What are the treatment options for wrinkles?

William I. Kestin, MD

Wrinkles on our face usually can be divided into two basic types. We are all much too familiar with our so-called frown lines. You know- the ones that look like an angry "11" between our furrowed brows. Those lines are a great example of wrinkles caused by the actions of groups of muscles of the face. Other examples are the fine lines alongside the eyes (crow's feet) and the horizontal lines we see on our forehead when we raise our brows. That type of wrinkle is best approached by reducing the power of just the right muscles to prevent them from pulling so hard on the skin. Products such as BOTOX, Dysport, and newly-approved Xeomin have all been certified by the FDA for the safe and effective reduction of those lines . A series of doses of the medicine is placed as needed to achieve significant improvement. The other types of wrinkles we see are those caused mainly by gravity and the loss of volume  that occurs on our faces  as we age. Examples of these include our frown lines (nasolabial folds}, "marionette" lines at the corner of our mouths, lines around the lips, and cheek hollows. These are best addressed by restoring lost volume by placing filler under the skin and recreating a more youthful, refreshed look. These products include Restylane, Perlane, Radiesse, and Juvederm. Fine wrinkles that remain can often be further improved utilizing a variety of skin resurfacing laser techniques.

Dermatologist Dr. Heidi Waldorf describes the treatment options for wrinkles. Watch Dr. Waldorf's video for tips and information on cosmetic dermatology and skin health.

Forehead creases and nose-to-mouth lines can add up to a face that looks unhappy even when you’re not. You can try shaping your brow with longer-lasting fillers that erase deep crevices for up to six months. Botox injections can also relax forehead muscles (and, hence furrows) and those in other areas of the face. A brow or an eye lift can also take care of lines and a lifetime worth of sag, pushing off a facelift (if you were so inclined) for another decade.

From The Mind-Beauty Connection: 9 Days to Less Stress, Gorgeous Skin, and a Whole New You by Amy Wechsler.

Celeste Robb-Nicholson
Internal Medicine
Wrinkles are a consequence of age, overexposure to sunlight, and other environmental factors such as cigarette smoke. Wrinkling reflects the loss of collagen and elastin, two components of the dermis, or second layer of the skin. Many skin rejuvenation treatments work by revving up the skin's natural biological processes. Some encourage the growth of new, younger cells on the surface of the skin. Others stimulate the production of more collagen and elastin beneath the surface. And many do both.

Skin resurfacing ranges from laser and light treatments to microdermabrasion, a procedure that involves sanding away the top layer of the skin. Daily topical treatments with Vitamin A-based drugs such as tretinoin (Renova) or tazarotene (Avage) or glycolic acids can stimulate collagen and elastin production.

Other types of therapies improve the appearance of the skin without altering it. Botox (botulinum toxin) injections paralyze the muscles used in frowning, smiling, or scowling. Soft-tissue augmentation employs fillers such as collagen, hyaluronic acid, and calcium hydroxyapatite injected below the skin's surface to supplement natural collagen and other soft-tissue components.

Like other medical procedures, all skin rejuvenation procedures carry a risk of side effects -- and the possibility that the results won't be what you're hoping for.
Debra Jaliman, MD

Modern medicine has yielded some great wrinkle treatments. Learn about the options in this video with dermatologist Debra Jaliman, MD.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.