Q: What causes wrinkles?

A. There are many factors that contribute to the onset of wrinkles. The following are the most significant:


Wrinkles are a by-product of the aging process. With age, skin cells divide slower, and the inner layer of the skin called the dermis begins to thin. The network of elastin and collagen fibers, which support the outer layer, loosens and unravels, which results in depressions on the surface. With aging, skin also loses its elasticity and is less able to retain moisture. In addition, oil-secreting glands are less efficient and the skin is slower to heal. All of these contribute to the development of wrinkles.

Facial muscle contractions

Lines between the eyebrows (frown lines) and lines jutting from the corner of the eyes (crows feet) are believed to develop because of small muscle contractions. Smiling, frowning, squinting, and other habitual facial expressions cause these wrinkles to become more prominent. Over time, the expressions coupled with gravity contribute to the formation of jowls and drooping eyelids.

Sun damage

Excessive exposure to ultraviolet radiation (too much sun) can result in premature aging of the skin. Premature aging of the skin is called photoaging. The ultraviolet sunrays that cause photoaging damage collagen fibers (the major structural proteins in the skin) and cause the excessive production of abnormal elastin (the protein that causes skin to stretch). When ultraviolet light damages skin tissue, an enzyme called metalloproteinases is produced. This enzyme creates and reforms collagen. During the process, however, some healthy collagen fibers are damaged, resulting in a disorganized formation of fibers called solar scars. Wrinkles develop when the rebuilding process occurs over and over.



Healthy skin perpetually regenerates. While old collagen is broken down and removed, new collagen is being produced and installed. Researchers have found that smoke causes a marked reduction in the production of new collagen. A lack of new collagen results in the development of wrinkles.

Q: Years of sitting in the sun has finally taken a toll on my skin in the form of wrinkles. Which is a better way to deal with my wrinkles: a chemical peel or laser resurfacing?

A. Laser skin resurfacing is a relatively new procedure which directs short, concentrated pulsating beams of light at superficial facial skin irregularities and fine wrinkles. It is most commonly used for treatment of facial wrinkles caused by sun exposure.

Because the procedure is so new, long-term data comparing the effectiveness of the different treatments for these types of facial wrinkles is not yet available. However, many physicians feel that the laser offers superior results because it is more precise and allows them to remove skin in a more controlled fashion layer by layer.

Moreover, it is easier to vary the amount of treatment to different areas of the face with a laser than with chemical peels or dermabrasion. That means fewer patients experience hypopigmentation, or lightening of the skin.

Laser skin resurfacing directed at specific areas, such as the lip or eye area, can take as little as 45 minutes. When applied to the entire face, the procedure can last up to 90 minutes. It is typically performed under local anesthesia with sedation.

There is no need for hospitalization after the surgery, and many patients plan to stay home for several days afterward to promote proper healing. After surgery, the area of the face that has been treated will weep as an open blister would. Typically, within five to seven days, the weeping will subside and the area will appear as if it were sunburned.

After one week, many people apply camouflage makeup and return to their normal activities. The redness will fade over about a six-week period.

If you choose laser resurfacing, check the qualifications of the physician. The procedure is generally performed by plastic surgeons and dermatologists. The physician should be board certified and should be trained in laser technology specifically for this technique.

Q: Does vitamin C prevent help prevent wrinkles?

A. One of the most potent antioxidants is vitamin C. Readily available in foods and supplements, vitamin C seems like an easy solution to the problem of environmental skin aging caused by free radicals. Why not wash down those wrinkles with a glass of orange juice every morning? Or prevent a cold and wrinkles at the same time by loading up on vitamin C tablets?

Unfortunately for skin, our bodies send dietary vitamin C and other antioxidants to other organs first. This means that the skin may not always get the amount of nutrients it needs. In addition, as skin ages, the blood vessels that nourish it constrict. Vital nutrients supplied in the blood do not easily reach the outer layers of the skin. The skin still survives, but the once-youthful glow is lost. So, to get vitamin C into the skin, researchers have developed ways to put it there directly.

Topical application of vitamin C may be in the form of creams, serums, or dermal patches. With these products, the antioxidants works directly on the surface skin layers to prevent wrinkles and the loss of elasticity caused by free radicals. An advantage of antioxidant delivery by dermal patch is that the vitamin availability is not diminished by evaporation on the skin, nor can it be rubbed off, as can happen with creams or serums. Also, vitamin stability is maintained in a dermal patch because ingredients are not exposed to air. The full strength of antioxidant penetrates into the skin to fight skin-damaging free radicals.