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Nelson Lee Novick, M.D.
500 East 85th Street
Suite P-1
New York, New York 10028
Tel: 212-772-9300
Fax: 212-772-0524
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cosmedispa@gmail.com
קוסמדיספא
רחוב החי"ל 49
רעננה, NA 43316
Israel
Tel: 077-2100818
Fax: 077-4811369

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Wrinkles (Rhytides)

Wrinkles

by Nelson Lee Novick, M.D., FAAD, FAACS

What They Are

Although most people know what wrinkles are, scientists are still actively investigating  the factors that contribute to their appearance. What we do know is that wrinkled skin results in large measure, (nearly 80% in fact) from the damaging effects of years of accumulated sun (ultraviolet light ) exposure. Other wrinkle-producing causes include cigarette smoking, chronological aging, individual sleep patterns, gravitational effects, and simply how much and in what specific ways our facial muscles move when we smile, laugh, eat, drink, etc. Contrary to a popular misconception, dryness does not  cause wrinkles, although it can certainly emphasize the appearance of any preexisting wrinkles.

Wrinkles are often given special or fanciful names depending upon their location or appearance. For example, the fine lines on the sides of the eyes are often called "crow's feet;" those between the eyes, "scowl" or "frown lines;" on the forehead "worry" lines; around the mouth, "lipstick bleeding" lines and "marionette" lines for the drooping folds extending from the sides of the mouth down around\ the sides of the chin. Deeper wrinkles are sometimes called furrows.

Under the microscope, wrinkled skin typically shows within the dermis the loss and/or disarrangement of the collagen proteins essential for the structural support of the skin, as well as abnormalities in the important elastin fibers, which are responsible for suppleness and elasticity. The characteristic etched appearance of a wrinkle may also in part be due to abnormal thinning within the most superficial  layer of the skin known as the epidermis.

Buyer Beware

Unfortunately many products, even those sold in the so called "finest department stores" do little for wrinkled skin. Most are simply moisturizers containing exotic or expensive additives that create allure through packaging and advertising hype. These products may contain collagen, procollagen, elastin, vitamin E, ordinary vitamin A, eggs, milk, honey, royal bee jelly, aloe vera and placental extracts, to name just a few. The fact is that the molecules of these substances are simply to large to be "eaten" or "drunk up" by the skin and do not get down to the deeper layers where they are needed to truly impact on wrinkles.

Some Common  HomeTreatments That Work

Nowadays, a variety of at home treatments, some of which require a doctor's prescription, are available to improve wrinkled skin. Ulnlike simple moisturizers, which work on the surface of the skin, these creams and lotions are believed to alter the structure and function of the skin below the surface.  They act both to enhance the appearance of the skin and as topical medications. These preparations may contain retinoic acid, retinol, alphahydroxy acids, betahydroxacids and antioxidants (eg. vitamin C). When used daily, these creams, applied either alone or in various combinations, have in my experience proven to be useful in reducing the appearance of fine lines and wrinkles and helpful for maintaining the corrections obtained by in-office treatments.

In-Office Treatments

Whereas not so long ago, expensive and often painful "face lifts" and strong chemical peels were all that could be done to help some forms of wrinkles, today there are a variety of surgical techniques to make your skin look younger. These include non-surgical "liquid facelifts," dermaspacing to stimulate native fibrous tissue formation; and milder chemical peels, lasers, radiowaves, and manual dermasanding (buffing) to smoothe the surface of the skin (see related articles in the library).

In addition there are Botox Cosmetic injections, which consist of the use of a neurotoxin to temporarily relax muscles that may contribute to some forms of wrinkling, and hyaluronic acid-containing filler substances, like Restylane and Juvederm to plump up the skin. More recently there is Radiesse, composed of calcium hydroxylapatite (a bone-like material), which can be used not only for treating wrinkles but for volumizing and contouring the cheeks and jawline.

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This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

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