Wrinkles, a natural part of ageing, are most prominent on sun-exposed skin, such as the face, neck, hands and forearms.
Although genetics mainly determine skin structure and texture, sun exposure is a major cause of wrinkles, especially for fair-skinned people. Other factors, such as pollutants and smoking, also contribute to wrinkling.
If your wrinkles bother you, you have more options than ever to help smooth them or make them less visible. Medications, skin-resurfacing techniques, fillers, injectables and surgery top the list of effective wrinkle treatments.
Wrinkles are the lines and creases that form in your skin. Some wrinkles can become deep crevices or furrows and may be especially noticeable around your eyes, mouth and neck.
Wrinkles are caused by a combination of factors — some you can control, others you can't:
Age. As you get older, your skin naturally becomes less elastic and more fragile. Decreased production of natural oils dries your skin and makes it appear more wrinkled.
Fat in the deeper layers of your skin diminishes. This causes loose, saggy skin and more-pronounced lines and crevices.
Exposure to ultraviolet (UV) light. Ultraviolet radiation, which speeds the natural ageing process, is the primary cause of early wrinkling. Exposure to UV light breaks down your skin's connective tissue — collagen and elastin fibres, which lie in the deeper layer of skin (dermis).
Without the supportive connective tissue, your skin loses strength and flexibility. The skin then begins to sag and wrinkle prematurely.
- Smoking. Smoking can accelerate the normal ageing process of your skin, contributing to wrinkles. This may be due to changes in the blood supply to your skin.
- Repeated facial expressions. Facial movements and expressions, such as squinting or smiling, lead to fine lines and wrinkles. Each time you use a facial muscle, a groove forms beneath the surface of the skin. And as skin ages, it loses its flexibility and is no longer able to spring back in place. These grooves then become permanent features on your face.
Several wrinkle treatment options are available to help smooth wrinkles or make them less noticeable.
Topical retinoids. Derived from vitamin A, retinoids — such as tretinoin (Renova, Retin-A) and tazarotene (Avage, Tazorac) — that you apply to your skin may reduce fine wrinkles, splotches and skin roughness.
Because retinoids can make your skin burn more easily, you'll need to use a broad-spectrum sunscreen and wear protective clothing daily. Retinoids may cause redness, dryness, itching, and a burning or tingling sensation.
Nonprescription wrinkle creams. The effectiveness of anti-wrinkle creams depends in part on the active ingredients. Retinol, antioxidants and some peptides may result in slight to modest improvements in wrinkles.
With nonprescription wrinkle creams, your results, if any, are limited and usually short-lived because these creams contain less of the active ingredients than do prescription creams.
Surgical procedures and other techniques
A variety of skin-resurfacing techniques, injectables, fillers and surgical procedures are available to smooth out wrinkles. Each has its own set of potential results and side effects. Some studies indicate that a combination of treatments may yield the most satisfying results.
Laser, light source and radiofrequency treatments. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis), stimulating the growth of new collagen fibres. As the wound heals, smoother, tighter skin forms.
It can take up to several months to fully heal from ablative laser resurfacing. Risks include scarring and lightening or darkening of skin colour.
Other laser techniques, such as nonablative laser fractional resurfacing, have decreased healing time and reduced risks. Nonablative lasers are better suited to people with moderate wrinkles because results are subtle. Nonablative laser treatment typically needs to be repeated more often than does ablative treatment.
There's also a device that uses radiofrequency instead of light for nonablative treatment that achieves mildly to the moderately tighter skin.
- Chemical peel. Your doctor applies an acid to the affected areas, which burns the outer layer of your skin to remove age spots and freckles, as well as wrinkles. Depending on the depth of the peel, you may need several before you see a difference. Redness lasts up to several weeks.
Dermabrasion. Also called dermaplaning, this procedure involves sanding (planing) the surface layer of skin with a rotating brush. The planning removes the skin surface, and a new layer of skin grows in its place.
Redness, scabbing and swelling generally last a couple of weeks. It may take several months for pinkness to fade and for you to see results.
Microdermabrasion. Similar to dermabrasion, this technique removes only a fine layer of skin. This technique usually requires a series of treatments to produce results.
You may notice a slight redness or stinging sensation on the treated areas. Microdermabrasion produces modest, temporary results.
Botulinum toxin type A (Botox). When injected in small doses into specific muscles, Botox keeps the muscles from contracting. When the muscles can't tighten, the skin appears smoother and less wrinkled.
Botox works well on frown lines between the eyebrows and across the forehead and on crow's-feet at the eye corners. Results typically last about three to four months. Repeat injections are needed to maintain results.
- Soft tissue fillers. Soft tissue fillers, which include fat, collagen and hyaluronic acid (Restylane, Juvederm, others), can be injected into deeper wrinkles on your face. They plump and smooth wrinkles and furrows. You may experience temporary swelling, redness and bruising in the treated area. The procedure may need to be repeated every few months.
- Skin tightening. Several devices use heat to tighten the skin. This noninvasive treatment produces mild to modest results, which usually develop gradually over four to six months. There's no recovery time for this procedure.
- Face-lift. The face-lift procedure involves removing excess skin and fat in your lower face and neck and tightening the underlying muscle and connective tissue. The results typically last five to 10 years. Healing times can be long after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.
Keep in mind that results vary depending on the location and depth of your wrinkles. Nothing stops the ageing process of skin, so you'll likely need repeated treatments to maintain benefits.