Our skin changes as we age. With time, aging skin develops wrinkles, lines and furrows.
Changes to the Skin with Aging
Aging skin loses its underlying layers of fat, and the production of collagen and elastin fibers slows. As a result, the skin loses its fullness and starts to sag.
It starts to develop the following characteristics:
- It becomes thinner
- It develops fine lines and wrinkles
- It develops darkened spots called lentigines
- It becomes drier and susceptible to itching
- It loses underlying fat, leading to hollowed areas near the eyes and cheeks. This loss of fat also causes tendons and blood vessels in the hands to become more noticeable
- Hair loses pigment and turns gray or white hairs
These changes develop slowly, but are continuous.
Although not usually obvious, the changes begin when people are in their twenties.
Factors That Promote Aging Skin and Wrinkles
A combination of factors determine the age at which wrinkles first appear, their location, and their prominence.
These factors include the following:
- Age. The older a person, the more likely he or she is to have wrinkles. Some people start developing wrinkles as early as their twenties, particularly if they have spent their teenage years in a sunny location without using sunscreen and other sun protection measures.
- Family history (Genetic Factors). A person's skin type is inherited. This means that a parent whose skin was prone to wrinkles at an early age can pass that trait onto their children.
- Smoking. Smoking leads to premature aging of the skin.
- Sun Exposure and UV Radiation. Exposure to the UV radiation in sunlight or indoor tanning booths leads to premature aging of the skin. Just a few minutes of sun exposure each day can cause noticeable changes to the skin over time. The term "photoaging" is used to describe this sun-related skin damage. In sunny climates, photoaging may be seen in people as early as in their twenties.
Wrinkles before and after treatment with a topical retinoid
Fine lines and wrinkles arise because of irregular thickening of the dermis and because of a decrease in the amount of water held by the epidermis. This is mainly caused by exposure to the UV radiation of sunlight and exposure to damaging chemicals, such as from smoking cigarettes.
Deeper lines or furrows are described as either “dynamic” when they appear as different muscles move, or “static” if they remain unchanged with muscle movement. Eventually, dynamic lines become static furrows. Some furrows are so common that they have been given their own names.
- “Crow's feet” appear around the eyes. These are due to smiling and activity of the eyelid muscles.
- “Worry lines” appear on the forehead. These are due to contraction of muscle used when raising the eyebrows
- “Frown lines” appear between the eyebrows are due to contraction of muscles when concentrating or angry.
- “Smile lines” frame the lips. These are due to the contraction of muscle due to smiling.
Wrinkle Treatment Options
There are a variety of cosmetic products, medications and procedures that can lead to younger looking skin. These are often combined for best results.
- Topical retinoids (Refissa®, Renova®, tretinoin)
- Chemical peels
- Dermabrasion and microdermabrasion
- Laser rejuvenation
- Laser resurfacing
- Botulinum toxin (Botox®, Dysport®, Xeomin®)
- Dermal Fillers (Belotero®, Juvederm®, Radiesse®, Resytlane®, Sculptra®)
Your physician will recommend a treatment based on multiple factors including the area to be treated and desired results.
Wrinkles are a fact of life. But there are some basic measures that can prevent their premature development. These include:
- Stop smoking
- Do not use indoor tanning booths or tanning lights.
- Use sunscreen every day, even on cloudy days or when the sun penetrates through glass. (UVA rays are a part of the UV spectrum that can pass through glass. Though these UVA rays do not burn, they are responsible for causing premature aging of the skin)
- Practice other sun protection measures, such as avoiding sunlight during peak hours and wearing a wide-brimmed hat.
Images courtesy of Gerald Goldberg, M.D.