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Wrinkle treatments

Wrinkles are folds or creases in the skin. There are many wrinkle treatments available and only the most common are discussed here.

About wrinkles

Wrinkles are part of the ageing process; as you grow older, your facial muscles slacken and your skin becomes less elastic, creating folds and lines called wrinkles.

Lines and wrinkles are often found where facial muscles move. Examples include facial expression lines and wrinkles such as frown lines, forehead lines and squint lines at the corners of the eyes (crow's feet).

Causes

Wrinkles are part of the ageing process. But environmental factors such as ultraviolet radiation from the sun, pollution and smoking can dry your skin and make wrinkles appear at a younger age. A poor diet, stress and drinking too much alcohol may also cause wrinkles to appear at a younger age.

Sun damage

Wrinkles usually appear on areas that are most exposed to the sun, such as the face, neck, backs of hands and upper arms. This is because ultraviolet radiation from the sun damages the DNA in skin cells causing it to age. Some sunlight is important because our skin uses it to produce vitamin D, which helps to build and maintain strong bones. But too much sun is harmful and people who spend a lot of time in the sun may develop fine lines and wrinkles at an earlier age compared with people who spend less time in the sun and protect their skin from ultraviolet radiation.

Smoking

Cigarette smoke in the environment dries the skin. Smoking constricts the blood vessels and so depletes the supply of oxygen and vital nutrients to your skin. As a result, people who smoke are more likely to have facial wrinkles at a younger age.

 

  

Treatment

Protecting your skin from ultraviolet radiation, looking after your health and good skin care may help delay the appearance of wrinkles. But eventually the natural ageing process, plus the effects of environmental factors, will lead to unwanted facial lines and wrinkles. Wrinkle treatments can help reduce the appearance of wrinkles, making the skin look smoother and more youthful. Some of the most common wrinkle treatments are discussed here.


Skin creams and gels

Fine wrinkles and some of the milder signs of ageing skin may be improved with prescribed or over-the-counter skin creams and gels containing retinoids (a form of vitamin A). The creams help tighten your skin so that fine lines are less visible.

Chemical peels

Chemical peels containing glycolic acid or lactic acid improve and smooth the texture of the facial skin by removing its damaged outer layers and may help reduce fine lines and wrinkles.

Laser facial resurfacing

Laser facial resurfacing is very effective at reducing mild scarring, or the effects of sun damage, such as wrinkles.

A laser (a beam of high-energy light) is used to remove the outer layers of the skin on your face and stimulate the growth of new collagen fibres. As the area heals, a new skin forms that's softer and less wrinkled or scarred.

Botulinum toxin injections

Lines and wrinkles are often found where facial muscles move. Facial expression lines and wrinkles such as frown lines, forehead lines and squint lines at the corners of the eyes (known as "crow's feet") can be reduced with botulinum toxin injections.

Botulinum toxin is a protein produced by the bacterium Clostridium botulinum. The protein is injected into specific facial muscles. It has the effect of relaxing the muscle, reducing its effect on lines and wrinkles. Untreated areas continue to move as normal and you will be able to laugh, smile and frown, but with less wrinkling of the skin in the treated areas.

The effects of botulinum toxin injections will gradually take effect within seven to 10 days and will achieve full effect in two to three weeks. The treatment usually lasts three to four months. Repeat injections are needed if you want to maintain your appearance.

Botulinum toxin injections are not recommended for pregnant or breastfeeding women or for people who have neurological disorders such as myasthenia gravis.

Dermal filler injections

There are a range of dermal fillers available on the market. They can be permanent or temporary. Your clinician will usually recommend using non-permanent dermal filler made from a tissue-friendly gel that closely resembles a naturally occurring acid in the body.

The filler is injected into the affected area with a tiny needle. It has the effect of plumping up the skin, making it appear fuller and smoother. Dermal fillers are often used to reduce/smooth nose to lip lines, lip to chin lines, lines and wrinkles around the lips, and to enhance lip shape.

The effect of treatment with non-permanent dermal fillers can last from four to nine months depending on the area treated. Repeat treatment is needed if you want to maintain your appearance.

Cosmetic surgery

Cosmetic surgery such as brow lift, forehead lift or a full facelift can help reduce deep wrinkles and sagging skin. The surgery involves lifting up the facial skin and tissues and/or the underlying muscle, to make the face tighter and smoother. The operation can be done on your whole face (a full facelift) or just on your brow area, lower face, or neck only.

The effects of a facelift last for about seven to 10 years. The best results are achieved if you maintain a stable body weight, have skin with good levels of elasticity, and have a strong bone structure. In older people, or people who spend a lot of time in the sun, the results don't last as long.

Deciding on treatment

If you are considering wrinkle treatments it may be useful to speak to your GP who would be able to recommend a suitably qualified cosmetic dentist/surgeon or a health professional trained in facial aesthetic treatments.

It's important not to rush into the decision to have any cosmetic treatment. It's sensible to discuss the options with a clinician who is suitably qualified. Before opting for treatment, discuss with your clinician what you are hoping to gain from the treatment and the result you can realistically expect. It's important to note that:

  • botulinum toxin injections won't improve deep wrinkles caused by ageing and sun damage
  • dermal fillers can't correct sagging skin
  • laser facial resurfacing can cause changes in the skin pigment (colour), so the treatment may not be suitable for people with a darker complexion
  • cosmetic surgery is a suitable option only if you want to remove sagging skin, extra fat and deep wrinkles

Further information

British Association of Aesthetic Plastic Surgeons (BAAPS)

British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

UK Department of Health

Sources

  • Blakemore C, Jennett S. The Oxford Companion to the Body. London: Oxford University Press, 2001:735
  • Samuel M, Brooke R, Griffiths C. Wrinkles. BMJ Publishing Group Ltd. www.clinicalevidence.bmj.com, accessed 4 December 2007
  • Hawk JLM, McGregor J. Understanding the Skin and Sunlight. London: British Medical Association, 2000
  • ASH Factsheet No 10: How smoking affects the way you look. Action on smoking and health (ASH). www.ash.org.uk, accessed 15 January 2007
  • Stratigos AJ, Arndt KA, Dover JS. Advances in cutaneous aesthetic surgery. JAMA 1998;280(16):1397-1398
  • Hruza GJ. Rejuvenating the aging face. Arch Dermatol 2004;140:1383-1387
  • Carruthers J, Fagien S, Matarasso SL, and the Botox Consensus Group. Consensus recommendations on the use of Botulinum toxin type A in facial aesthetics. Plast Reconstr Surg 2004;114(6):1S-22S
  • Dastoor SF, Misch CE, Wang H-L. Botulinum toxin (BOTOX) to enhance facial macroesthetics: A literature review. J Oral Implant 2007;33(3):164-171
  • Botulinum toxin. Trade names include Botox, Vistabel and Dysport and Neurobloc. Department of Health. www.dh.gov.uk, accessed 9 November 2007
  • Dermal filler. Department of Health. www.dh.gov.uk, accessed 13 November 2007
  • Dastoor SF, Misch CE, Wang HL. Dermal fillers for facial soft tissue augmentation. J Oral Implant 2007;33(4):191-204
  • Facelifts. British Association of Aesthetic Plastic Surgeons (BAAPS). www.baaps.org.uk, accessed 4 February 2008

Related topics

Facelift surgery

Laser facial resurfacing

Sun care

Non-surgical facial aesthetic treatments from Bupa Wellness