As we journey through this adventure called “life,” there are numerous memorable milestones. First job, first car, first grey hair… and yes, first wrinkle. These first signs of aging skin are a reminder that we are no longer those girls from our smooth-faced youth. For decades, there have been anti-aging creams including eye cream for wrinkles and crow’s feet that claim to be the ‘answer.’ While anti-aging face cream can help reduce fine lines, there are more effective anti-wrinkle treatments available.
The reality is that skin aging is a combination of intrinsic (genetic, or built-in) and extrinsic (environmental) factors. While we cannot control our genetics or the number of birthday candles we blow out, there are multiple options for modifying both intrinsic and extrinsic aging of the skin, especially the signs of aging on your face. Firstly, sunscreen, hats, and a good pair of broad-spectrum sunglasses should be part of your anti-aging strategy.
Signs of Skin Aging - Yes, Wrinkles!
What is a wrinkle, anyway? Those lines or crinkles around eyes, between brows, across the forehead, and the ‘parentheses’ around your smiling mouth, are all ‘weak points’ that we get from repetitive motion.
2 types of wrinkles:
Static (still) are those that stay even when your face is completely relaxed.
Dynamic (moving) occurs with motion, such as smiling and frowning. As our vision changes (far-sightedness or presbyopia), we tend to squint more, which accentuates lines around the eyes charmingly referred to as crow’s feet.
|Fine lines/wrinkles||Ultraviolet damage, loss of collagen|
|Dryness & roughness||Loss of estrogen, environmental exposures including skincare regimen|
|Uneven tone||Ultraviolet damage|
|Dullness||Decreased cell turnover|
|Laxity (sagging)||Loss of collagen|
|Larger pores||Loss of collagen|
|Dark spots||Ultraviolet exposure|
Personalized anti-aging treatments. For you.
Causes and Symptoms of Skin Aging
Skin aging is a combination of your genetics (intrinsic), and your level of exposure to environmental (extrinsic) factors that may damage your skin.
Intrinsic Aging includes those predetermined factors like skin pigmentation, the concentration of oil glands, skin thickness, and timing of hormonal changes (did you enter puberty and menopause late or early?).
Fairer skin is more prone to sun (ultraviolet) damage. Yes, that means that they will have more wrinkles, freckling/sunspots, and uneven tone at a younger age than skin types with more color or pigment (melanin) in their skin.
Drier skin types, with less oil production and dryness, will notice earlier wrinkling and worsening dryness.
Thicker skin may have those larger, more noticeable pores, but they are also more resistant to age-related lines and sagging.
Hormone Levels specifically estrogen, progesterone, and testosterone begin to drop with perimenopause and accelerate aging-related changes in the skin.
Extrinsic (external) Aging factors include those activities that expose your skin to damage. Lifestyle modifications can prevent and to some degree, reverse the signs of skin damage and subsequent wrinkles.
Anything that suppresses the immune system.
Where you live, work, and play affect skin aging. The extrinsic factors listed above will impact the youthful appearance of your skin more than others. Those in more detail:
The greatest contributor to skin aging is sun damage. Ultraviolet radiation contributes to brown spots, fine and deep lines, skin roughness, and enlarged pores. Even if you were a dedicated sun goddess in your youth, it is never too late to exercise healthy sun-protective behavior. Eliminate the phrase “healthy tan” from your vocabulary, as there is no such thing. Tanning is a reflection of damage. The golden glow of your teens and 20s will be the spots and wrinkles of your 30s, 40s, and beyond.
Yes, the sun and UV exposure is our biggest extrinsic wrinkle contributor. So does this mean you must be a vampire and live in Seattle? Absolutely not! Get out and enjoy the great outdoors, but be smart about it. Sun protective clothing (UPF 50+), broad-brimmed hats, and sunscreen are your damage control. Try to avoid outdoor activities during peak UV hours and remember to reapply your sunscreen every 2 hours while exposed. Adding supplements such as Heliocare and niacinamide (B3) may provide additional benefits, but should never be used in place of broad-spectrum sunscreen (UVA/UVB, 30+).
Pay Attention to Hormones
The evidence surrounding how hormone replacement therapy (HRT) plays a role in anti-aging treatments is solid. As you age and move into perimenopause, at about 35 years of age, your levels of estrogen, progesterone, and testosterone drop. This drop begins long before you are thinking about menopause, and accelerates aging-related changes in the skin.2
Hormones that decrease with menopause can be replaced with HRT. But how effective is HRT at reversing these changes? Very.
Diet: An anti-inflammatory diet rich in antioxidants and limiting refined sugars will improve skin appearance.
Stress: The stress hormone ‘cortisol’ is so important for skin health and overall well-being. Keeping cortisol levels down is an important step to a more healthy, youthful appearance.
Exercise: Daily walk, meditation, yoga, and self-care practice is essential.
