Wrinkles

Wrinkles are a natural part of the aging process.  They occur most frequently in areas exposed to the sun, such as the face, neck, back of the hands and forearms.  Over time, skin gets thinner, drier and less elastic.  Ultimately, this causes wrinkles – either fine lines or deep furrows.  In addition to sun exposure, premature aging of the skin is associated with smoking, heredity and skin type (higher incident among people with fair hair, blue-eyes and light skin).

Treatment for wrinkles runs the gamut from topical creams and moisturizers to cosmetic procedures.  The medical treatments available at our office include:

• Retinoids – these are preparations derived from Vit A and are applied to the skin.  The most widely know retinoid is Retin-A (or tretinoin) which has been extensively studied and shown to increase skin collagen, repair elastic fibers, reduce sun damage, and help reverse fine wrinkling.  Tretinoin is available only by prescription.  Other retinoids include retinol which is available in over the counter preparations but is less efficacious than prescription retinoids.
• Alpha-hydroxy acids – are preparations made from “fruit acids” that produce subtle improvements in the appearance of wrinkles and skin texture.
• Antioxidants – such as creams with high concentrations of green tea that improves the appearance of wrinkles and provides some additional sun protection.

Cosmetic procedures available at our office include:

• Chemical peels – act as exfoliants and can decrease the severity of skin blotchiness and improve skin texture and fine wrinkling.  Chemical peels are available in multiple forms and strengths. Stronger chemical peels produce more pronounced results but can also cause scaling and crusting for up to 10-14 days.  Excellent results can be achieved with a series of milder peels which have a shorter recovery time.
• Botox® and Dysport® - lines that appear between the brows, on the forehead and around the eyes (crow’s feet) are the result of repetitive muscle movement over time.  With aging, the skin becomes less elastic and repeated use of the muscles used for frowning, smiling or raising the eyebrows can result in moderate to severe wrinkles in these areas.

Both Botox® and Dysport® work by blocking nerve impulses to the muscles preventing them from contracting.  With less movement, the skin surface gradually smoothes out and wrinkles begin to fade.  The treatment is performed in the office, without requiring anesthesia, and takes approximately 10-15 minutes.

Depending on the patient, results are seen in 2-10 days. Visible results can last up to four months (average 3 months).  Both Botox® and Dysport® have been extensively studied and are both FDA approved.

• Fillers– As one ages, the skin undergoes many changes.  One of the most visible is the loss of volume and youthful contours of the skin.  This is due primarily to the loss of hyaluronic acid which is a naturally occurring substance found in skin that is plentiful in youthful skin but becomes depleted over time.  With the loss of volume wrinkles form and become apparent.  Fillers, which replace the lost volume, are available in many forms, the most commonly used are the hyaluronic acid fillers such as Restalyne®, Perlane®, Juvederm® and Prevelle®.  These products are administered directly into the skin by injections of small amounts via an ultrafine needle.  The effects can be seen immediately.  Some patients may experience bruising or swelling at the injection sites which resolves within a few days.  The fillers listed above last about 6 months.
• IPL (Intense Pulsed Light or Photorejuvenation) – treats the skin with customizable laser-like wave lengths of light which target dilated (“broken”) capillaries or darker pigmentation seen as “age spots” or mottled pigmentation.  The light emitted by the IPL is absorbed by capillaries causing them to coagulate and disappear.  Absorption by pigmented lesions causes them to darken and eventually to slough off.  The skin is also stimulated to form new collagen fibers giving the skin a renewed and more youthful appearance.  Depending on the number of conditions you are treating and the severity of each, a series of four to six treatment sessions may be recommended.  You can return to work the same day and resume all your regular activities.  By dividing the full program into several treatments, the procedure provides gradual improvement with very low risk.