DescriptionAn in-depth report on the treatment and prevention of wrinkles.
Alternative NamesAlpha Hydroxy; Chemical Peels; Plastic Surgery
Needless to say, the best long-term prevention for overly wrinkled skin is a healthy lifestyle including the following:
Eat Healthily. A diet with plenty of whole grains, fresh fruits and vegetables, and the use of healthy oils (such as olive oil) may protect against oxidative stress in the skin. In fact, a 2001 study reported that people over 70 years old had fewer wrinkles if they ate such foods. Diet played a role in improving skin regardless of whether the people in the study smoked or lived in sunny countries. Benefits from these foods may be due to high levels of anti-oxidants found in them.
Exercise. Daily exercise keeps blood flowing, which brings oxygen to the skin, an important ingredient for healthy skin.
Reduce Stress. Reducing stress and tension may have benefits on the skin.
Quit Smoking. Smoking not only increases wrinkles, but smokers have a risk for squamous cell cancers that is 50% higher than nonsmokers' risk. Smokers should quit to prevent many health problems, not just unhealthy skin.
Daily Preventive Skin Care
Some daily measures for skin protection are as follows:
Antioxidant Products: General Information
Antioxidants are substances that act as scavengers of oxygen-free radicals, the unstable particles that can damage cells and which are implicated in sun damage and even skin cancers. Antioxidants in the skin are depleted when exposed to sunlight and must be replaced.
Vitamin A. Vitamin A is important for skin health and UV radiation produces deficiencies in the skin. Topical products containing natural forms of vitamin A (retinol, retinaldehyde) or vitamin A derivatives called retinoids (tretinoin, tazarotene) have proven to be beneficial for skin damaged by the sun and also by natural aging.
Warning: Any vitamin A derivative, it should be avoided by pregnant women and those who may become pregnant. For example, oral tretinoin causes birth defects, and women should avoid even topical Retin-A when pregnant or trying to conceive.
Vitamin C. Vitamin C, or ascorbic acid is a very potent antioxidant and most studies on the effects of antioxidants on the skin have used this vitamin. In laboratory studies, large amounts reduced skin swelling and protected immune factors from sunlight. It may even promote collagen production. Vitamin C by itself is unstable, but products that solve the delivery problem are now available (e.g., Cellex-C, Avon's Anew Formula C Treatment Capsules, Physician Elite, and others). Studies using these formations in 2002 (one using Cellex-C) reported reduction in wrinkles and appeared to improve skin thickness. In one of the studies, wrinkle improvement with a time-released vitamin C product was as effective as with topical retinoids and some laser treatments. Of concern, according to one 2002 study, ascorbyl palmitate, a vitamin C derivative found in many skin products, may actually increase skin damage from UV rays. More research is needed, since other studies have found this chemical to be protective.
Other Antioxidants. Other antioxidants are also being investigated for their value in skin protection Even with these antioxidants, however, most available brands contain very low concentrations of them. In addition, they are also not well absorbed and they have a short-term effect. New delivery techniques, however, may prove to offset some of these problems.
Alpha Hydroxy Acid and Home Exfoliation
One of the basic methods for improving skin and eliminating small wrinkles is exfoliation (also called resurfacing), which is the removal of the top layer of skin to allow regrowth for new skin. Methods for doing this run from simple scrubs to special creams to intensive peeling treatments, including laser resurfacing. People with darker skin are at particularly higher risk for scarring or discoloration with the more powerful exfoliation methods.
Abrasive Scrubs. Scrub gently with a mildly abrasive material and a soap that contains salicylic acid to remove old skin so that new skin can grow. The motion should be perpendicular to the wrinkles. Use textured material or cleansing grains with microbeads. Organic materials, such as loofahs or sea sponges may harbor bacteria. Avoid cleansing grains that contain pulverized walnut shells and apricot seeds, which can lacerate skin on a microscopic level. Cleansing grains with microbeads dont have sharp edges and remove skin without cutting it. Exfoliation using scrubs, however, can worsen certain conditions, such as acne, sensitive skin, or broken blood vessels.
Topical Alpha Hydroxy Acid and Similar Substances. Alpha hydroxy acids facilitate the shedding of dead skin cells and may even stimulate the production of collagen and elastin. They are found naturally as follows:
Lactic and glycolic acids are used most often in commercial products. The preparations containing lactic acid may be slightly more effective than those made with glycolic acid. Products have also been developed that are made from larger molecules called poly-alpha-hydroxy acids and others from beta-hydroxy acids or BHAs (usually containing salicylate acid, the primary ingredient in aspirin). Manufacturers claim that such products are less likely to irritate the skin.
