33 year old male with old looking skin in visible areas. Can I reverse or improve the look of these wrinkles? (Photos)

hank you for sharing your concern and the detailed images — they help provide valuable context. Based on your description and photos, the appearance of fine lines and persistent folds in areas like the back of the neck and hands can be due to a combination of factors, many of which are manageable or reversible with the right care.

Possible Causes:
Chronic Dehydration (External & Internal)
While lack of water exposure from fewer showers might slightly affect skin surface hydration, true skin dehydration is more related to internal hydration and skin barrier health. A dry stratum corneum (top layer of the skin) can lead to wrinkling, dullness, and a crepey texture.

Environmental Stressors & Lifestyle
Factors like sun exposure, inadequate hydration, poor nutrition, harsh soaps, or inconsistent skincare can prematurely age the skin—even without traditional signs like deep wrinkles.

Reduced Collagen/Elasticity
It’s possible that your skin is showing early signs of collagen loss or slower cellular turnover, which can occur even in the 30s, especially if genetically predisposed or exposed to environmental damage.

Genetics & Skin Type
Some skin types are more prone to showing fine lines and creasing, especially in flexural areas like the neck and hands.

Recommendations:
1. Hydration & Moisture Retention
Use a thick, ceramide-rich moisturizer twice daily.

Consider using hyaluronic acid serum on damp skin to help plump and retain moisture.

Drink plenty of water throughout the day to support skin health from within.

2. Barrier Repair & Exfoliation
Use a gentle exfoliant (like a lactic acid or polyhydroxy acid product) 1–2x per week to improve texture.

Avoid over-cleansing or harsh soaps. Opt for pH-balanced cleansers.

3. Sun Protection
Daily sunscreen (SPF 30 or higher) is essential even if you're mostly indoors. UV exposure is a major factor in premature skin aging.

4. Topical Treatments
Start incorporating retinoids or retinol gradually to help boost collagen production and improve elasticity.

Antioxidants (like vitamin C) in the morning can protect against environmental damage and help even skin tone.

5. Professional Options
Microneedling can be effective for collagen induction and skin texture improvement. It helps stimulate natural healing and collagen production.

Chemical peels and laser resurfacing may also be options in the future if you seek more dramatic texture improvement.

Growth factor serums or peptide-based creams can help strengthen the skin matrix over time.

Final Thoughts:
It’s not too late to care for your skin — you’re still young, and the skin is remarkably responsive to consistent, targeted care. With time, hydration, and collagen-stimulating treatments, your skin texture can significantly improve. The most important step is starting a consistent and protective skincare routine now.

Your concern is valid, and with a combination of home care and potentially professional treatments, you can absolutely see progress.

Let me know if you'd like a product-based regimen or further guidance on ingredient selection.

Most chemical peels remove the top layers of skin through exfoliation. Although this may initially thin the skin, the goal is to stimulate new skin with denser collagen to form. Deep chemical peels and lasers tend to give you more collagen-rich skin that is healthier and more youthful.
The amount of skin recovery really depends on the depth of your chemical peel. Light chemical peels have little to no downtime, whereas deeper chemical peels may penetrate the dermis and cause 7-10 days of skin recovery and peeling. During the initial dryness and peeling stage, your skin may become noticeably darker as the pigment is driven towards the surface of your skin. Redness, skin tightness, mild discomfort, and itching are all normal elements of recovery. We encourage patients to use a lightening SPF sunscreen during the day. It is advisable to avoid direct sunlight and picking of any dried or peeling skin.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. What you’re describing sounds like signs of early skin laxity and thinning, which can stem from a combination of factors like collagen and elastin loss, dehydration, and genetics. Even though you're only 33, skin aging can appear early—especially on delicate areas like the hands, neck, and under the chest—if there’s underlying collagen depletion, sun exposure history, or lifestyle factors. Not showering often wouldn’t directly cause wrinkles, but lack of regular hydration (both internal and topical) and a disrupted skin barrier can make skin appear crepey and less elastic. Microneedling can help by triggering collagen production and improving skin texture over time. However, for more advanced or widespread thinning, fractional CO2 laser resurfacing may offer stronger, more visible results—it works by deeply stimulating collagen and tightening the skin. It’s particularly effective for crepey skin and can restore smoother texture and resilience over multiple sessions, though downtime and professional assessment are important. To support results, maintaining a consistent skincare routine that includes retinol, peptides, and daily sunscreen is key. And yes, this kind of aging can be improved—especially if you begin now, before changes become more severe. I hope this helps and best of luck!