What causes wrinkles?
Wrinkles are a natural part of getting older, manifesting as folds and lines on the skin's surface. The depth and size of wrinkles vary from fine lines to deep creases and grooves.
The way your skin looks and feels is largely influenced by your genetics. You may also notice wrinkles appearing more often on areas of your body that are frequently exposed to sunlight, like the face, neck, arms, and hands
Not all wrinkles are the same, however. There are 4 distinct types, each with its own unique set of causes and characteristics.
Atrophic Crinkling Rhytids
Horizontal parallel fine lines known as atrophic crinkling rhytids, or fine wrinkles, often appear around the eyes and is a sign of degrading skin elasticity. This is typically caused by a decrease in collagen production and the degradation of collagen in the skin as we age.
As the skin becomes thinner and more delicate, it produces less oil, making it drier and more prone to creasing. As fat dissipates in the deeper skin tissue, volume loss makes wrinkles more noticeable.
Smoking can also accelerate the aging process by impairing the blood flow to the skin and exposing the body to harmful chemicals.
Permanent Elastotic Creases
Wrinkles that are caused by sun exposure are called permanent elastotic creases and are typically found on the cheeks, upper lip, and back of the neck. A 2013 study reported that a significant portion, up to 80%, of the visible skin changes related to aging are caused by the sun. In addition to wrinkles, the sun can also cause pigmentation problems and increase the risk of skin cancer. UV rays harm collagen and elastin, the connective tissue that gives the skin its elasticity and firmness. Without these supportive fibres, the skin sags, resulting in the formation of wrinkles.
To minimise sun exposure and prevent wrinkles, it is suggested that you avoid the sun from 10 am to 2 pm, when the sun's rays are the strongest. If you must be outdoors during these times, take protective measures such as wearing long sleeve clothing, sunglasses, a hat, and apply sunscreen. The Cancer Council recommends using a sunscreen labelled broad-spectrum, water resistant and with an SPF of 30+ to protect your skin from the sun's damaging rays. Not only can sunscreen help prevent wrinkles, but it may also reverse existing signs of sun damage and wrinkles, according to one study.
Dynamic Expression Lines
Dynamic expression lines are wrinkles that occur as a result of repeated facial movements. These lines form in the skin around the muscles involved in the movement, such as squinting, frowning, or smiling. As we age, the skin loses its elasticity and these grooves become more pronounced.
Common types of expression wrinkles include crow's-feet around the eyes and glabellar lines (also known as "11s") between the eyebrows. Wrinkles can also be named by the action that causes them, such as frown lines or smile lines. Lastly, wrinkles that occur from repeatedly pursing the lips around a straw or cigarette are known as "smoker's lines."
Gravity plays a significant role in the appearance of wrinkles, especially in areas such as the nasolabial folds. These wrinkles, commonly referred to as gravitational folds, are caused by the pull of gravity over time, occurring as loose or drooping skin. Additionally, weight or fat loss, specifically in the face, can exacerbate the appearance of these wrinkles, making them more noticeable.
At what age do wrinkles start appearing?
As we age, the body's production of collagen, a protein that helps keep skin firm and elastic, begins to decline. This natural process typically starts to occur around the age of 25, and by then many people begin to notice wrinkles on their face. However, certain lifestyle factors such as sun exposure, poor diet, smoking, and menopause can accelerate collagen loss and cause wrinkles to appear earlier and more pronounced.
Facial movements can also play a role in the visibility of wrinkles, individuals who have expressive faces are more prone to their development. Common areas for wrinkles to appear are around the eyes, mouth and lips, including nasolabial folds (smile lines), and marionette lines which deepen as time passes.
Nonsurgical ways to get rid of wrinkles
Medical treatments such as laser therapy and neuromodulators (anti-wrinkle injections) have been proven to be more effective in reducing and preventing wrinkles when compared to over-the-counter skincare products.
When treating wrinkles, the most effective approach will vary depending on the type and severity of wrinkles. However, according to doctors and patients, these are some of the best options.
