Best wrinkle treatments?

There are many different ways to reduce the appearance of wrinkles. It depends on their location and cause.

• BOTOX Cosmetic may be used to prevent a wrinkle caused by repetitive muscle movement from getting deeper.
• Injectable filler materials (e.g., Restylane, Juvederm, Radiesse) may be used to temporarily fill wrinkles.
• Lasers (e.g., carbon dioxide, erbium:YAG) may be used to resurface the skin.
• Chemical peels and dermabrasion may also be used to resurface the skin.

An evaluation by a physician is necessary to determine which treatments are best for a given patient. Minimizing sun exposure and using sunblock are also important to reduce the development of wrinkles and the risk of developing skin cancer.

The best way to reduce wrinkles is to prevent them before it is a problem.

Many of our younger patients are realizing the value of using Botox as a preventative treatment by relaxing hyperactive muscles that may lead to permanent folds, creases, and wrinkles.

An often underrated method of wrinkle prevention is daily use of sunscreen, as photodamage is the number one reason why men and women alike both seek treatments for the face.

Apart from prevention, we address existing fine lines and wrinkles with a variety of lasers. Patients may choose laser treatments that do not involve any downtime and are very safe for all skin types and ages. For example, we use the Aramis Quantel with a proven record for patient satisfaction when used for fine lines around the eyes. Our Q-Switched lasers also have proven very valuable.

For those seeking more aggressive treatments, we stick with what is tried and true - the Erbium MicroLaserPeel. This treatment has provided consistent and predictable outcomes. The concept with class IV medical lasers is that we are harnessing thermal energy to stimulate the body to remodel and stimulate collagen.

Combining lasers with appropriate skin care products (they don't have to be expensive!) and Botox/fillers has proven valuable to many of our patients.

The best way to reduce wrinkles is to prevent wrinkles from forming, or becoming worse. This includes not smoking, drinking alcohol, sunbathing, or living in dry climates (I know, no fun). You should also stay hydrated (read: water, not carbonated or caffeinated beverages), eat a varied diet rich in antioxidants, use sunblock with SPF 25+, and sleep on your back. Skin products with Retinol are also helpful in increasing skin turnover, to help your plump baby cells to come to the surface.

If you just can't change your lifestyle, there is still hope. Botox is great for wrinkles caused by muscle movements, such as frown lines (a.k.a. angry 11's, between the brows), worry lines (horizontal lines across the forehead), crow's feet, lipstick lines (those vertical lines caused by puckering, drinking through straws, etc). The effect of Botox is temporary, lasting 3 - 6 months, and it will not improve your wrinkles much better than if you looked at yourself without making an expression.

However, if these lines have become relatively permanent or static (they are still present when you make no expression), then the lines can be minimized using exfoliation techniques such as microdermabrasion and chemical peels. These techniques are relatively more economical, have little down time, but are effective for more superficial wrinkles.

Microdermabrasion is basically a fine sandblasting of the surface of the skin, removing the top layer of the dead skin cells. Chemical peels do the same, but also loosen up the connections between these dead skin cells, allowing some other cosmeceuticals to penetrate deeper. You will peel after both of these treatments, but more like after a sunburn, not sheets of skin peeling off. These treatments usually cost in the low $100s, depending on who is performing the treatment. Multiple treatments may be necessary, and can be performed as often as every 10 - 14 days if you have a special event coming up.

Lasers are also a great way to resurface the skin to treat deeper wrinkles. Erbium lasers are safe on all skin types and colors, since it targets water, and basically vaporizes the water under the surface, and the skin on top. Peels of different depths are available with the erbium laser, with corresponding amounts of downtime. CO2 lasers have considerably more down time than erbium lasers, and sometimes have issues with loss of pigment if the laser goes too deep or affects the melanocytes (the cells that produce pigment). Laser treatments in general cost into the thousands, but it's usually a treatment that gets profound results in one hit.

Fractional technology is something that has recently come out that breaks up the laser beams into smaller columns to vaporize smaller areas, leaving intact skin in-between. This treatment usually has less down time than the straight lasers, but they typically cost as much. These treatments can also be performed after an ablative laser treatment with the erbium, especially for deeper lines, but a lot of this depends on the type of laser your physician has. Ask to see before and after photos, and also in-between photos, so you can get a good idea about how you will look during the downtime.