Skin Wrinkling

Wrinkles are a natural part of aging that everyone experiences, appearing as lines, creases, or folds on the skin, most commonly on the face, neck, hands, and arms.

Table of contents

• What Are Wrinkles?
• How Wrinkles Appear and Where They Form
• What Causes Wrinkles?
• Types of Wrinkles
• Preventing Wrinkles
• Treatment Options

What Are Wrinkles?

Wrinkles are lines that form on your skin as a natural part of your body’s aging process^[1]. They appear as folds, creases, or ridges on the skin, similar to the wrinkles you might see on a shirt that needs ironing^[2].

Everyone who ages experiences wrinkles. As your body gets older, fine lines start to appear on your body, which can begin after age 25. The most common age group for people who seek wrinkle treatment is between ages 40 to 55, and wrinkles become more prominent after age 65^[2].

• Skin
• Face
• Neck
• Hands
• Arms

How Wrinkles Appear and Where They Form

If you look at the palm of your hand, you have lines in your skin. As you age, lines like those in your palm will form on other parts of your body’s skin^[2].

Wrinkles can appear anywhere on your skin but are most common on your face, hands, neck, arms, and legs^[2]. The skin is most likely to form wrinkles on areas that are often exposed to the sun, such as the face, neck, hands, and forearms^[1].

Some wrinkles become deep and may be especially noticeable around the eyes, mouth, and neck. Wrinkles around the mouth, eyes, and neck are common with aging, as the skin in these areas gets thinner, drier, and less elastic^[1].

Wrinkles are apparent when you’re at rest, but they may become more noticeable when you move your facial muscles by smiling or frowning^[2].

What Causes Wrinkles?

Slow skin cell production, thinning skin layers, and a lack of collagen proteins cause wrinkles to form on your skin. Collagen is a protein within your body that gives your skin structure and provides stretchiness or elasticity so you can move easily^[2].

Your skin is similar to a rubber band. If that rubber band stretches or moves too much, the rubber band becomes loose and loses its ability to snap back to its normal size and shape. When your body’s cells age, their ability to produce proteins slows down, which makes it more difficult for your skin to snap back to its original shape, causing wrinkles^[2].

Aging

Wrinkles are a natural by-product of the aging process. As people age, skin cells divide more slowly, and the middle layer of your skin—the dermis—begins to thin. The dermis has a network of elastin and collagen fibers, which offer support and elasticity. As this network loosens and unravels with time, depressions form on your skin’s surface^[2].

Aging skin is also less able to retain moisture, less efficient in secreting oil, and slower to heal. All of these factors contribute to the development of wrinkles^[2]. The numbers of elastin and collagen fibers in the skin are reduced as we age, causing wrinkles^[4].

Our skin has a layer of fat just below the surface, which gives form and structure. This layer of fat thins out as we age, causing the skin to sag^[4].

Sun Exposure

Sun exposure is the most common cause of skin damage and wrinkling^[4]. Excessive exposure to ultraviolet (UV) radiation from the sun can result in premature aging of your skin, also known as photoaging. Exposure to UV light breaks down collagen fibers and leads to the production of abnormal elastin^[2].

UV rays prompt the formation of free radicals within the skin, which damage elastin fibers in the skin and contribute to wrinkling and skin cancer^[4]. In addition to fine lines and wrinkles, UV damage causes brown spots and pigment irregularity, as well as broken capillaries and red blotches^[4].

People with fair skin have less protection against UV-induced skin changes and tend to develop more wrinkles than people with dark skin^[4].

Facial Muscle Contractions

Lines on your forehead, between your eyebrows (frown lines), and jutting from the corners of your eyes (crow’s feet) develop because of small muscle contractions. Smiling, frowning, squinting, and other habitual facial expressions cause wrinkles to become more prominent. Over time, these expressions coupled with gravity contribute to the formation of wrinkles^[2].

The first wrinkles tend to appear on a person’s face in areas where the skin naturally folds during facial expressions^[5]. Squinting is the most common cause of crow’s feet around the eyes. Frowning, especially when done frequently, may cause deep wrinkles, especially on the forehead^[4].

Smoking

As well as all the other health risks associated with smoking, smokers will have more wrinkles. These changes may not show up until you are in your 30s or 40s. Fine lines around the mouth are most common^[4].

Regular smoking accelerates the aging process of skin because it reduces the blood supply to the skin^[5]. Tobacco products cause your body to slow down its production of collagen, and too little collagen causes wrinkles^[8].

Other Contributing Factors

Many factors affect the development of wrinkles, including dehydration, some medications, and environmental and genetic factors^[5]. Alcohol dehydrates the skin, and dry skin is more likely to develop wrinkles^[5].

People who work in sunlight have a higher chance of early wrinkles. Wearing protective clothing such as hats or long sleeves may delay the development of wrinkles^[4].

Types of Wrinkles

Wrinkles can be classified into two main categories: dynamic and static^[16].

Dynamic Wrinkles

Dynamic wrinkles form due to repeated facial movements and muscle contractions. These wrinkles are primarily caused by expressions like smiling, frowning, or squinting. Over time, the repeated folding of the skin leaves creases that become more noticeable^[16].

