Wrinkles: cause and treatment

What are Wrinkles?

They are lines, creases or folds on the face, neck and hands. They are depressions in the skin that are caused by skin drying and losing its elasticity. Examples are:

• fine facial lines in corners of eyes and upper lips (such as laugh lines)
• deeper lines or furrows that mark the neck, face and hands

Causes

1. Aging: Facial wrinkles are generally a sign of aging as elastic fibers that keep the skin tight begin to loosen over time and allow it sag.
2. Exposure to sunlight: Sun exposure and wrinkles are strongly correlated. It is believed that UV rays increase the production of enzymes that break down the proteins in the connective tissue under the skin layer. Premature wrinkling may be an early warning sign of the type of sun overexposure associated with Skin cancer.
3. Cigarette smoking: This can thicken and break down elastin, the key ingredient that gives skin its overall resilience. Many long time smokers also tend to have deep lines in the upper lip made by the repeat puckering of the lips when inhaling on a cigarette. There is also a theory that nicotine is a 'vaso-constrictor'- this means that less blood gets to the capillaries in the face skin. Smoking also decreases the level of estrogen which helps to keep the skin young and supple. (With this theory, women might be more prone to aging from smoking then men might be.)
4. Yo-Yo dieting: Those who have gained and lost large amounts of weight may see an increase in wrinkles as the skin gets stretched and shrunk over and over.

Prevention

• Stay out of the sun; Wear strong sunscreen (at least SPF 15, but the higher the better) and protective clothing and hats when you are in the sun.
• Keep the skin moisturized. Given that fine lines are caused by dry skin, many wrinkles can be avoided if the skin stays supple and moist.
• Drink lots of water. Fluids also help to keep the skin hydrated.
• Don't smoke.

Topical Treatments Applied at Home

Retin-A: Retinol and other Vitamin A derivatives are known to minimize wrinkles. Retin-A is a topical cream or gel that was originally formulated to help treat severe acne and has recently been prescribed for wrinkles as well. The generic name for Retin-A is tretinoin. This drug is related to the acne medication known as Accutane, another vitamin A derivative. In the 1990's tretinoin was first marketed as a wrinkle remover in a brand called Renova.

Most find that Retin-A causes skin irritation, redness and dryness for the first few weeks of taking it. Women who are nursing, pregnant or planning on becoming pregnant should not use Retin-A or any retinol type product. Some doctors are cautious to provide Retin-A because of its side effects, many skin care companies are marketing over-the-counter products that contain Vitamin A derivitives that are said to combat wrinkles but are actually not as effective.

Vitamin C and E: Vitamin C and E are known to combat free radicals that are created by ultra-violet rays in the skin. Vitamin C has become an increasingly popular ingredient in skin creams. Some research shows that it protects against sun damage.

Vitamin E generally comes in an oil format, so putting that on the skin will, in the very least, keep it moisturized. Some people do have skin irritation to excessive levels of these vitamins on the skin. Thus, an individual needs to assess their senstivity before starting a regular program.

Glycolic Acid / Alphahydroxy Acids: These were originally derived from fruits and sugars. Facialists have been using these products for years as it helps to exfoliate layers of the skin to get rid of find wrinkles. Dermatologists also perform glycolic peels in their office- these get at deeper layers of the skin. There are also many over-the-counter products that carry Glycolic acid- it is questionable whether or not that are effective. It is best to purchase products directly from your dermatologist.

Be careful to protect the face with a hat and sunscreen when using products with glycolic acid as it makes the skin very photo-sensitive. Much of the photo-sensitivity is caused by a thinning of the skin.

Face creams derived from Minerals There has been increasing attention in the dermatology world toward the use of mineral derived face creams. Copper and other minerals have been shown to help heal burn victims skin- which has lead cosmetic manufacturers to develop products to also fight wrinkles.

Treatments Applied by Professionals

Chemical peels: These are dramatic vitamin C, glycolic and Beta peels that cause radical exfoliation of the skin. They can be quite painful and some patients are encouraged to take topical pain-killers before getting them. Many people experience heavy peeling after these treatments but do report more youthful looking skin when they are done.

Microdermabrasion: This has been an increasinly popular form of treatment for fine lines. Both dermatologists and licensed facialists perform this procedure. A gentle small massager head is run over the face to exfoliate and re-generate the skin.

Laser Surfacing: In this treatment, a dermatologist will run a high frequency laser over the skin's surface. This helps to regenerate layers of collagen. The lasers are getting more advanced -they are causing less damage to the skin but still have stong effects.Most report smoother and more supple skin.

Plastic Surgery: In extreme situations, someone may opt to get a 'face-lift'. A fairly invasive procedure that requires sedation. In this procedure a plastic surgeon makes incisions in the face, near the hair line, and removes excess skin. The skin is then pulled back and re-sewn so that the end result is less saggy skin with less lines and wrinkles.

References

• The Complete Home Wellness Handbook, part of the UC Berkeley Wellness Center