Several changes that naturally occur with age, such as drying of the skin, loss of sweat glands, and loss of elasticity contribute to wrinkling. The tendency for wrinkling is also in no small part determined by genetics, which we have no control over. Thus, wrinkles are often viewed as the inevitable result of aging, and this was a truism in the past. Even now, there is some truth to this. However, this is slowly changing due to two major factors: We have a better understanding of the environmental factors that contribute to premature aging, and we have procedures that are capable of major improvements in skin aging, including wrinkling.
Much of what many call "the clock" moves at different rates depending on environmental factors, and in the case of skin aging, sun exposure is one of the most important factors that influence how quickly we age. Although the same thing can be said in other medical fields, even minor changes in lifestyle will have a major impact in the long-term as these good and bad habits are repeated for years or decades.
Procedures like botox, fillers, and cosmetic surgery are relatively new in the field of dermatology, but have had an excellent safety record overall. Its effectiveness made many change the way we view aging; flaws like wrinkles are now viewed as preventable to a certain extent, and are in many ways reversible.
While some of the factors that influence wrinkles are inevitable or beyond our control, many are environmental factors that can be improved with lifestyle changes. Prevention is often considered to be the best medicine, and this applies in this case too. It is important to remember that wrinkles and other forms of skin damage are the result of accumulating minute amounts of damage over a very long period of time. Sun exposure from a single vacation in Mexican beach or a drinking binge at Las Vegas (both very dangerous for other reasons) is not likely to play a large role in wrinkle formation, but the use or non-use of sunscreens on a regular basis likely will. Thus, improvement must aim at a long-term lifestyle reform.
Sun exposure is one of the largest causes of premature aging and can have a large effect on wrinkle formation in particular. Regular use of broad spectrum sunscreens with a SPF of 15 or higher is recommended. This simple adjustment can make a huge difference in skin health over the years. A good way to visualize the effect and significance of sun damage is to compare the inside of your arms which is typically protected from sun exposure with the outside of the arms, which is typically exposed. The difference in skin quality is the result of years of accumulated sun damage.
Smoking is a well known source of many health problems. It also damages the skin, by breaking down collagen which is required to regenerate new skin tissue. Similarly chemicals in cigarettes reduce blood flow and make it difficult for the nutrients to reach the skin. These effects serve to accelerate skin aging and promote wrinkle formation. Stop smoking as soon as possible; your skin will thank you for it.
Other environmental factors
Diet, stress, and exposure to pollution are all considered to be factors that affect premature aging as well as general health. While sun exposure and smoking are the two major culprits, making healthier choices in the other areas of life can make a big difference in skin aging, as well as provide you with other health benefits.
Topical treatments can roughly be divided into cosmetics which are available over the counter, and prescription products which are designed to treat aging skin. Cosmetic products are mainly moisturizers which improve the appearance of fine lines and superficial wrinkles by moisturizing the skin. It is important to understand the limitations of moisturizers and creams that are available over the counter. Over the counter products are not regulated by the FDA, and claims that seem too good to be true should be viewed with suspicion.
Topical products can only affect the top layer of the skin, and will not affect deeper wrinkles, and their effect is only temporary. Prescription products which contain acids, work as a chemical peel, designed to damage the top layer of the skin in a controlled manner, promoting collagen production and healing. These have a greater effect on wrinkles compared to cosmetic creams but are limited to treating superficial lines.
Botox is one of the most popular and effective treatment methods for deeper wrinkles. Its main function is to prevent the development and advancement of wrinkles by paralyzing the facial muscles. Botox is especially effective for forehead lines which are primarily caused by overuse of facial muscles over the years. Unlike topical treatments, Botox can have a direct impact on the processes that affect wrinkling that occur deeper in the skin.
Botox treatment is one of the most effective treatments for deeper wrinkles, but Botox treatments are not permanent, and retreatment will be necessary in 3 to 6 months. As treatments can cost a few hundred dollars, maintenance can be costly.
Various surgical techniques are available for rejuvenating the face, which includes improvement of wrinkles. The depth and goal of the procedures vary but generally the procedures aim to pull the skin and reduce excess skin which causes laxity, and a wrinkled look. Although these procedures involve risks associated with any surgery, its effect on overall appearance is unparalleled. In many cases, a procedure can make a patient appear 5 to 10 years younger in terms of skin health.
Cosmetic surgery is one of the most powerful tools that cosmetic dermatologists have at their disposal to improve appearance. The effects of the procedure are long lasting unlike Botox or other fillers and topical medication. It is important to note, however, that no procedure will stop the normal aging process, or counter the continual effects of gravity or use of facial muscles. Retreatment is a possibility years down the line.
Cosmetic surgery also comes with all the risks inherent in any surgical procedure, which may disqualify some patients, such as those who smoke or those with blood pressure problems, as the risk may be too high to justify for a non-medical procedure. It is very important that patients choose a qualified surgeon that have proper credentials as well as experience, and can communicate well with the patient, as both parties need to work as a team for the procedure to be fruitful. Some key points that all parties should be aware of are:
- Total costs of the procedure
- Expectation (patients must have realistic expectations and understand the limits of the procedure, and surgeons and patients should meet eye to eye on the expected results)
- Risks (All surgical procedures come with inherent risk such as infection) should be understood in full
- Scar Management (scarring is not considered a risk, but rather an inevitability-surgeons are aware of this, and will have methods to make the scars less noticeable)
- Pain Management (Patients should be aware of post operative pain, its severity and effect on daily tasks, and duration)
- Preparation (Patients must understand any preparatory steps, which could include lifestyle changes such as stopping smoking or weight loss)
- Recovery Period (Many cosmetic procedures involve significant cutting, and take time to heal. During recovery, activities will be limited, and pain and distress also need to be accounted for. How one copes during the recovery is individual, as well as the rate of healing, but patients and surgeons should understand the expected duration and restrictions during the recovery)