TREATMENT GUIDE |
treatment guide Fine lines and wrinkles
Dr Daron C. Seukeran reviews the treatment options available for fine lines and wrinkles
significant factors in producing lines and wrinkles are photoageing owing to occupational and recreational sun exposure over a number of years, smoking, and the degree of skin pigmentation, which would provide a level of natural sun protection. Also, as the face ages there is a loss of volume that further accentuates fine lines and wrinkles. Deeper lines of furrows are classified as
F
dynamic or static. Dynamic lines appear with activity of facial muscles, such as frown lines, whereas static lines are unchanged with movement. Dynamic lines can eventually become static. There are many products and
procedures that promise to reduce lines and wrinkles. Some treatments can produce significant improvements while other procedures or products seem to have little effect. There are two approaches for the management of lines and wrinkles: one is prevention and the other is treating the existing lines and wrinkles.
Prevention The main prevention method is to minimise sun exposure using adequate sun protection measures, such as wearing appropriate clothing, applying sun screen, and avoid getting sun burnt as well as sun beds. Environmental toxins, particularly tobacco smoke, should be avoided.
92 ❚ October 2013 |
prime-journal.com
INE LINES AND WRINKLES arise because of the loss of collagen and elastin in the dermis and a decrease in the amount of water held by the epidermis. The
Moisturisers can have some impact on
making lines look less prominent when compared to dehydrated dry skin by improving the water–holding capacity of the skin.
Treatment The treatment of lines and wrinkles can vary from conservative topical treatments to more invasive treatments such as laser resurfacing and surgery. Often it is the combination of
different
procedures that provides the best results. There are different ways of
Topical treatments Topical retinoids are derived from Vitamin A. Tretinoin has been used in topical preparations for treatment of ageing skin and fine lines. It is thought to result in proliferation and reduced keratinisation of the superficial cells. Other agents inlcuding vitamin C, alpha hydroxy acids, and other antioxidants can also be used but their effectiveness remains unproven1
. The treatment of lines and wrinkles can
vary from conservative topical treatments to
more invasive treatments such as laser resurfacing and surgery.
trying to reduce a line or wrinkle: ■ Remove the surface of the skin and allow a new layer of skin with new collagen to be laid down, this will naturally contract as part of the wound healing process and improve the skin
■ Fill in a depression of skin ■ Paralyse the muscles that lead to movements of skin and facial expression thereby reducing certain lines such as frown lines.
Aesthetic treatments In the past, chemical peels have been quite popular and can be divided into superficial and deeper peels. Facial peels, such as glycolic acid, are often used by beauticians and can lead to improved texture of the skin but really have little
Figure 1 (A) Before and (B) after laser resurfacing for wrinkles with a Er:YAG laser
impact on actual lines and wrinkles. Deeper peels such as those using trichloroacetic acid can sometimes help to improve fine lines, however, it is very important that the person using this type of peel is well trained as it can lead to scarring or pigmentary changes if used inappropriately. Microdermabrasion is sometimes
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