Stop Smoking: If you are a smoker (yes, this includes vaping), commit to stopping right away. Smoking deprives the skin of oxygen and nutrients while exposing it to heat and multiple chemicals. The action of squinting and pursing lips while smoking makes crows-feet and lip lines more prominent. Smoking also impairs wound healing.
Can Damage Done Be Reversed?
Absolutely! Healthy diet, hormone balance, hydration, stress management, and sun protection act both as prevention and healing for damaged skin. In addition, topical vitamin C has been shown to improve brown spots and prevent further damage. The vitamin A family, retinoids, is a powerhouse for skin repair and protection.
Personalized anti-aging treatments. For you.
What Treatment is Right for You?
Fine lines and wrinkles are some of what make a person look older. As a result, if there was a way of minimizing their appearance, you can have a more youthful appearance. There are a number of non-invasive anti-aging treatments that you can try in addition to HRT. Non-invasive means they do not require general anesthesia or long recoveries.
Treatment options for wrinkles are dependent on the type of wrinkle. For those very early, fine lines, increasing moisture in the skin, and using a retinoid may be enough.
Other options include Azelaic acid, niacinamide (vitamin B3), Spironolactone, Topical vitamin C, and Kojic Acid is a popular ingredient in Asia for treating acne and pigmentation.
For static lines, doctors inject fillers into your skin to fill out wrinkles and lines. Popular fillers include collagen, hyaluronic acid gel, and fat. You can use fillers on your lips, face, and hands. You don’t need downtime after getting filler and will see the results right away. Fillers last from 2 months to 3 years, depending on what type you get.
Location and depth determine the most appropriate treatment. Fillers are generally hyaluronic acid (naturally found in the skin) and will vary by viscosity (stiffness). The viscosity is important to pay attention to - a filler appropriate for the lip is not suitable for deep nasolabial (smile) lines. Not only do fillers fill up those lines, but they also can stimulate collagen production.1 Certain areas of the face are not appropriate for filler due to the risk of adverse events, including blindness. Research your provider well*.
Those dynamic lines (wrinkles) can respond beautifully to neuromodulators (Botox, Dysport, Jeuveau, Xeomin), and some women are using them as a prevention for future lines. The most well-known non-surgical method for removing wrinkles works to relax the facial muscles to minimize the appearance of wrinkles.
Specifically, frown lines in between the eyebrows and crow’s feet at the corners of the eyes. This treatment works because the injection prevents the nerves from communicating with the muscle and reduces muscle activity and keeps the muscles in these areas from tightening. There is usually no recovery time for this cosmetic procedure, but it can take several weeks to see the effects. The results typically last about 3 to 4 months.
Used to treat wrinkles, age spots, sun damage. Wet/dry microdermabrasion is used to exfoliate the skin. Dermabrasion uses a small rotating brush to remove the outer layer of the skin from small areas of the face and new, smoother skin grows to replace it. New skin will be pink, and there is some scabbing or swelling for a few weeks after the treatment. It can take weeks or months to see the full results.
Like dermabrasion, this treatment removes the top-most layer of skin. But microdermabrasion uses a machine to spray tiny particles on the skin. It is less abrasive than dermabrasion and takes less time to heal.
Your doctor uses acid to peel away the outermost layer of skin. It removes age spots and wrinkles and gives a brighter skin tone. It takes some time to heal after the peel and will appear red for a week or two.
Fractional Laser Skin Resurfacing
Your doctor uses a special laser to treat narrow columns of skin. The laser damages deep layers of skin, which stimulates new skin cell growth. The damaged areas peel away and reveal smoother younger-looking skin. Fractional laser skin resurfacing can help treat wrinkles and fine lines. You may have some redness, pain, peeling, or scabbing.
Non-ablative Skin Rejuvenation
Non-ablative skin rejuvenation uses lasers and other types of energy to treat wrinkles, age spots, and loss of skin tone. This type of treatment does not remove the outer layer of skin, and you don’t usually need any recovery time.
When is a Facelift Appropriate?
As women mature past their 60s, neuromodulators and fillers may no longer be enough to reverse laxity and wrinkles. At this point, consultation for ablative laser vs. facelift can be considered.
While anti-aging face cream can help reduce fine lines, there are more effective anti-wrinkle treatments available to reduce the signs of aging and get those early wrinkles under control. Prevention is the key to youthful-looking skin. Prevent sun damage, get your hormones balanced, and reduce your stress to keep yourself looking and feeling young. Reach out to Winona today for your free consultation with our physicians.
*The amount and placement of the injection to fill lines are critical. Always research your provider's credentials and be suspicious of deals that seem too good to be true. Verify board-certification in Dermatology, Ophthalmology, Plastic Surgery or Otorhinolaryngology (ENT) as these physicians have extensively studied facial anatomy and are trained to handle complications
“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”
Stein, Scientific American, Feb 2007