ARE WRINKLES INEVITABLE?

The quality of our skin deteriorates as we age.  The manifestations of skin ageing depend largely on genetically determined factors.  Fair-skinned Caucasians tend to develop facial wrinkles whereas Asians, especially darker-skinned races, are prone to developing freckles, sunspots and other pigmentation problems.

While we are unable to alter our genetic heritage, extrinsic factors such as incessant ultraviolet radiation or smoking will contribute to the rapidity of skin ageing, principally via the damaging effects of free radicals.  Abnormal elastic fibers accumulate, collagen fibers degenerate and the blood circulation within the skin is impaired.  These result in a rough surface texture with wrinkling, scaling, pigmentation spots, broken vein appearances, and skin laxity.

Wrinkles are major clinical signs of skin ageing.  In addition, repeated movements of the muscles that contribute to facial expressions result in etched wrinkles on the skin, much akin to the deep creases on our palm surfaces.  This is why most of the wrinkles on our faces appear around the corners of the eyes and mouth, and also why people like actors and orators tend to exhibit prominent wrinkles and furrows on their faces.

Wrinkles have always been the bane of the appearance-conscious since time memoriam.  Soured milk, vegetable extracts, and mud were some of the applications used by ancient Egyptian Pharaohs.  In early medicine days, physicians resorted to the use of strong chemicals like phenol or harsh physical abrasive methods like salt dermabrasion.  There were a lot of experimentations then and catastrophes were not uncommon.

Nowadays, the physician’s armamentarium includes an impressive array of treatment methods.  Topical application of retinoid and fruit acid on a frequent basis reinvigorates the skin and ensures constant skin renewal.  Microdermabrasion exfoliates skin and is able to improve wrinkle appearances.  Chemical peels incorporating glycolic or lactic acid are able to denature and remove unwanted dead skin.

LASERs are increasingly used for cosmetic indications in skin rejuvenation.  There is a plethora of LASER technology dedicated for such purposes.  These include the CO2 or Erbium LASER resurfacing machines used principally to treat scars as well as wrinkles.  There is also the long-pulsed NdYag LASER that effects skin rejuvenation on a non-ablative mode, thereby eliminating the “downtime” associated with ablative LASERs such as the CO2 LASER.  The promising development of LASERs based on “Fractional Photothermolysis” represents the next stage of LASER skin procedures.  It is able to combine the benefits of the aforementioned LASERs whilst at the same time minimizing downtime.

The use of botulinum toxin and hyaluronic acid gel injections represent a breakthrough in cosmetic dermatology and eliminated the need for invasive surgeries.  A few miniscule injections here and there and you will be able to rid yourself of unsightly crows’ feet and frown wrinkles while hyaluronic acid fillers are able to improve the appearances of deep sadness lines around the mouth.  These procedures are effective and hardly disrupt the busy executive’s work schedule.

With the advancement of medical technology and affordability of many procedures, looking good is increasingly becoming a way of life and no longer only restricted to the rich and famous.

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Dr Loo Han Woen