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Medical Author:

Alan Rockoff, MD

Alan Rockoff, MD

Dr. Rockoff received his undergraduate degree from Yeshiva College with the distinction of Summa Cum Laude. He received his medical degree from the Albert Einstein College of Medicine. His internship and two years of Pediatric residency were at the Bronx Municipal Hospital Center, followed by training in Dermatology at the combined residency program at Tufts and Boston Universities. Dr. Rockoff is certified by both the American Board of Dermatology and the American Board of Pediatrics.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Introduction

Although wrinkles can signify wisdom, most people nowadays would rather not have them.

Many products and procedures promise to reduce wrinkles. Some do little or nothing (like the products that claim they reduce "the appearance of fine lines," which means that they don't reduce the lines themselves). Others can achieve a fair amount of success.

Skin ages all over the body, but much more so where there has been sun exposure. Changes brought on by sun damage (photoaging) include "dryness" (really roughness), sagginess, skin growths like keratoses ("liver spots"), and wrinkles.

Most wrinkles appear on the parts of the body where sun exposure is greatest. These especially include the face, neck, the backs of the hands, and the tops of the forearms. Wrinkles come in two categories: fine surface lines and deep furrows. Wrinkle treatments are in general much more effective for fine lines. Deeper creases may require more aggressive techniques, such injection of fillers or plastic surgery.

What factors promote wrinkles?

Factors that promote wrinkling include:

• Smoking
• Light skin type (people with blue eyes and easily burned skin are more prone to sun damage)
• Heredity (some families wrinkle more)
• Hairstyle (some styles provide cover and protection against sun damage)
• Dress (hats, long sleeves, etc.)
• Occupational and recreational habits (farming, sailing, golfing, using tanning booths, and so forth)

Some of these factors are beyond our control. The main preventive measures we can take are to minimize sun exposure and not smoke.

SPF numbers on sunscreen labels refer to protection against UVB radiation (shortwave ultraviolet light, the "sunburn rays"). More and more sunscreens offer protection against UVA radiation (longer-wave ultraviolet light) as well. UVA rays are the ones you get in tanning salons; they may not cause immediate sunburn but do promote sun damage and skin cancer risk over time. (Sorry, but there is no such thing as a "safe tan.") Sunscreens that block UVA indicate this on the label and include such ingredients as Parsol 1789. The FDA has recently approved Mexoryl, another UVA-blocking ingredient, which has been available in Europe for some time. For more, please read the articles, Sunburn and Sun Sensitizing Drugs and Sun Protection and Sunscreens.