Jonathan
M. Sykes, M.D. |
Eliminating
or reducing the amount of facial wrinkles creates a healthy, rested, and
youthful face. Successful wrinkle treatment requires an in-depth look at
the cause of the wrinkles and a treatment plan designed to lessen the number
and depth of these skin irregularities.
Causes of Wrinkling
The
most common cause of wrinkles is a loss in the elasticity of the collagen
layer. Collagen is a connective tissue layer that supports the outer layer
of the skin (the epidermis). As we age, there is a loss of collagen elasticity
and support of the overlying skin. This causes facial wrinkling. Although
our genetic make-up predisposes us to have either relatively smooth or
wrinkled skin, we clearly can do things to affect our skin texture, hydration,
and overall health.
There
are many detrimental environmental agents that negatively affect the health
of our skin. Smoking clearly decreases the microcirculation to the skin
and increases the amount of facial wrinkles. Many chronic tobacco users
have a marked increase in the number wrinkles around their mouth (particularly
on their upper lip). Exposure to the sun or in tanning beds also decreases
the elasticity of the skin, dehydrates the skin, and increases wrinkles
in the skin. Harmful UVA and UVB solar rays deplete the skin of moisture
and thin the dermal layer of the skin.
Treatment
of Wrinkles
Unfortunately,
we cannot control our genetic make-up. However, avoidance of tobacco,
sun, and tanning beds decreases exposure to agents in the environment
that can harm the skin. If sun exposure is unavoidable, a sunscreen with
SPF greater than or equal to 15 (sun protection factor) is important to
protect the skin. This will minimize the sun exposure to toxic solar radiation
and decrease the chance of acquiring a skin malignancy. A daily moisturizer
will also keep the skin hydrated and prevent the loss of water when the
skin is exposed to environmental irritants.
Topical
medication can also help to thin the epidermis (outer cell layer of skin)
and thicken the dermis (inner cell layer of skin). These agents remove,
or exfoliate, the dead superficial skin layer, producing a healthier revitalized
skin texture. Medications such as Retin-A or Renova, as well as topical
alpha-hydroxy acids, improve the quality of the skin and reduce fine wrinkles.
There
are many types of skin wrinkles or folds. These include superficial wrinkles
that are increased by sun and smoking. Deep folds, such as the grooves
adjacent to the corner of the mouth, are increased by sagging of facial
tissue. Lastly, muscle related wrinkles, such as in the forehead or in
the corners of the eyes (crow's feet) are increased by facial expression.
The specific treatment of these wrinkles is related to the cause and location
of the wrinkle. Filling the wrinkle, smoothing the tissue next to the
wrinkle, or weakening the muscle that causes the wrinkle are all methods
to decrease skin irregularities. The treatment chosen should be carefully
considered. In the next few articles, I will go into detail about specific
wrinkle treatments.
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Jonathan
M. Sykes, M.D., F.A.C.S.
is the director of facial plastic and reconstructive surgery at the University
of California, Davis Medical Center. He has an active practice in
facial plastic and reconstructive surgery and is involved in the teaching
of other plastic surgeons state of the art plastic surgery techniques.
Dr. Sykes has published over 80 medical articles and has recently designed
new instrumentation to simplify the endoscopic browlift procedure.
For information or a consultation please contact his office at (916) 734-2831.
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