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

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.

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.