Wrinkles
Cosmetic dermatology uses techniques and medications developed
for dermatological purposes but applied for cosmetic effect. They are all
serious treatments and attention should be paid to possible unwanted effects. Study
these advice sheets and then, if you would like to take it further, ring for an
appointment with a consultant dermatologist. The following specific treatments
are available:
Prescription creams for fine lines and mild to moderate sun damage
Botox® injections for movement related wrinkles in the upper half of the
face
Hyaluronic fillers for gravity related wrinkles in the lower half of the
face
Intense Pulse Light treatment for mild to moderate sun damage such as uneven
skin tone
Microdermabrasion which gives a light peel for mild sun
damage
Chemical peel for a deeper effect.
Understanding wrinkles
Normal ageing leads to the formation of skin wrinkles. As the years go by, the elastic fibres that keep the skin taut begin to loosen. This makes the skin sag. Wrinkles are also caused by facial expressions, such as the frown lines that form between eyebrows. How much sagging and how many movement wrinkles wrinkles you get depend in part upon your heredity.
Most wrinkles, however, are caused by cumulative exposure to the ultraviolet rays of the sun. There are two types of ultraviolet rays: UltraViolet A and UltraViolet B. UVA is associated with skin tanning, wrinkles and melanoma, a form of skin cancer. UVB is associated with sunburn, basal and squamous cell carcinoma; two other forms of skin cancer.
There are three different types of wrinkles:
 | Fine lines occurring throughout the face due to gradual loss of elasticity. |
| Expression lines where the muscles of facial expression cause permanent creases. |
| Gravity lines as the tissues of the face sag a little forming furrows between. |
and different treatments suit different types of wrinkles:
Treatment of wrinkles
Cosmetic treatments available for the treatment of wrinkles include: surgical face lifts, laser resurfacing, dermabrasion, chemical peels, fillers, muscle relaxing injections, photo-rejuvenation and prescription creams.
The following treatments are available at the cosmetic dermatology clinic:
| Prescription creams, tretinoin cream used for several months, can be beneficial for fine lines, acne and uneven skin tone. It increases cell turnover and smooths the surface of the skin. Initially it may cause some dryness and redness but the skin adjusts within 7-10 days. Azelaic acid cream is also useful for these problems. Hydroquinone cream can be tried for pigment problems |
| Photo-rejuvenation, is the treatment of the face using intense pulsed light (IPL) technology. It helps to refine uneven skin tone, reducing redness and brown blotches. It also stimulates collagen production helping fine lines. Photo-rejuvenation makes the skin look smoother with minimal downtime. It cannot be used on tans or darker skin types. Best given as a course, we suggest four treatments, performed at 6 – 8 week intervals. |
| Botulinum Toxin Type A injections are used to relax the muscles that cause expression lines between the eyebrows - frown lines, forehead wrinkles, and beside the eyes - crow’s feet. The effect is to smooth out the wrinkles and give a more relaxed, youthful appearance. The effect takes a couple of weeks to start and then wears off after 3 – 6 months when the treatment can be repeated. Side effects are rare and reversible. Treatment costs £180 - £360 depending on the number of areas needing treating. Please read the more detailed advice sheet carefully. BOTOX® and Dysport® are trade names. |
| Fillers are used to fill out deeper creases and gravity lines. We use Hyaluronic acid, trade name Restylane. Hyaluronic acid is one of the skin’s own ingredients and occurs in all animals. It has the same structure in all species. It is a clear gel with good safety profile and skin testing is not required. The gel is gradually absorbed, and its effect lasts 3 – 12 months. Please read the more detailed advice sheet carefully. |
| Peels improve fine lines, sun damaged skin, acne scarring, freckles, age spots, and irregular pigmentation. With careful skin preparation they can be used on darker skin types, although the risk of unwanted pigment change is higher. We use the Obagi Blue peel. The active ingredient is TCA, a diluted acid that is painted over your face. This causes a burning sensation for 5 – 10 minutes. Your skin will be blue-grey and start to peel in 24 hours. This stage may last a few days. The new skin underneath is smoother, tighter and the complexion more even. Further improvement can be obtained by repeating the peel in 2 – 3 months time. Please read the more detailed advice sheet carefully. |
How to postpone the development of wrinkles
Wrinkles are part of natural ageing; they have to be
accepted as such. None of the treatments above can turn the clock back far, and
none are without risk.
To help postpone the development of wrinkles we recommend the following:
| Use a moisturiser regularly; the cheaper ones can be as effective as the more expensive ones. |
| Keep your face out of the sun and use sun block if exposure is unavoidable. If you need a tan on your face apply it from a bottle. |
| Maintain a healthy balanced diet with plenty of natural anti-oxidant vitamins such as A, C and E to defend your body from the action of free radicals that damage healthy cells. |
| Stop smoking. |
