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?

• 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)

Preventive measures

• 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

Treatment

There are several medical (topical medicines and creams) and cosmetic techniques available for reducing wrinkles.

They include both medical and surgical methods.

Medical treatment

Vitamin A acid- may produce redness and peeling at first, but discomfort can usually be minimized by lowering the cream's concentration or applying it less often until the skin gets used to it

Alpha-hydroxy acid may produce redness and peeling at first, but discomfort can usually be minimized by lowering the cream's concentration or applying it less often until the skin gets used to it

Antioxidants- include vitamins A, C, and E, as well as beta-carotene. Such creams may provide a certain amount of sun protection as well as mild improvement of fine wrinkles

Moisturizers- reduce the appearance of fine lines.

Cosmetic procedures

Glycolic acid peels-superficial peels can make a very slight difference in the intensity of fine wrinkles.

Deep peeling

• Deeper peels-these peels use ingredients like salicylic acid and trichloroacetic acid and penetrate somewhat deeper into the skin.
• Deeper peels do a better job of smoothing fine lines
• The deeper the peel, however, the greater the risk of side effects, such as long-lasting pigment changes (changes in the color of the skin) and scarring
• Such peels do not require anesthesia. Mild sedation helps ease short-term but fairly intense discomfort

Microdermabrasion

This refers to "sanding the skin" with a machine containing silica or aluminum crystals.

Microdermabrasion does not change skin anatomy, though it may make the face feel smoother.

 Laser resurfacing

• Using instruments such as the carbon dioxide and erbium lasers, results similar to those of dermabrasion with greater reliability and precision
• The laser is passed several times over the area to be treated until the peel reaches the middle of the dermis, the skin's second layer
• This helps stimulate the body's natural collagen synthesis (production), which plumps up sagging skin and wrinkles
• Procedures may need to be repeated to maximize improvement. Skin takes a long time to heal (weeks to months) after resurfacing.
• In addition, this procedure, like dermabrasion can cause permanent pigment changes and scarring

Non-ablative laser resurfacing-newer lasers attempt to stimulate collagen synthesis under the skin without peeling or damaging the epidermis.

Heat and radiofrequency-Another variation of noninvasive facial rejuvenation is to heat tissue using radiofrequency devises and infrared light sources.

 Botox

Injection of botulinum toxin, the muscle poison, can paralyze muscles that produce the "frown lines" on the forehead, fine lines around the eyes, and other wrinkles. Botox is quite safe

The muscle poison does not spread through the body to do damage elsewhere

Fillers

Fillers are injected into the skin to increase volume and flatten wrinkles and folds. Hyalouronic acid and calcium hydroxy apatite, have become popular, because their effect can last six to nine months, or even longer.