Sept 12, 2010
Wrinkles, also known as rhytides, are folds or creases in the skin, resulting from loss of elasticity and skin turgor associated with aging and with years of daily exposure to the ultraviolet rays of the sun. But a major factor is the lack of proper skin care, which should include the frequent use of skin moisturizers. This healthy daily practice should not be a monopoly of women. Men also have skin that needs good care every day, part of which is the use of moisturizers two to three times a day like women do. After a shower, a significant amount of the natural oil in the skin is washed away. This is where the use of facial and body moisturizers becomes most beneficial to the skin of the individual. What is skin photodamage?
Skin photodamage is a spectrum of changes in the skin caused by chronic exposure to the ultraviolet rays of the sun. They include hyperpigmentation, teleangiectasia, wrinkles and tactile roughness. The prevalence of skin disorders that are linked to ultraviolet light exposure goes up with age and the changes develop over several decades. Asian women, who prefer not to expose themselves to the sun have younger looking skin, compared to their American counterpart who sunbathe and “worship” the sun. Prolonged exposure to the sun, and even the indirect sun reflection (from the sand, water or from any surface), are harmful to the skin.
Does smoking cause wrinkles?
Yes, cigarette smoking is an important factor that contributes to the development of wrinkles, especially on the face. Smoking hastens facial wrinkle formation even among the young and also speeds up the aging process. The other extrinsic factor is exposure to ultraviolet rays of the sun. The intrinsic factors are: hormonal status, aging, and inter-current diseases.
What do these factors do?
The etiologic factors listed above contribute to the thinning of the epidermis (outer layer of the skin), fragility of the skin, loss of elasticity, and formation of creases and lines, wrinkles. Facial wrinkles in men and women are more common among smokers compared to non-smokers. Among postmenopausal women, the fall in the estrogen level contributes to the development of, and increase in, wrinkles.
How about CO2 laser?
Carbon Dioxide laser has been found to be of little benefit in removing or lessening facial wrinkles in 6 months compared to chemical peel, which is a bit superior, according to one small randomized clinical trial. Erythema (excessive redness) is noted to be equal in both regimen. It has also been found that there is no difference in perioral (around the mouth) wrinkles between CO2 laser treatment and dermabrasion. There was more erythema with CO2 laser. Are cartilage preparations beneficial?
There is no convincing evidence that oral preparation of cartilage polysaccharide was truly effective in reducing wrinkles, although some manufacturers claim that their product does. One study shows the topical (cream) form was beneficial in reducing fine wrinkles at 120 days. The final word on the anti-wrinkle properties of cartilage polysaccharide has not been said yet. Is Tretinoin effective for wrinkles?
Under the supervision of a physician, the use of topical Tretinoin for 6 months has been found to be efficacious in significantly reducing fine wrinkles, but not course wrinkles. Usual short term complications include burning, itching and erythema. Skin feeling occurs in all users and this peaks at 12-16 weeks. The idea is to replace the olds kin with the “new” skin. Isotretinoin, on the other hand, has been found in two randomized trial to be effective in improving both course and fine wrinkles in 36 weeks among those with mild to moderate photodamage. The downside is the severe facial irritation that happens as a complication in about 5-10% of individuals on isotretinoin.
How safe are these medications?
Tretinoin and isotretinoin, and other drugs, have been used by dermatologists and plastic surgeons extensively and, under their supervision, these medications have apparently been safe. We strongly recommend that these, and other “anti-wrinkle” medications, be used only under a physician’s supervision. Are facial moisturizers beneficial?
While facial moisturizers do not remove wrinkles, they can delay wrinkle formation by keeping our skin healthier and a bit more resistant to damages caused by dry and neglected skin. Even the skin turgor appears to be firmer among those who use facial moisturizers. A well “hydrated” skin makes for a more youthful-looking face. Besides living a healthy lifestyle, which includes, among others, a low- fat, low-carbohydrate, high-fiber diet of fish, vegetables, nuts and grains, and daily exercise, hygiene and skin care every day are a must for everyone. Medically speaking, the daily use of facial moisturizer and body lotion is not cosmetic vanity but a physiologic necessity.
The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities, and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.
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