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Wrinkles
Over time, the sun’s ultraviolet (UV) light damages the
fibers in the skin called elastin. The breakdown of these fibers
causes the skin to lose its ability to snap back after
stretching. As a result, wrinkles form. Gravity also is at work,
pulling at the skin and causing it to sag, most noticeably on
the face, neck, and upper arms.
Cigarette smoking also contributes to wrinkles. People who
smoke tend to have more wrinkles than nonsmokers of the same
age, complexion, and history of sun exposure. The reason for
this difference is not clear. It may be because smoking also
plays a role in damaging elastin. Facial wrinkling increases
with the amount of cigarettes and number of years a person has
smoked.
Many products currently on the market claim to “revitalize
aging skin.” According to the American Academy of Dermatology,
over-the-counter “wrinkle” creams and lotions may soothe dry
skin, but they do little or nothing to reverse wrinkles. At this
time, the only products that have been studied for safety and
effectiveness and approved by the Food and Drug Administration
(FDA) to treat signs of sun-damaged or aging skin are tretinoin
cream and carbon dioxide (CO2) and erbium (Er:YAG) lasers.
Tretinoin cream (Renova), a vitamin A derivative available by
prescription only, is approved for reducing the appearance of
fine wrinkles, mottled darkened spots, and roughness in people
whose skin doesn’t improve with regular skin care and use of
sun protection. However, it doesn’t eliminate wrinkles, repair
sun-damaged skin, or restore skin to its healthier, younger
structure. It hasn’t been studied in people 50 and older or in
people with moderately or darkly pigmented skin.
The CO2 and Er:YAG lasers are approved to treat wrinkles. The
doctor uses the laser to remove skin one layer at a time. Laser
therapy is performed under anesthesia in an outpatient surgical
setting.
The FDA currently is studying the safety of alpha hydroxy
acids (AHAs), which are widely promoted to reduce wrinkles,
spots, and other signs of aging, sun-damaged skin. Some studies
suggest that they may work, but there is concern about adverse
reactions and long-term effects of their use. Because people who
use AHA products have greater sensitivity to the sun, the FDA
advises consumers to protect themselves from sun exposure by
using sunscreen, wearing a hat, or avoiding mid-day sun. If you
are interested in treatment for wrinkles, you should discuss
treatment options with a dermatologist.
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