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Wrinkles

Definition

Wrinkles are the thin, creased, and sagging skin that is especially noticeable on the face, neck, and hands.


 
Description

Wind, heat and chemicals and the natural effects of aging cause a certain amount of wrinkling in everyone, but it is much worse in people who spend a lot of time in the sun. Years of exposure to the sun cause "photoaging," which includes freckles, yellowing, roughness, visible blood vessels, and dark spots, as well as wrinkling.

Typically, as a person ages, the sweat and oil glands of the skin become less numerous and smaller in size. This causes the skin to lose moisture and to dry out, and it soon begins to sag in places where the collagen, the elastic fibers that support the skin, has weakened the most. The skin around the eyelids, jaw, and neck is especially thin, and therefore more naturally prone to aging.

Much of wrinkling is predetermined genetically from one's parents.

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Causes and Risk Factors

Although people may have a genetic predisposition to severe wrinkling, it is known that sun exposure promotes and exacerbates wrinkling of the skin. Smoking may also negatively affect the skin.

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Treatment

Some physicians may recommend daily moisturizing creams, including those with hydroxy acids as well as sunscreen (SPF 15 or greater).

It is not possible to repair deeply furrowed skin or the tiny blood vessels that appear with photoaging, but wrinkles, dark spots, and rough skin may be improved with the use of topical tretinoin.

This medication must be prescribed by a doctor and rubbed on daily for several months before improvement is noticeable. Tretinoin is usually used to treat acne. Health insurance usually does not cover the cost. It is not effective if you continue to sunbathe or use a tanning bed. The effectiveness of long-term use and the ability to retain any improvement after discontinuation of the product is not known for sure.

In some cases, a doctor may apply a chemical to the face ("chemical peel"), causing the skin to peel as it would after a sunburn. This improves fine wrinkles but can cause scarring if it is not carefully limited to the surface layers of the skin.

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Laser Surgery

Laser surgery may help resurface superficial and moderately deep wrinkles of the face.

Rapid pulsing or scanning of the laser beam precisely removes the top layer of skin. This vaporizes the extra folds that cause the wrinkle, leaving a fresh skin surface.

The laser also affects collagen within the dermis, the second layer of the skin. The heat generated by the laser stimulates the collagen to re-form, resulting in a tightening of the skin and a more uniform, smooth appearance. Moreover, results are technique-sensitive, so physicians with extensive laser skills and experience are the best choices for treatment.

Risks include scarring and infection. In addition, laser resurfacing can be expensive and is usually not covered by health insurance.

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Prevention

Onset of wrinkles and further progression of those already present can be prevented by following these tips:

  • Never use a sunlamp or tanning bed or lie in the sun to get a tan.

  • When exposure to the sun cannot be avoided, wear a wide-brimmed hat, sunglasses, and tightly-woven clothing. The sun can cause damage even on cloudy and winter days, especially between 10 AM and 3 PM.

  • About 30 minutes before you go out in the sun, apply a sunscreen with a sun-protection factor (SPF) of at least 15. If you have a fair complexion or sun-sensitive skin, you may need a higher SPF, such as 30 or even 45, especially in a southern climate or at a high altitude. Remember that water, sand, snow, and concrete reflect the sun's rays and increase the likelihood of sunburn. Rub plenty of sunscreen on all exposed skin, paying special attention to the back of the neck, ears, nose, and shoulders.

  • If you choose a sunscreen that is not waterproof, reapply it after swimming, perspiring heavily, or toweling off.

  • To keep the skin from drying, use a moisturizer on a regular basis after washing. A good lotion or cream applied to the dampened skin helps keep it from drying by trapping and holding the moisture on the skin surface.

Harmful effects of the sun build over a lifetime, so protection should begin in early childhood. Although sunscreens are very helpful, they do not protect you completely from the sun's damaging rays.

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Questions to Ask Your Doctor

What is the principal cause of the wrinkles?

Are any treatments effective?

What are the risks and side effects?

If there is improvement, how long will it last?

What is the cost?

What can be done to prevent any further wrinkling?

Would a moisturizer help?

Does sunscreen help?

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