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Our skin is the largest organ of the human body, and it is one of the body’s most important structures, not only functionally, but also aesthetically. When wrinkles appear, in aging, most of us struggle with hiding, or even erasing them. Crease lines form as the skin tension decreases; the aged and damaged skin displays more lines because the elastin fibers break and lose their effectiveness. The elastin fibers may be thought of as tiny rubber bands, which keep the skin supple and tight. When these fibers break into small pieces, they are no longer effective in keeping the skin attached to the underlying structures and assisting in the rebound after the skin is stretched or pulled. The aged skin thins and falls into folds according to its attachments to the muscles beneath.

The major problem associated with aging is probably caused by free radical damage. This damage results in the destruction of elastin fibers, collagen, and even the internal repair mechanisms within the skin itself. Thinking of the free radical as the villain, assists in understanding preventative measures, protective agents and even restorative procedures to combat the extremely harmful effects of this damage to the skin. The toxic effects of free radicals can, in part be mediated or reduced through the use of antioxidants, such as vitamin A, C, and E, which act as free radical scavengers. Additionally, protection from sun and tanning light exposure greatly reduces the damage resulting in the formation of fine lines and wrinkles. A sun block lotion of at lease 30, applied hourly to the sun exposed skin is the most cost-effective measure of UV-A and UV-B radiation protection.

In treating fine lines, most of the creams and lotions just plump the skin with fluid. This process reduces the appearance of fine lines, but they reappear when the product is discontinued. If lines are thought of as valleys, then lowering the surrounding skin can reduce the depth and severity of the wrinkles. This principle is applied to dermabrasion, a surgical procedure of dramatic skin sanding. Micro-dermabrasion, a non-surgical removal of the top layers of the skin and non-ablative laser treatments, remove the very top layer of the skin to freshen your appearance. In these treatments, the skin surface is smoothed, the bumps reduced and the lines are decreased. There are many lasers on the market and some are being developed to stimulate the regeneration of the skin’s own collagen.

Before and after Botox in the brow and Radiesse filler around the cheeks and mouth.

Botox is a popular treatment of rejuvenation, resulting in the weakening of facial muscles, not in their paralysis. The distinction is an important one as the active ingredient, in low doses, weakens the muscles but does not entirely prevent them from working. The wrinkles are softened with the injections, but do reappear in three to six months when the nerves recover. Of course, repeat injections are needed to sustain the results and lengthen the time between treatments.

Filling the lines with injectables has led to the development of over a dozen products with numerous uses and effects. Restylane is a non-animal, stabilized hyaluronic acid approved by the FDA to correct facial wrinkles and folds. Restylane has a low allergic potential, lasts six to twelve months and looks natural. Atrefill is a collagen product, suspended in a longer lasting microsphere solution. Silikon 1000 contains silicone and is an FDA off-label product for facial injections. The use of silicone in the face should be approached cautiously, considering the possibility of long-term complications. Sculpta is marketed in Europe as NewFill and is a biodegradable polylactic acid used in suture materials. Sculptra is not yet FDA approved for use in this country. Radiance is a solublized calcium product, used extensively in Europe for cosmetic filling of facial lines. This product is FDA approved and the longevity of Radiance is thought to approach two to six years.

Since wrinkles appear where the skin is in relative excess, reducing the skin, reduces the wrinkles. Most skin reducing procedures are surgical, involving the cutting away of the excess, supporting and lifting the facial skin. Facelifts, browlifts, necklifts and eyelid surgeries accomplish rejuvenation with incisions. Endoscopic lifts are minimal incision surgeries, which change the muscle attachments of the facial skin. These procedures require anesthesia and some one to three weeks of recovery before social engagement. The results are long lasting and in some cases, lifetime, but the aging process continues even after surgery, so touch-up surgeries are common in ten to twenty years.

Probably most important in maintaining beautiful skin includes a healthy lifestyle of good nutrition, adequate hydration, regular exercise, proper rest, minimal alcohol consumption and smoking cessation. Stress reduction and adequate sleep are also important in today’s world of busy schedules. In taking the time to care for yourself, you will reap the rewards of glowing, gorgeous skin.