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Treatments and drugs
By Mayo Clinic staffIf your wrinkles are bothering you, you have many options to help eliminate or at least reduce their appearance. Wrinkle treatments include:
Medications
- Topical retinoids. Derived from vitamin A, retinoids that you apply to your skin may be able to reduce fine wrinkles, splotchy pigmentation and skin roughness. Retinoids must be used with a skin-care program that includes sunscreen and protective clothing because the medication can make your skin burn more easily. It may also cause redness, dryness, itching, and a burning or tingling sensation. Tretinoin (Renova, Retin-A) and tazarotene (Avage, Tazorac) are examples of topical retinoids.
- Nonprescription wrinkle creams. The effectiveness of anti-wrinkle creams depends in part on the active ingredient or ingredients. Retinol, alpha hydroxy acids, kinetin, coenzyme Q10, copper peptides and antioxidants may result in slight to modest improvements in wrinkles. However, nonprescription wrinkle creams contain lower concentrations of active ingredients than do prescription creams. Therefore results, if any, are limited and usually short-lived.
Surgical procedures and other techniques
A variety of skin-resurfacing techniques, injectables, fillers and surgical procedures are available to smooth out wrinkles. Each works a little differently and has its own set of potential results and side effects:
- Dermabrasion. This procedure consists of sanding down (planing) the surface layer of your skin with a rapidly rotating brush. The planing removes the skin surface and a new layer of skin grows in its place. Redness, scabbing and swelling generally last a couple of weeks. It may take several months for the pinkness to fade and for you to see the desired results.
- Microdermabrasion. This technique is similar to dermabrasion, but less surface skin is removed. It's done using a vacuum suction over your face while aluminum oxide crystals essentially sandblast your skin. Only a fine layer of skin is removed. You may notice a slight redness to the treated areas. Microdermabrasion usually requires repeated treatments to maintain the subtle, temporary results.
- Laser, light source and radiofrequency treatments. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis), which stimulates the growth of new collagen fibers. As the wound heals, new skin forms that's smoother and tighter. It can take up to several months to fully heal from ablative laser resurfacing. Newer developments in laser technology have decreased the healing time. Less intense lasers (nonablative lasers), pulsed light sources and radiofrequency devices don't injure the epidermis. These treatments heat the dermis and cause new collagen and elastin formation. After several treatments, skin feels firmer and appears refreshed. This means shorter recovery times, but treatment typically needs to be repeated more often and results are subtle.
- Chemical peel. Your doctor applies an acid to the affected areas, which burns the outer layer of your skin. With medium-depth peels, the entire epidermis and a small portion of the dermis are removed. New skin forms to take its place. The new skin is usually smoother and less wrinkled than your old skin. Redness lasts up to several weeks. With superficial peels, only a portion of the epidermis is removed. After a series of peels, you may notice less fine wrinkling in your skin and a fading of brown spots.
- Botulinum toxin type A (Botox). When injected in small doses into specific muscles, Botox blocks the chemical signals that cause muscles to contract. When the muscles can't tighten, the skin flattens and appears smoother and less wrinkled. Botox works well on frown lines between the eyebrows and across the forehead, and crow's-feet at the corners of the eyes. Results typically last about three to four months. Repeat injections are needed to maintain results.
- Soft tissue fillers. Soft tissue fillers, which include fat, collagen and hyaluronic acid (Restylane, Juvederm), can be injected into deeper wrinkles on your face. They plump and smooth out wrinkles and furrows and give your skin more volume. You may experience temporary swelling, redness and bruising in the treated area. The procedure may need to be repeated every few months.
- Face-lift. The face-lift procedure involves removing excess skin and fat in your lower face and neck and tightening the underlying muscle and connective tissue. The results typically last five to 10 years. (Healing times can be lengthy after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.
Keep in mind that results vary depending on the location of your wrinkles and how deep your wrinkles are. However, nothing stops the aging process of skin, so you'll likely need the treatments repeated to maintain benefits.
These procedures aren't usually covered by insurance. In addition, any of the procedures can have side effects, so be sure to discuss them with your doctor. Make sure your dermatologist or plastic surgeon is specially trained and experienced in the technique you're considering.
References
- McCullough JL, et al. Prevention and treatment of skin aging. Annals of the New York Academy of Sciences. 2006;1067:323.
- Renova (tretinoin cream). U.S. Food and Drug Administration. http://www.fda.gov/cder/foi/label/2002/21108s1lbl.pdf. Accessed Nov. 25, 2008.
- Rabe JH, et al. Photoaging: Mechanisms and repair. Journal of the American Academy of Dermatology. 2006;55:1.
- Soft tissue fillers. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/SoftTissueFillers.htm. Accessed Nov. 25, 2008.
- Kafi R, et al. Improvement of naturally aged skin with vitamin A (retinol). Archives of Dermatology. 2007;143:606.
- Facial skin rejuvenation. American Academy of Dermatology. http://www.aad.org/public/publications/pamphlets/cosmetic_facial.html. Accessed Nov. 25, 2008.
- Helfrich YR, et al. Overview of skin aging and photoaging. Dermatology Nursing. 2008;20:177.
- Mature skin. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/MatureSkin.htm. Accessed Nov. 25, 2008.
- Baumann L. Cosmetics and skin care in dermatology. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://accessmedicine.com/content.aspx?aID=3007166&searchStr=xerosis. Accessed Nov. 25, 2008.
- Freiman A, et al. Cutaneous effects of smoking. Journal of Cutaneous Medicine and Surgery. 2004;8:415.
- Physician's guide to cosmetic surgery: Facial surgery and skin care surgical procedures. American Society of Plastic Surgeons. http://www.plasticsurgery.org/medical_professionals/publications/Physicians-Guide-to-Cosmetic-Surgery-Facial-Surgery.cfm#. Accessed Nov. 25, 2008.
- Rados C. Science meets beauty: Using medicine to improve appearances. FDA Consumer Magazine. http://www.fda.gov/fdac/features/2004/204_beauty.html. Accessed Aug. 20, 2008.
- Just M, et al. Effect of smoking on skin elastic fibres: Morphometric and immunohistochemical analysis. British Journal of Dermatology. 2007;156:85.
