I Have Aging Thin Sun Damaged Skin. What Can I Do to Fix Crinkly Fine Lines and Wrinkles on my Cheeks? (photo)

I'm aware I can get Botox for the lines near my eyes and a filler for deep lines near my mouth, but my biggest area of concern is the thin wrinkly skin on my cheeks (see pictures). It makes me look older than my 40 years. I have very thin skin--not sure whether to call the lines wrinkles, fine lines or just plain skin damage. I read that chemical peels can thin the skin out even more. I don't want to do any more damage. Is there a procedure to fix or improve the appearance of these lines on my cheeks?

Doctor Answers 11

Thin skin more prone to fine lines and wrinkles

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The skin tends to thin out with age and and this is more obvious in individuals who have thinner, more delicate skin to begin with. 
To reduce the fine lines, you'd essentially need to plump and thicken your skin. I'd recommend stepping up your skin care by adding retinol in incremental steps and to protect your skin from UV exposure and also give up smoking if necessary/possible. 
Consider adding regular treatments that will help promote further collagen stimulation. Micro-needling, mesotherapy and platelet rich plasma treatments involve using fine needles and the down time is minimal. 
Laser treatment e.g. CO2 laser produces very good results but you need to allow up to a week for recovery.

Birmingham Plastic Surgeon
4.8 out of 5 stars 100 reviews

Treatment of fine lines

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It's normal to start noticing the early signs of aging in your thirties and forties.   The best treatment for texture, pores and fine lines is the microablative fractionated CO2 laser like SmartSkin. This laser is very effective for wrinkles, acne scars, and improving skin texture.  You seem to have a fair skin complexion.  This laser treatment is very precise and predictable.  You will have two days of swelling, two days of peeling and two days of redness.  To maintain your result I would consider using SkinMedica TNS essential serum with growth factors.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Reversing signs of early aging, thin skin and chemical peels. Consider CO2 resurfacing

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Chemical Peels actually strengthen and thicken the skin.  A vital part of improving your skin though is your daily routine.  Some of the clinical products I would recommend are Vitamin C&E to neutralize free radical damage, a NIA 24 product which is designed to thicken and strengthen the skin, and Retin A or a Retinaldehyde to stimulate cellular turnover, therefore reducing the signs of aging.  That, coupled with Chemical Peels, Needling (along with PRP/Platelet Rich Plasma injections or topical infusion (no downtime)), would introduce you to a good program.  CO2 laser resurfacing is always an excellent choice as well, but it depends on whether you want to ease into the process or jump in!  Either way, you need an experienced and trusted clinician to advise and educate you as well as administer your treatment.

Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Fine wrinkles

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Fine wrinkles and pigmentation problems of facial skin is best treated with medical grade skin care followed by CO2 laser resurfacing. It also improves on the skin quality in general. Better color, better skin quality, long term results.

Recovery 2 weeks, then redness of the face for few weeks.

Samir Shureih, MD
Baltimore Plastic Surgeon

How to correct fine crinkly lines and wrinkles on cheeks

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I would prepare your skin with micro-dermabrasion treatments and a topical ask fully and such as Retin-A if she can tolerate it or vitamin C.

You need a combination of methods to produce new collagen to plump the skin and a face the wrinkles.

Personally I would start with fractional non-ablative Erbium laser treatments to build new collagen and plump the skin.  You will need 3-4 treatments and don't expect immediate results as it takes several months to build the new collagen however it will happen.

If in the fourth month you're not seeing results then a final combined laser resurfacing treatment with the 1540 laser followed immediately by a 20/9/40 ablative fractional erbium laser treatment will be her best option.

There are many different non-ablative fractional erbium laser is out there the way links include 1540, 1450, and 1585.

Skin Rejuvenation

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The wrinkles you see are a natural result of decreasing collagen and elastin that occurs as we age. Fillers and chemical peels do not address this fundamental problem.