Anti-wrinkle injections are neuromodulators that temporarily interrupt nerve signals to the face muscles, preventing them from moving, which helps minimise the appearance of wrinkles and lines.
They work best on dynamic expression wrinkles, which are caused by repeated muscle movements. These injections can also help prevent wrinkle formation by inhibiting repetitive facial expressions.
However, anti-wrinkle injections are not effective for treating deep, static wrinkles that are visible regardless of muscle movement.
The Therapeutic Goods Administration (TGA) has currently approved several anti-wrinkle formulations as treatments for specific wrinkles lines, e.g. crow’s feet on the side of the eyes, lines on the forehead and frown lines in between the brows. Though it is also frequently used off-label to treat other facial wrinkles such as wrinkles around the lips, nose bridge, the neck and wrinkles on the lower face.
Anti-wrinkle injection results usually last for around 3 to 4 months, this can vary depending on an individual's metabolism, for long-lasting results, regular upkeep is required. It is also important to visit an experienced injector to ensure the best outcomes and avoid complications.
Dermal filler injections can be used to improve the appearance of wrinkles by adding volume beneath the skin. The fillers work by smoothing out the skin, which instantly softens wrinkles. Dissolvable fillers are mostly made of a chemical that is naturally present in the body and deemed very safe. In Australia, the Therapeutic Goods Administration (TGA), a division of the Department of Health, regulates the promotion of dermal fillers and prohibits the open discussion of specific brand names and ingredients. In order to receive dermal filler, a prescription from a doctor is required.
Dermal filler injections are fast and relatively painless, although to maintain the results follow on appointments may be necessary. The results usually last longer than anti-wrinkle injections, with longevity typically seen to be 12 to 18 months.
It's worth mentioning that dissolvable fillers are considered the safest option among fillers, as the effects can be reversed by using an enzyme to break down injections.
Chemical peels are a cosmetic procedure that involves applying an acidic solution to the skin to remove the outer layers, giving a smoother and more revitalised look. This process not only minimizes the appearance of fine lines and wrinkles but also helps to improve other skin concerns like acne scars and sun spots. Lastly, it also promotes cell turnover and stimulates collagen production. The strength of the peel can be tailored to your specific skin condition and tone. Moreover, chemical peels can be a more budget-friendly alternative to laser treatments, which may offer similar outcomes.
Medium-strength peels are an effective option to address wrinkles and other signs of mild sun damage, as they target the outer layer of skin and the upper dermis. These peels typically require a few days for recovery, during which the skin may be red and flaky.
It's worth noting that there is a risk of developing hyperpigmentation from chemical peels and yearly appointments are necessary to maintain results. Since there is a wide range of peels available, make sure to consult a dermatologist to determine the best solution for your individual needs and skin condition.
Laser resurfacing is a procedure that utilizes laser beams to target deep layers of the skin, producing microscopic wounds that activate the body's natural healing response. This process also helps to stimulate collagen and elastin production, resulting in improved skin tone and texture. The newly formed fibres in the skin can result in a firmer, more supple look and feel, reducing the appearance of wrinkles.
Laser skin resurfacing can be broadly classified into two categories: ablative and non-ablative. Ablative lasers deliver effective and long-lasting results in a single treatment but the procedure can be uncomfortable and requires a week to recover. On the other hand, non-ablative lasers provide comparable results with minimal or no time off needed but usually requires multiple sessions. One popular laser treatment, Fraxel, utilises both ablative and non-ablative technology, reducing downtime by targeting only a small area of the skin at a time.
The micro-needling procedure involves puncturing the skin with tiny needles. This creates tiny wounds, which activate the body's natural healing process and encourages collagen production. The new collagen that is produced improves the skin's surface smoothness, reducing the appearance of wrinkles.
This treatment is fast, budget-friendly, and suitable for all skin types. However, it is not recommended for people who have ongoing skin conditions like eczema or rosacea.
You can expect 1 to 3 days of recovery after a micro-needling procedure, during which the skin may appear like it is sunburnt. Unfortunately, some patients have also reported mild scarring and the presence of small puncture marks across their skin, particularly if they have attempted DIY micro-needling or have received the treatment from an inexperienced practitioner.
