What causes wrinkles?
Wrinkles
are a natural part of aging. Wrinkles form in part because the
supportive components of the skin (such as elastin, collagen
and hyaluronic acid) degrade as we get older. Although much
research has been directed at understanding why this happens,
it is still a mystery. Everyone ages at a different rate based
on genetics, sun exposure, general health, and lifestyle choices
(such a smoking and drinking). You can profoundly affect how
rapidly you age by avoiding the sun and living a healthy lifestyle.
For example, sunlight damages the natural layers of the skin
and destroys collagen. For proof of this, examine parts of your
skin with minimal sun exposure, such as the inner arms, inner
thighs, or buttocks. Notice how soft and smooth the skin is
compared to your forearms or face.
Is there an effective wrinkle treatment?
The best wrinkle
treatment is prevention. By avoiding the sun (including
tanning booths) and living a healthy lifestyle, your skin will
look younger. However, there are many techniques in use today
to treat wrinkles.
Nonprescription and Prescription Creams:
• What are they?
Available over the counter, most wrinkle creams
essentially moisturize the skin. Some formulations (such as those
with retinol, vitamin C, or glycolic acid) may improve the texture
and color of the skin. Unfortunately, they typically do not have
dramatic effects and can be quite expensive. Prescription creams,
most notably synthetic derivatives of Vitamin A (retinoids), can
provide better results in improving sun-damaged and aging skin.
• What are the risks?
Over the counter creams are usually well tolerated.
However, retinoids can be irritating and some people are not able
to use them. Also, they must be used continuously for continued
benefit. Creams may not work for everyone and the risks and benefits
need to be discussed with your physician.
Dermabrasion (Mechanical Resurfacing)
• What is it?
Mechanical resurfacing of the skin has been in
use for about 30 years and involves the use of motorized abrasive
tools to remove the outer layers of the skin in a controlled setting.
A new layer of skin replaces what was removed and the new layer
typically has a more youthful appearance.
• What are the risks?
Local anesthesia is required for pain control
during the procedure. Dressings usually need be worn after the procedure
and temporary facial swelling and pain is normal. Within 7-10 days,
the skin has healed but is often very red. Complete healing may
take up to one month and collagen remodeling may continue for months
after the procedure. With the advent of newer, less destructive
techniques, dermabrasion has become less popular. It is still used
for acne scarring, however. Complications are rare but include infection,
prolonged healing, abnormal discoloration, and scarring. Dermabrasion
is not for everyone and the risks and benefits need to be discussed
with your physician.
• What is it?
Microdermabrasion is a fairly new and popular
procedure and is classified as very superficial dermabrasion. This
method employs aluminum oxide crystals which are propelled at the
skin and then immediately vacuumed up. Although not scientifically
proven to improve wrinkles, many patients report that their skin
feels smoother after multiple treatments (7-10, spaced about one
week apart).
• What are the risks?
Because microdermabrasion penetrates only the
most superficial layers of the skin it is painless and requires
no downtime. The cost is moderate and requires a series of treatments.
Microdermabrasion is not for everyone and the risks and benefits
need to be discussed with your physician.
• What are they?
Your physician can administer a peel using a variety
of different chemicals to remove age spots, discoloration, wrinkles
and fine lines. Chemical peels may smooth and firm the skin and
may lighten age spots gradually. The superficial peels, such as
a glycolic acid peel can be done during your lunch hour, and there
is no recovery time. Deeper peels are more effective but require
longer recovery. See more details under discussion chemical peels.
• What are the risks?
Different kinds of peels carry different risks.
Superficial peels are usually quite safe. However, you may need
a series of superficial peels (done approximately once a month)
before you'll notice improvement. Costs can add up if you choose
a series of peels. The risks and benefits vary depending on the
kind of peel need to be discussed in detail with your physician.
• What is it?
Laser resurfacing is an in-office treatment where
age spots, wrinkles and lines are “burned” off with
a laser. Laser resurfacing usually removes most age spots, age related
discoloration, and wrinkles, often in just one treatment. Some lasers,
such as the CO2 laser are considered the gold standard in terms
of facial rejuvenation. With good sun protection, the effects can
last up to five years. See more details under discussion of lasers.
• What are the risks?
Lasers actually remove the outer portion of the
skin- called the epidermis. Because of this, you may experience
some pain as well as redness and peeling. You may even form scabs
in the days after the procedure. Expect recovery time of at least
a week. Laser therapy is also expensive. One treatment can cost
anywhere from $1,000 to $5,000, depending on how much of your face
is treated. The risks and benefits of laser resurfacing need to
be discussed in detail with your physician.
• What is it?
IPL is one of the newer forms of facial rejuvenation.
Unlike lasers, which use intense, focused light, IPL is intense
broadband light. Although IPL delivers energy to both the superficial
and deep layers of the skin, the epidermis is spared from damage.
Thus, there is virtually no recovery time. In the studies that have
been performed so far, IPL can smooth the skin and fade age spots,
freckles, melasma, and even broken blood vessels. Improvements usually
last for about a year with good sun protection.
• What are the risks?
IPL is safer than laser therapy because IPL does
not damage the epidermis. There may be some pain during the procedure
but no recovery time. Unlike laser therapy, however, you may need
multiple treatments (average is 4-6, at three weeks intervals) to
get the full benefit. The cost is variable, but is usually more
expensive than peels and less expensive than lasers (300-600 dollars
per treatment on average). The risks and benefits of IPL therapy
need to be discussed in detail with your physician
• What is it?
Thermage uses a technology that delivers a radiofrequency
pulse deep into the skin. The thermage probe simultaneously cools
the epidermis to protect it during treatment. The energy from the
radiofrequency heats the collagen which immediately tightens the
skin. Heating of the collagen may also stimulate the production
of new collagen such that improvements may continue for up to six
months. Thermage can be performed on all skin types.
• What are the risks?
Although relatively new, thermage appears to be
safe with side effects reported in less than 1% of patients. Like
IPL, thermage does not damage the epidermis. Thus, there is usually
no recovery time. It can be painful, however, and your physician
may offer you pain medication or topical anesthesia. Side effects
include swelling, redness, bumps and blisters on or around the treated
area. These side effects usually disappear in a few days or weeks.
A rare (<0.2%) but longer lasting side effect described as a
skin depression has also been reported. The risks and benefits of
thermage need to be discussed in detail with your dermatologist.
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