Struggling with your mirror image

Find the treatments for lines and wrinkles

By: Richard Thomas, MD, FRCPC

As we age, the skin droops and develops wrinkles, lines and furrows. Depending on your skin type, you may find your skin to be pre-disposed to wrinkling. But thanks to diligent research and new advances, there are a number of solutions to combat facial lines.

Causes of facial lines

In addition to aging, facial lines can form because of the following:

• Sun damage (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. caused mainly by sun damage.) (Read more at Sun Damaged Skin)
• Smoking
• Muscle movement / Dynamic lines (People tend to smile or frown more on one side than the other, or consistently sleep on the right or the left cheek. Crow's feet around the eyes are due to smiling and activity of the eyelid muscles. Worry lines on the forehead are due to contraction of the muscle when raising the eyebrows)
• Gravity is responsible for folds in the skin

What treatment is available?

See your dermatologist for information about what might work well for you, which could include (Also see treatments for sundamaged skin):

• Topical agents which produce collagen in the skin, Vitamin A acids (Tazarotene, Tretinoin, Adapelene) and Vitamin C or alpha Hydroxy acids
• Microdermabrasion has a very modest benefit for very fine lines
• Injectionable fillers such as Restylane (Hyaluronic acid)
• Botox for dynamic lines (Check-out www.BotoxFacts.ca)
• Lasers. Traditionally the CO2 and Erbium lasers (ablative) were used to essentially peel off a layer of skin and then allow a new skin to grow in. Results were impressive but the healing time of many weeks and sometimes months of redness has reduced the use of this approach. Patients with darker skin would often end up with darker skin and those with very fair skin sometimes white skin
• Plastic surgery is usually used to improve skin folds rather than fine lines and wrinkles
• The newer non-ablative laser treatments do not have the down time of the older methods nor do they have the degree of improvement. Repeat treatments with lasers that essentially produce a heating of the dermis, which in turn encourages collagen production, Lasers such as the Nd: Yag, V Beam and Smooth Beam may be used.
• The Fraxel laser is a modification of an Erbium laser that just treats multiple small pinpoint areas of skin allowing a quick recovery after a treatment. We will be hearing more of this in the future
• Cosmetic facial surgery

Prevent it before it happens

You can take steps to protect your skin. You’ve heard it before, and it’s worth repeating:

• Avoid excessive time in the sun, and always use a sunscreen of SPF 15 or higher
• Avoid smoking and exposure to second-hand smoke or other pollutants. Smoking increases facial lines and wrinkles and delays skin healing.
• Exercise. It’s good for the skin as well as for your general health.
• Aging skin feels and looks better when moisturizers are applied regularly. These improve the water-holding capacity of the skin. Choose one that feels nice to apply, doesn't sting or burn or provoke acne
• Use tepid or warm water and a non-soap cleanser to wash your face twice daily
• Drink plenty of water to rehydrate internally. Because moisture content is related to water, not oil or grease, oily-skinned women need to rehydrate as conscientiously as their dry-skinned counterparts
• Eat a balanced diet that includes plenty of fruits and vegetables
• Generally what is healthy for your heart and brain is good for your skin

See your doctor or dermatologist to determine which solutions best suits your experience with facial lines. For more skincare related information visit SkinCareGuide.ca.

About the author:
Richard Thomas, MD, FRCPC is Assistant Professor of Clinical Dermatology, Department of Dermatology, University of British Columbia, Vancouver, Canada.

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