Micro-needling does not provide transformational results for wrinkles caused by sagging, but it can enhance the skin's overall appearance by reducing fine lines and shallow wrinkles. To achieve visible effects, multiple treatment sessions are typically required.
RF Microneedleing (Vivace, Morpheus 8)
Vivace, Morpheus8, and other comparable treatments merge micro-needling and radiofrequency to tighten the skin. Micro-needling activates the body's healing process and ability to create collagen, while radiofrequency waves firm the skin and reduce wrinkles. Together, this dual treatment improves the skin's overall touch and feel, smoothing lines and wrinkles.
How soon you see results from RF needling depends on your body's collagen production rate. Generally, 3 to 4 treatment sessions, over several months is required to produce observable results. Many patients also require yearly appointments to maintain the effects.
Retinoids are considered as one of the most effective chemicals when it comes to combating wrinkles. Vitamin-A derived retinoids accelerate cell renewal and collagen production, thus resulting in smooth and supple skin. The most common formulation is known as Tretinoin, which is also used to treat acute acne.
However, retinoids also have some drawbacks, Tretinoin can be an exceptional product to slow aging, prevent wrinkles and improve collagen production, but it can lead to skin irritation. To avoid this side effect, it is suggested you start with a lower concentration, such as 0.25%. Making sure, to begin with infrequent application before gradually increasing to everyday use is also beneficial.
Surgeries to get rid of wrinkles
The results from a surgical procedure can be more effective when it comes to removing deep wrinkles and folds.
Blepharoplasty, also known as eyelid surgery, is a surgical procedure that tightens saggy skin on the lower or upper eyelids to minimise wrinkles and elasticity. Recovery is generally short, with most patients experiencing only 4 to 7 days of downtime.
This operation is considered safe and effective, with results lasting 10 to 15 years with minimal risk & side effects.
A facelift, while effective in treating saggy skin on the cheeks, chin, marionette lines, and neck may not be the best option for handling fine lines and superficial wrinkles. For these issues, other cosmetic procedures may be more appropriate. But a facelift can produce very noticeable results for deep folds, wrinkles, and sagging skin.
A facelift procedure should be performed by a specialist plastic surgeon, who tightens the face muscles, repositions the skin, and removes any extra skin to smooth out wrinkles and folds on the face.
A facelift can be performed under general anesthesia or local anesthesia with intravenous sedation, and typically takes place on an outpatient basis, meaning you can return home the same day.
However, it's important to note that this procedure is on the higher end cost-wise and may require up to two weeks of recovery time (although some patients return to regular activities sooner). Due to the complex nature of this surgery, there is also a higher risk of complications compared to less invasive alternatives. Despite this, patients tend to have high satisfaction with facelift results.
For individuals seeking a more defined jawline and a smoother neck, a neck lift is a great choice. A neck lift can be carried out under general or local anesthesia, and the procedure focuses on removing surplus fat and loose skin along the neckline.
A neck lift is an extensive procedure that often requires 1 to 2 weeks of rest. Also, you can expect a period of 3 to 4 months before being fully healed. Despite this, the results can last for many years.
Neck lift surgery is deemed relatively safe. However, as with all surgical procedures, there are some rare side effects and risks that should be noted. For example, nerves on the face can be temporarily damaged during a neck lift, resulting in limited movement on a side of the lower face. Luckily, patients usually recover from this side effect within 3 to 6 months.
To elevate drooping eyebrows and reduce wrinkles on the forehead, a brow lift is a surgical procedure that can give the upper section of the face a more young and rejuvenated look.
Different techniques are used to perform brow lifts but all of them involve incisions and can lead to scarring or hair loss at the incision site, bruises and swelling are also common post-op.
Though recovery times vary from person to person and the final results can be seen after roughly 6 months. The outcomes of a brow lift can last as long as 10 years if proper care is taken, e.g. using dermatology-grade skincare and SPF 50+ sunscreen products.
Can over-the-counter skincare products get rid of wrinkles?
