoids can also make your skin more sensitive to sunlight, so they are often applied at night. If used during the day, sunscreen with at least SPF 30 and protective clothing, like a wide-brimmed hat, are recommended.  
• Botox injections: Small doses of Botox are injected into specific facial muscles to temporarily paralyze them, reducing the appearance of wrinkles. Botox is effective for frown lines, forehead creases, and crow’s feet. Results typically take up to seven days and last for a few months, with repeat treatments required to maintain the effect. Possible side effects include headaches, droopy eyelids, and localized pain, swelling, or bruising at the injection site.  
• Chemical peels: This procedure removes the top layers of skin by applying a chemical solution, resulting in smoother skin as new skin grows back. Chemical peels may be done without numbing, but sedation is sometimes used for deeper resurfacing. Multiple sessions may be needed for noticeable results. Side effects can include scarring, infection, and changes in skin color, particularly for those with brown or Black skin, who have a higher risk of long-term changes in skin pigmentation.
• Facial fillers: Injectable fillers are used to plump and smooth wrinkles. Examples include calcium hydroxylapatite, poly-L-lactic acid, and hyaluronic acid. It may take 1 to 3 sessions to achieve the desired result, and touch-ups are generally needed every six months. Common side effects include redness, bruising, and temporary skin color changes, which usually resolve within a few weeks.  
• Laser resurfacing: This term covers a variety of facial rejuvenation techniques that use energy to improve skin texture. Ablative laser resurfacing removes the outer layer of skin and heats the underlying tissue, promoting collagen growth for smoother skin. Recovery typically takes 7 to 10 days. Nonablative laser resurfacing is a less intense option that also stimulates collagen production but requires shorter recovery time and has subtler results. 

Both methods can utilize a fractional laser, which creates microscopic columns of untreated tissue in the treatment area. A procedure using a fractional laser may result in a shorter recovery time and a lower risk of side effects. Typically, multiple treatment sessions will be necessary. Risks include scarring, infection, and skin color changes, especially for people with darker skin tones. Consult an experienced professional if you have concerns about hyperpigmentation or keloid scarring.  

• Deoxycholic acid injections: Deoxycholic acid is used to reduce fat under the chin. It is injected under the skin to break down extra fat cells, resulting in less fullness under the chin. Usually, several injections are needed for the best results. Side effects include swelling, pain, numbness, bruising, and hardness in the treated area.  
• Face-lift and neck lift: These surgical procedures lift and tighten the skin and underlying muscles to enhance the appearance of the jawline, neck, and lower face. A neck lift is often performed alongside a face-lift. While these surgeries improve sagging skin, they do not address fine lines, sun damage, uneven skin tone, or creases around the nose and upper lip. The surgery may be performed in a hospital or outpatient center, with local anesthesia, sedation, or general anesthesia. Risks include bleeding, infection, and hematoma (blood collection under the skin). Recovery can take several weeks, and bruising and swelling may persist for some time. Although the results are long-lasting, they are not permanent, and some people choose to have additional procedures years later.  

It’s important to discuss any potential side effects with your doctor, as many of these treatments can have them. Additionally, ask about their experience with patients of your skin tone and how many times they’ve performed the specific procedure you’re considering.