Wrinkles have several causes. They may result from damage to the skin from sun exposure or smoking, loss of collagen and underlying support tissue as a process of aging, or bunching of the overlying skin associated with movements of facial expression. The method for treating wrinkles varies depending on the underlying cause and area being treated. Of course, the most important first step to treating wrinkles is to follow a sensible skin care regimen that includes using sunscreen daily.
Forehead and Frown Lines
Wrinkles on the forehead and frown are primarily caused by movements of facial expression. They are best treated with Botox alone or in combination with Restylane. Botox is the primary treatment, but Restylane is needed if the lines are so advanced that they are etched into the skin. Restylane also prolongs the effects of Botox; thus, requiring fewer treatments per year.
Lines of the crows feet result from contraction of the muscles around the eyes and chronic sun damage. These lines can be lessened using Botox, Restylane, and topical medications such as tretinoin, vitamin C, and glycolic acid.
Crepe-like Wrinkles Under the Eyes
Treatment of these lines can be challenging, but they may respond to chemical peels, Sculptra, Botox, and topical medications. Chemical peels resurface the damaged skin, Sculptra thickens the thin skin making it more resistant to wrinkling, and Botox lessens movement in this area.
Mid Cheek Lines
These are the cross-hatched lines that develop on the cheek and often run parallel to the big smile lines. They may appear as a result of volume loss and thinning of the dermis from sun damage. Treatment is therefore directed at thickening the dermis and preventing further damage. Sculptra, Restylane, sunscreen, and tretinoin or other medications provide the best results.
Nasolabial folds are the deep lines that go from the corners of the nose to the corners of the mouth. Marionette lines extend downward from the corners of the mouth. These lines are best treated by filling them with Radiesse or Restylane. Sculptra can also provide improvement. A drop of Botox can also help lift the corners of the mouth.
Lip lines extend outward from the lips and are a nuisance because lipstick often tracks into them. They are caused, in part, by puckering. Botox can lessen the action of the muscle that causes puckering, and Restylane or collagen can be used to fill the remaining lines. Chemical peels can also help soften these lines in difficult cases.
As we age, our lips lose volume. Restylane or Juvederm can replace this volume without making the lips look “fake” or “overdone”.
Neck lines can also be treated with Botox.