Cosmetic Procedures: Wrinkles

We've all heard the clichés: Wrinkles are a roadmap of your life. But many of us would rather not be reminded of the distance we've traveled. What can you do? First, understand what causes wrinkles. Then, if you still want to reduce wrinkles, explore your treatment options.

What Causes Wrinkles?

The following factors are the most significant:

Aging

Wrinkles are a by-product of the aging process. With age, skin cells divide more slowly, and the inner layer, called the dermis, begins to thin. The network of elastin (the protein which causes skin to stretch) and collagen fibers (the major structural proteins in the skin), which support the outer layer, loosen and unravel, causing depressions on the surface. With aging, skin also loses its elasticity, is less able to retain moisture, oil-secreting glands are less efficient and the skin is slower to heal. All of these contribute to the development of wrinkles.

Facial Muscle Contractions

Lines between the eyebrows (frown lines) and lines jutting from the corner of the eyes (crows feet) are believed to develop because of small muscle contractions. Smiling, frowning, squinting and other habitual facial expressions cause these wrinkles to become more prominent. Over time, the expressions coupled with gravity contribute to the formation of jowls and drooping eyelids.

Sun Damage

Exposure to ultraviolet radiation (too much sun) can result in premature aging of skin. Premature aging of the skin is called photoaging. The ultraviolet sunrays that cause photoaging damage collagen fibers and cause the excessive production of abnormal elastin. When ultraviolet light damages skin tissue, an enzyme called metalloproteinase is produced. This enzyme creates and reforms collagen. During the process, however, some healthy collagen fibers are damaged, resulting in a disorganized formation of fibers called solar scars. Wrinkles develop when the rebuilding process occurs over and over.

Smoking

Healthy skin perpetually regenerates. While old collagen is broken down and removed new collagen is produced. Researchers have found that smoke causes a marked reduction in the production of new collagen. A lack of new collagen results in the development of wrinkles.

What Are the Treatment Options for Wrinkles?

There are numerous over-the-counter treatment options for wrinkles, including various creams and lotions. Prescription treatments, including the retinoid cream renova, are also an option.
Removing skin layers to reduce wrinkles or irregular depressions is an effective way to regain smoother, more youthful looking skin. Dermabrasion (scraping layers away) and chemical peels (dissolving skin away) are two of the traditional methods used in skin resurfacing. Laser skin resurfacing with an ablative laser (such as an erbium or carbon dioxide laser) is another technique that, like dermabrasion and deeper chemical peels, may require some downtime during the healing process.

Other lasers, known as non-ablative lasers, may also be beneficial in treating wrinkles. These lasers work by heating the dermis and stimulating collagen growth. This process, which leaves the outer layers of skin intact, has no downtime associated with it. However, the results are not as dramatic as the ablative lasers which actually remove the surface layers of skin.
Botox collagen and other injections are the addional techniques available to help minimize wrinkles.

If you are considering treatment for your wrinkles, ask your doctor which procedure is right for you. There is no replacement for your doctor's professional advice. Each person has his or her own individual needs; similarly, each procedure fulfills its own specific need.

Reviewed by the doctors at The Cleveland Clinic, Department of Dermatology.