Over-the-counter skincare products containing ingredients such as retinol, peptides, hyaluronic acid, and antioxidants may lightly reduce the appearance of wrinkles. However, the results are not comparable to dermatology-grade skincare products or in-clinic treatments. Consistently moisturising also hydrates and firms the skin, making wrinkles less visible.
Antioxidants play a crucial role in maintaining skin health by protecting the skin from sun exposure, decreasing inflammation, lightening skin tone, and assisting in cell regeneration. Additionally, on top of the natural metabolic process, oxidative stress can be caused by environmental factors such as sun damage, smoking, and pollution. Regularly incorporating antioxidants into your skincare routine can help offset these elements.
Vitamin C as an antioxidant has been extensively researched and is known for its ability to stimulate collagen and safeguard the skin from the harmful effects of sun exposure and premature aging. A top-rated range of Vitamin C products, Obagi Serums are particularly popular among experts due to their high antioxidant content and effectiveness in delivering the benefits of Vitamin C to the skin.
Vitamin A is considered one of the strongest and most effective antioxidants. It works by stimulating the skin's cellular repair process, which helps to eliminate wrinkles and other signs of aging.
Coenzyme Q10 is an antioxidant that our body naturally produces. Our supply of this antioxidant, which is vital for maintaining healthy skin, elasticity, and texture, decreases as we get older. Incorporating supplements and products containing CoQ10 can help to restore your skin's youthful appearance and radiance.
Resveratrol has antioxidant and anti-inflammatory properties that enable longer cell life.
Niacinamide also referred to as Vitamin B3, is recognised for its effectiveness in reducing clogged pores and fading blemishes, it can also treat fine lines and wrinkles.
Flavonoids, commonly found in green tea, are antioxidants that protect the skin by absorbing UV rays thus slowing down the process of photoaging.
Diet and Nutrition
Proper nutrition is a vital aspect of maintaining healthy skin. One of the best habits to build is drinking at least 1 litre of water a day. This helps to replenish fluids lost through natural processes such as sweating.
In addition to hydration, incorporating foods rich in omega-3 fatty acids, such as fish, nuts, and olive oil, into your diet can help to promote cell repair and boost collagen production, resulting in glowing smooth skin. Fatty fish like salmon, are an excellent source of omega-3s, which not only moisturise the skin but also protect it from damaging UV rays.
Studies and Sources
Cancer Council n.d., About SPF50+ sunscreen, www.cancer.org.au, viewed 12 January 2023, <https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/about-sunscreen/spf50-sunscreen>.
Flament, F, Bazin, R, Rubert, V, Simonpietri, E, Piot, B & Laquieze, S 2013, ‘Effect of the sun on visible clinical signs of aging in Caucasian skin’, Clinical, Cosmetic and Investigational Dermatology, vol. 6, p. 221, viewed 12 January 2023, <https://www.dovepress.com/effect-of-the-sun-on-visible-clinical-signs-of-aging-in-caucasian-skin-peer-reviewed-fulltext-article-CCID>.
Randhawa, M, Wang, S, Leyden, JJ, Cula, GO, Pagnoni, A & Southall, MD 2016, ‘Daily Use of a Facial Broad Spectrum Sunscreen Over One-Year Significantly Improves Clinical Evaluation of Photoaging’, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], vol. 42, United States, no. 12, pp. 1354–1361, viewed 12 January 2023, <https://journals.lww.com/dermatologicsurgery/Abstract/2016/12000/Daily_Use_of_a_Facial_Broad_Spectrum_Sunscreen.7.aspx>.
Skin Health Institute n.d., Skin Health Institute - Ageing Skin and Rejuvenation, Skin Health Institute, viewed 12 January 2023, <https://www.skinhealthinstitute.org.au/page/91/ageing-skin-and-rejuvenation>.
Therapeutic Goods Administration (TGA) 2020, Advertising therapeutic goods with related services, Therapeutic Goods Administration (TGA), viewed 12 January 2023, <https://www.tga.gov.au/resources/resource/guidance/australian-regulatory-guidelines-advertising-therapeutic-goods-argatg/advertising-therapeutic-goods-related-services>.