The skin is the body's largest
organ, and is divided into 3 layers: the epidermis, the dermis,
and the hypodermis (also known as the subcutis).
The epidermis is the outermost
layer of skin and contains regenerative layers of skin cells. The
dermis is the next layer and contains connective tissue (i.e. collagen)
and other fibers that give the skin strength and elasticity. The
deepest layer, known as the subcutis or hypodermis, is composed
primarily of fat. The subcutis supports blood vessels and nerve
fibers that feed the overlying dermis and epidermis.
As skin ages, the supportive components
of the skin are gradually destroyed. For example, elastic fibers
in the dermis break down and are permanently lost. Collagen fibers
degrade and undergo chemical modifications that destroy their function.
There is also gradual loss of hyaluronic acid, a substance that
maintains the texture in the skin. Thus, the skin becomes stiffer,
thinner, and sags. In addition, wrinkles also appear over facial
muscles as they stiffen with age. Thus, areas subjected to repeated
movements with facial expression, such as the forehead, and around
the eyes and lips, become wrinkled. Finally, the normal healing
processes and cellular repair are gradually diminished; leaving
older skin less resilient to environmental insults. Excessive sun
exposure (including tanning beds) and smoking can greatly accelerate
the aging process.
The classification of wrinkles,
also known as rhytids, is based on how deep into the skin the wrinkles
extend. Fine lines are the result of changes in the upper dermis
and may appear “etched” in the skin. Medium wrinkles
reach the mid-dermis, and deep wrinkles (also known as furrows or
folds) reach the deep dermis and subcutis.
While we cannot reverse every
possible cause of wrinkling, there are steps we can take to minimize
the aging process:
Avoid excessive sun exposure,
including sun lamps and tanning beds. Ultraviolet exposure is greatest
between 10am and 4pm. Use sunscreens in combination with other sun-protective
Quit Smoking. Smoking not only
increases perioral wrinkles (wrinkling around the mouth) but also
places you at a higher risk for skin cancer.
Lead a healthy lifestyle. This includes a balanced
healthy diet, daily exercise, and stress reduction.
Daily skin care should consist of mild cleansing
of the face daily, application of a moisturizer, and daily sunscreen
Many commercial and prescription products are
available topically for the treatment of wrinkles. Professional
treatments for resurfacing or implantation of materials can also
be used for wrinkle treatment. These include:
- Dermal fillers like Collagen, Restylane and Radiesse.
- Botox (Botulinum toxin)
- Laser Resurfacing
- Chemical Peel
- Topical antioxidants- Vitamins A, C, E, selenium, coenzyme Q10, and alpha-lipoic acid.
- Exfoliants- alpha hydroxy acids
- Vitamin A derivatives: Retin A, Renova, etc.
- FotoFacial and IPL Treatment may be used for fine lines
- » Find a Wrinkle Treatment Specialist
All photos courtesy of S. Zimmet, MD and P. Bitter Jr., MD