Dermal heating stimulates the natural production of collagen, elastin and hyaluronic acid. This reduces wrinkles by treating their underlying cause. The result is truly younger skin at a molecular level with increased elasticity and thickness. I am consistently impressed by ePrime, which delivers fractionated radiofrequency to precisely heat the deep dermis. This approach would be perfect for you.

Treating Fine Lines and Wrinkles across the Cheeks

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Sun overexposure, cigarettes, alcohol, ill health, and select medications are just some of the contributing factors that can cause a premature aging of the skin. Before recommending a treatment, you’d have to be examined to identify the source of your problem. Based on the results of your examination, I might recommend a combination of treatments. However, I’d starting with Platelet Rich Plasma (PRP) therapy to revive the skin and reduce the appearance of those fine lines and wrinkles crisscrossing your cheeks. The treatment involves the injection of your own extracted blood platelets. The nutrients and growth factors can then repair the damaged tissue by jumpstarting the body's natural collagen and hyaluronic production.

Hal Michael Bass, MD
Miami Plastic Surgeon

The Punctuated Phenol Peel Works Well For Crepeyness and Fine Wrinkles

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Chemical peels have been a reliable mainstays of the cosmetic physician's toolbox for well over a century. The "Punctuated Phenol Peel"--a very recent advance in chemical peeling technique--is one that is sure to put chemical peeling squarely back on the map and in competition with the more expensive, more heavily hyped laser and light-based therapies currently intensively marketed to consumers. The technique works especially well for crepey and finely wrinkled skin.

The procedure is simple, requires no sedation, and has little or no downtime. Using 88% plain phenol, fine lines and crinkles are treated in punctuated (i.e. fractionated or pixelated)  fashion. Using a very finely pointed applicator, the chemical is applied in a serial spot fashion with each spot separated from surrounding treatment spots by approximately one-quarter inch. The use of serial spot coverage, rather than coverage of whole areas, allows for rapid recovery as healing takes place from the intervening non-treated areas. It is precisely the same rational for the use of fractional lasers.

The "Punctuated Phenol Peel" technique is a novel approach to rejuvenation that limits the overall potential for toxicity and downtime of traditional deep peels while constituting focal spots of more intense peeling. Wrinkle lines and crepeyness can be traced in this punctuated fashion, and treatment sessions can be repeated at monthly intervals if necessary until the desired result is obtained. (When appropriate, acne scarred areas may likewise be treated in a punctuated fashion.)

Consultation with and treatment by an aesthetic physician experienced in chemical peeling is an absolute must for determining  the appropriateness of this novel approach for any particular situation.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Fine lines and wrinkles - try this first

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Thin skin can get dehydrated very easily. The lack of moisture in the skin will accentuate even the tiniest of lines.

I would recommend that you embark on a topical skin program first. Even if you decide to have laser procedures or peels, you'll need to pay attention to the moisture content in your skin.

There are over the counter lotions and creams which contain ceramides that would be helpful in moisture retention.

Most people forget that skin care can often mitigate many of the issues they have with their skin.

A further topical step might be retinoids - but with your skin fragility you may prefer to go with retinols instead of RX products as they are less irritating to sensitive skin.

Chemical peels or fractional laser might be the next step, but I would recommend a soft first step to see what kind of improvement you get with products.


Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

3 Unique Ways to Reduce Facial Wrinkles without Downtime

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My recommended treatment plan  for Crepey, Fine Line Facial Wrinkles,  would depend upon an examination but I will do my best to respond.  First I would not recommend a laser resurfacing procedure at you age.  The reasons are:  1. SLOW RECOVERY 2. A difficult post-laser treatment plan. 3.We tend to reserve laser resurfacing for the older patient with extremely deep wrinkles.  I would therefore recommend a plan that is less aggressive and will give you about a 40% to 50% improvement with minimal downtime.

• Pelevee' Skin Treatments x 3 per year (see link below for details)

• Profractional Laser: once per year

• Topical Tripeptide Cell Activator (with Stem Cell)
This plan of action will give a good controlled semi-conservative approach that will help promote collagen production in the deep layers of your skin  and will also help delay the overly envasive Full Laser Resurfacing which may be required in your  late 50's.

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.