Wrinkles (cont.)

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Introduction to wrinkles

Although wrinkles can signify wisdom, or at least some level of maturity, there is no question that newly born infants also have wrinkles. The real concern that most of us have is that certain types of wrinkling is associated with aging. Aging in our current "pop" culture is not viewed positively. Generally, the treatment of normal skin aging that does not produce a functional abnormality is termed "cosmetic." And most cosmetic procedures are not covered by health insurance.

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, lentigos ("liver spots"), and wrinkles.

Most wrinkles associated with aging appear on the parts of the body where sun exposure is greatest. These especially include the hairless scalp, face, neck, the backs of the hands, and the tops of the forearms. Wrinkles come in two categories: fine surface lines and deep furrows. Some deep furrows are anatomical in nature and have little to do with aging. Generally, it is only the aging wrinkles that really bother people. There are two basic approaches to the amelioration of these signs of aging: prevention and removal. Topical wrinkle treatments are, in general, much more effective for fine lines. Deeper creases may require more invasive techniques, such injection of fillers or plastic surgery. There is a special form of wrinkling called "cellulite" that produces a "cottage cheese-like" appearance to the skin. This is most commonly noted in the hips and buttocks of women and is due to fat deposition in certain anatomical areas in the dermis.

Reviewed by William C. Shiel Jr., MD, FACP, FACR on 2/17/2012

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