Fine Lines & Wrinkles

Background

The skin is the body's largest organ, and is divided into 3 layers: the epidermis, the dermis, and the hypodermis (also known as the subcutis). The epidermis is the outermost layer of skin and contains regenerative layers of skin cells. The dermis is the next layer and contains connective tissue (i.e. collagen) and other fibers that give the skin strength and elasticity. The deepest layer, known as the subcutis or hypodermis, is composed primarily of fat. The subcutis supports blood vessels and nerve fibers that feed the overlying dermis and epidermis.

As skin ages, the supportive components of the skin are gradually destroyed. For example, elastic fibers in the dermis break down and are permanently lost. Collagen fibers degrade and undergo chemical modifications that destroy their function. There is also gradual loss of hyaluronic acid, a substance that maintains the texture in the skin. Thus, the skin becomes stiffer, thinner, and sags. In addition, wrinkles also appear over facial muscles as they stiffen with age. Thus, areas subjected to repeated movements with facial expression, such as the forehead, and around the eyes and lips, become wrinkled. Finally, the normal healing processes and cellular repair are gradually diminished; leaving older skin less resilient to environmental insults. Excessive sun exposure (including tanning beds) and smoking can greatly accelerate the aging process.

Wrinkles

The classification of wrinkles, also known as rhytids, is based on how deep into the skin the wrinkles extend. Fine lines are the result of changes in the upper dermis and may appear “etched” in the skin. Medium wrinkles reach the mid-dermis, and deep wrinkles (also known as furrows or folds) reach the deep dermis and subcutis.

Wrinkle Prevention

While we cannot reverse every possible cause of wrinkling, there are steps we can take to minimize the aging process:

Avoid excessive sun exposure, including sun lamps and tanning beds. Ultraviolet exposure is greatest between 10am and 4pm. Use sunscreens in combination with other sun-protective measures.

Quit Smoking.  Smoking causes wrinkles and causes existing wrinkles to worsen. 

Daily skin care should consist of mild cleansing of the face daily, application of a moisturizer, and daily sunscreen use.

Wrinkle Treatment

Many commercial and prescription products are available topically for the treatment of wrinkles. Professional treatments for resurfacing or implantation of materials can also be used for wrinkle treatment.

The laser procedure is a non-invasive treatment with very little discomfort and no down time. It provides cost effective wrinkle reduction.

All photos courtesy of S. Zimmet, MD and P. Bitter Jr., MD