Acid concentrations in over-the-counter AHA preparations are 2% to 10%. One clinical study suggested that 8% concentrations showed modest improvement. Some examples include Avon's Anew Intensive Treatment (8% glycolic), Pond's Age Defying Complex (8%), Elizabeth Arden's Alpha-Ceramid Intensive Skin Treatment (3% to 7.5%), and BioMedic's home product (10%). Prescription strength creams contain at least 12% glycolic acid, and glycolic acid peels of 30% to 70% concentration may be administered in a doctors office at weekly or monthly intervals.
Response to AHA varies, and the treatment is not without risk, particularly in high-concentration products. Side effects from over-the-counter creams, prescription products, and professional AHA peels can include burns, itching, pain, and possibly scarring. Studies also suggest that AHA may increase susceptibility to sun damage, even at concentrations as low as 4%. Such effects can persist up to a week after the products have been stopped. Experts advise that people should purchase products with AHA concentrations of 10% or less. (Chemical peels of up to 60% are available without prescription on the Internet. Such concentrations are not recommended except in consultation with a physician.) If any adverse effects occur, the product should be stopped immediately. In all cases, people are advised to avoid sunlight or use proper sun protection when using them.
Experts are further concerned because part of the wrinkle-reducing effects of alpha hydroxy involves calcium loss, which in turn may promote cell growth and impair differentiation. Theoretically, this might increase the risk for skin cancer. There is no evidence of this at all, but more research is warranted on long-term effects of AHA.
Other Skin Treatments
Copper Peptides. Certain copper containing compounds may both protect skin and help repair it. Of note, copper itself is a toxic metal and it should only be used in products that contain peptides (small protein fragments) that bind to copper. Most studies have been conducted on a copper peptide glycyl-l-histidyl-l-lysine:copper (II) or GHK-Cu. It is currently used in a number of products (e.g., CP Serum, Neutrogena's Visibly Firm, ProCyte's Neova).
Furfuryladenine. Furfuryladenine (Kinetin, Kinerase) is a naturally occurring growth hormone found in plant and animal DNA; it has antioxidant and anti-aging properties. Some small laboratory studies suggest that it may both delay the onset and decrease the effects of aging on skin. However, no well-conducted human trials have been performed.
Vitamin K. Microsponge-based vitamin K is being promoted to clear bruises spider veins, and other small blood vessel damage. Vitamin K is important for blood clotting.
TNS Recovery System. California physicians have developed a product, TNS Recovery System (NouriCel), which was discovered as a byproduct of a process that grows human skin for burn victims. Research conducted by the manufacturer has suggested that it may produce new collagen and significantly eliminate wrinkles compared to Retin-A. The product is a combination of growth factors, collagen, antioxidants, and other ingredients.
Moisturizers help prevent dryness, bruising, and tearing but have no effect on wrinkles by themselves. They should be applied while the skin is still damp. These products retain skin moisture in various ways:
Most moisturizers contain combinations of these and usually have other ingredients, such as AHA, sunscreens, collagen, and keratin. (Collagen and keratin leave a protein film and temporarily stretch the skin.) They range widely in price, and a major consumer organization found little difference in general between the more and less expensive products.
The skin under the eyes is very thin and does not produce as much of the protective oils that keep skin soft and supple. Under-eye gels are aimed at reducing puffiness and dark circles. They typically work in one of two ways:
Cosmetics, if properly applied, can be surprisingly effective in camouflaging the signs of aging skin, including wrinkles and age spots. Moreover, they offer additional benefits by retarding water loss and providing a physical barrier to UV radiation. However, as women age, less is more. Here are some suggestions for older women:
Moisturizers. Moisturizers should be applied before foundation. If reddish discoloration is extensive or the skin is sallow, tinted moisturizers may be helpful and can be worn alone or under foundation.
Foundations. Caking on make-up will cause cracks at the wrinkle lines and only increase the appearance of aging. Large areas of the face are best covered with a moderate-coverage foundation with a matte or semi-matte finish. Facial powder reflects light and thus minimizes wrinkles but should be avoided by people with dry skin.
Correcting Color. When blemishes are especially prominent, applying color correctors under the foundation can be very effective:
Blushes. Blushes and color washes can help conceal the spidery network of dilated capillaries on the nose and cheeks. Powder blushes are preferred because they blend easily on top of foundation.
Eyes. Powder eye shadows applied on top of a moisturizer are preferred to cream-based shadows. The appearance of deep-set eyes is best offset with light-colored shadow, which should be applied along the upper eyelid crease and above the iris. A slightly deeper shade of the same color should then be applied to the lower part of the eyelid and drawn out to the corner.
Lips. A lip-setting cream or facial foundation should be applied before lipstick to help prevent it from bleeding into surrounding wrinkles. Try using a stiff bristle brush instead of a lip pencil. The brush will help keep the lipstick on and prevent bleeding. (Some women use the pencil itself for the full lip, which gives color but appears natural.) Some make-up artists recommend cream lipsticks instead of matte.