Common locations for dynamic wrinkles include forehead lines (caused by raising the eyebrows) and crow’s feet (fine lines radiating from the outer corners of the eyes, intensified by squinting or smiling)^[16].

Static Wrinkles

Static wrinkles are visible even when the face is at rest. They result from the natural aging process, sun damage, and loss of skin elasticity and volume^[16].

Preventing Wrinkles

While wrinkles will appear at some point in life, taking good care of your skin from a young age is key. It’s best to implement prevention practices starting in your 20s, but skin care at any age can have a huge impact later^[14].

Sun Protection

One of the most important ways to take care of your skin is to protect it from the sun. Sun protection is one of the most important steps for slowing skin aging^[13].

The best way to prevent wrinkling caused by sun exposure is to wear protective clothing, avoid the sun around the middle of the day, and use sunscreen for the parts of skin that can’t be protected by clothing^[4].

Apply a broad-spectrum sunscreen with at least SPF 30 every morning, even on cloudy days and in the winter. UV rays can penetrate clouds and windows, so don’t skip the sunscreen because it isn’t sunny or you’re staying inside^[14].

Daily use of a high SPF sunscreen (SPF 15 plus or SPF 30 plus) is the most effective thing you can do to prevent wrinkles^[4].

Quit Smoking

Smoking makes skin look older and plays a part in wrinkles forming. Smoking narrows the tiny blood vessels in the outermost layers of skin^[18].

Skin Care Routine

Use a mild cleanser once daily to remove dirt and oil without stripping your skin of its natural moisture. Avoid harsh soaps, which can be too drying^[13].

As skin gets drier with age, applying a moisturizer can help keep it hydrated and smooth. Apply a fragrance-free moisturizer daily after showering and whenever your skin feels dry. A moisturizer containing hyaluronic acid or glycerin can be particularly beneficial^[13].

Skin care products with antioxidants like vitamin C can help protect skin from environmental damage. Vitamin C protects the skin from damage caused by free radicals, which are unstable molecules that break down skin cells^[13].

Healthy Lifestyle

Stay hydrated and eat a healthy diet. Manage your stress. Check your skin often for any changes and visit a dermatologist regularly^[20].

Treatment Options

Since wrinkles are a normal part of your body’s aging process, they don’t need treatment. If you don’t like how wrinkles look on your skin, there are treatment options available to cosmetically improve your appearance^[8].

Prescription Creams and Serums

Your doctor may prescribe an anti-wrinkle product with prescription-strength retinoids. This ingredient is derived from vitamin A. These creams and serums are intended to reduce fine wrinkles and splotches. You may need to use the product for a few weeks or months before you notice improvement^[7].

Examples include tretinoin (Renova, Retin-A), tazarotene (Avage, Tazorac), and adapalene (Differin). Retinoids might cause a rash, burning, or dryness. Products with retinoids are not for use when pregnant^[7].

Retinoids that include retinol and other forms are chemicals that come from vitamin A that help reduce lines and wrinkles in your skin and improve your skin’s texture, pigment, and hydration levels. Retinol can penetrate deep into your skin’s layers to activate collagen and elastin, which give your skin structure and support to prevent wrinkles^[8].

Injectable Treatments

When injected in small doses into specific muscles, Botox (and similar products like Dysport, Xeomin, and Jeuveau) prevents the muscles from contracting. This weakening or paralyzing effect on the facial muscle temporarily reduces or eliminates skin creasing. The effect typically lasts 3 to 4 months in most individuals before full muscle movement returns^[12].

Injectable fillers are substances used to replace lost volume in certain areas of your face. When used appropriately, they can result in substantial and fairly long-lasting improvement. They treat deeper creases and folds that are not due to muscle activity^[12].

Common fillers include hyaluronic acids (Juvederm, Restylane), which are soft to the touch and used in the lips and other areas where a softer product is needed. Calcium hydroxylapatite microspheres (Radiesse) have a paste-like consistency and are used where a thicker, firmer filler is needed. Poly-L-lactic acid (Sculptra) stimulates your body to generate new collagen^[12].

Skin Resurfacing Procedures

Microneedling, or skin needling, is a facial rejuvenation procedure that uses a device with several tiny needles that create miniature wounds in the top layer of your skin. This wound heals within minutes and causes new collagen and elastin to form as your skin heals. Microneedling is effective at improving wrinkles or fine lines in your skin^[8].

Microdermabrasion gently removes or sands away thick or uneven outer layers of your skin. This treatment is best to treat scarring or stretch marks, skin discoloration, or sun damage^[8].

Dermabrasion scrapes away layers of your skin, removing skin layers to reduce wrinkles or irregular skin depressions. This helps you regain smoother, more youthful-looking skin^[8].

Chemical peels dissolve skin imperfections using small amounts of a chemical solution. The solution removes the top layers of your skin and makes room for new, healthy skin to grow in its place. Chemical peels are best to treat wrinkles, skin discoloration, or scars^[8].

Laser skin resurfacing reduces facial wrinkles and irregularities caused by sun damage or acne. The laser technique directs concentrated light at the skin to remove damaged layers^[8].

Surgical Options

For more significant wrinkles and skin changes, surgical options may be considered. These procedures are typically performed by specialists and may involve longer recovery times^[7].