Facial skin care and wrinkle treatments for younger-looking skin

Wrinkles can be a sign of a life well lived. They might deepen each time you smile, laugh at a joke or squint to read. While there’s nothing unhealthy about wrinkles, treatments are available to help fill them in, smooth them out and make them less visible.

Wrinkles tend to appear in areas that get a lot of sun, such as the backs of your hands and your face. As skin ages, it loses elasticity, so it doesn’t spring back into place like a baby’s smooth skin does. Genetics, sunlight, smoking and exposure to pollutants all contribute to signs of aging on the skin.

Essential skin care routine for wrinkle prevention

A good skin care routine can help protect your skin and prevent wrinkles.

Five steps to do daily are:

• Wash your skin with a mild cleanser.
• Use a physical or chemical exfoliant to get rid of dead skin cells. If you have sensitive skin, do this step only a few times a week.
• Apply a toner — a water-based lotion or tonic to clean and tighten your pores.
• Moisturize to hydrate your skin and temporarily fill in little creases.
• Apply sunscreen to exposed areas, such as your face and neck.

Some moisturizers include sunscreen, combining steps 4 and 5. Use sunscreen every day, year-round — even sunlight that shines through windows can age skin.

“It’s ideal to use a physical sunscreen, such as one containing zinc oxide or titanium dioxide. This creates a physical barrier against UV rays. Also, a tinted sunscreen can be nice because it’s like a light layer of makeup on the skin,” says Alison Bruce, M.B., Ch.B., a dermatologist at Mayo Clinic in Florida.

Here are more steps for fresher-looking skin without surgery.

Anti-aging creams and at-home treatments

Moisturizers and creams are the first step in reducing wrinkles. You can get products with retinol, antioxidants and peptides at drugstores or anywhere you buy cosmetics.

• Retinols and retinoids are forms of vitamin A. They are a cornerstone of wrinkle products. While retinols are available over the counter, retinoids are available by prescription only. Used consistently, products that contain retinols or retinoids can reduce signs of aging.
• The products can reduce fine wrinkles, splotches and roughness. But they also can make skin more sensitive. “You may notice redness and dryness when you first start using retinol or retinoid. It takes the skin about 4 to 6 weeks to adapt so that those side effects are no longer visible,” says Leila Tolaymat, M.D., a dermatologist at Mayo Clinic in Florida.
• Peeling is proof that the cream is helping the skin exfoliate properly. With continued use, better color and luster will likely emerge in a few weeks.

Unless your dermatologist suggests otherwise, use retinol products at night because they can be inactivated by sunlight. The sun tends to burn skin treated with these products more easily, though that can be countered by using sunscreen.

Ramp up product use gradually if you get skin irritation. Start using it every third night, then every other night and finally every night.

Skin care products available without a prescription are classified as cosmetics, so they aren’t regulated the same way that drugs are. That could mean that your product contains only a little bit of the active ingredient. Mayo Clinic experts also say that expensive products don’t necessarily work better than less expensive products.

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Professional wrinkle-reducing procedures without surgery

Nonsurgical wrinkle treatments — like peels and laser treatments — are done by licensed professionals.

Wrinkle treatments come with some risk, including swelling, redness and irritation. A dermatologist or licensed aesthetician can help you choose the procedure that’s best for you and assess your skin’s health at the same time. People who are pregnant or have a weakened immune system should first talk to their healthcare team or avoid these procedures.

“There’s a big advantage to seeking this type of care from medical professionals, as they can do the peel or injection and also are able to assess the skin in general,” Dr. Bruce says. “If there’s something there that is worrisome and needs a biopsy, there’s an advantage to having someone skilled in medicine taking care of those things.”

Here are some nonsurgical skin procedures to consider:

Laser resurfacing for smoother skin

• Ablative laser takes off the outer layer of skin (epidermis) and heats the underlying skin (dermis) to stimulate the growth of new collagen. This leads to smoother, tighter skin as it heals.
• Nonablative laser also stimulates collagen by warming the dermal layers without the peeling that comes from removing the outer layer of skin. This type of laser therapy has a faster recovery time, but the results are more subtle.

Today, both methods commonly involve a fractional laser, which leaves microscopic columns of untreated tissue throughout the treatment area. Fractional lasers were developed to shorten recovery time and reduce the risk of side effects.

Laser resurfacing helps manage fine lines and mild skin discoloration but is less effective for deep wrinkles. With your input, the dermatologist or licensed aesthetician can control how deep to set the laser and which areas of the skin to treat or avoid.

• Healing time: about a week after a laser session.
• You may need repeated treatments to get the desired results.

Chemical peels for wrinkle reduction

With a chemical peel, a chemical solution is applied to remove the outer layer of skin. Just as with laser resurfacing, the skin tightens and smooths as it heals. However, peels are less precise than laser resurfacing.

“Peels can be a little more unpredictable depending on the thickness of the skin and where the skin is being treated,” Dr. Bruce says.

Things to keep in mind about chemical peels:

• Different peel depths may be recommended.
• A medium or deep peel may require a sedative or pain medication.
• Immediately after your peel, your skin will likely be red, tight and irritated.
• Deeper peels will take about a week to heal, with lighter peels needing less recovery time.
• Good results may require more than one treatment or maintenance peels every few months.

Dermabrasion and microdermabrasion for fine lines

Dermabrasion uses sandlike particles to remove the outer layer of skin. This decreases the appearance of fine lines since the skin that grows back is smoother.

• Microdermabrasion uses even finer particles and can be used to remove scars, age spots and tattoos.
• Dermabrasion can be combined with other cosmetic procedures.
• Healing time: about a week. Multiple treatments aren’t always necessary.

Botox injections to smooth forehead and eye wrinkles

Botox — one of the brand names for a botulinum injection — is a neuromodulator, which works by disrupting nerve signals and allowing muscles to relax. People often use the name Botox to refer to any injection of botulinum, but there are different brands — such as Dysport and Xeomin — that are approved for different uses. They can be injected at targeted nerves in specific sites, like the forehead.

• Neuromodulators used for wrinkles are classified as cosmetic injectables.
• They are injected into the skin with a thin needle.
• When the muscles relax, the skin on top appears smoother.

These injections are often used between the eyebrows, across the forehead, and at the corners of the eyes.

• They can reduce the appearance of frown lines and other facial wrinkles for 3 to 4 months at a time.
• It’s important for the injection to be precisely placed so there won’t be any unintended effects.
• Risks include allergic reaction, muscle weakness, vision problems, and difficulty talking, swallowing or breathing.

Dermal fillers to restore volume and reduce deep wrinkles

Fillers are a type of injectable usually made of hyaluronic acid (Restylane, Juvederm). The filler plumps facial tissue, which smooths out wrinkles or softens the “hills and valleys” of the face, making deep lines less obvious.

The fillers gradually absorb into the skin.

“Fillers can last for six months to a year depending on the specific filler and where it’s placed,” Dr. Tolaymat says.

Embracing aging while exploring wrinkle solutions

In a culture driven by keeping a grip on youth and vitality, fine lines and wrinkles may be an unwelcome arrival. But many people learn to accept — even embrace — the signs of aging.

If you are bothered by those aging signs, however, science can provide relatively safe ways to keep them at bay. Regular “tweakments,” as Dr. Bruce calls them, are one way to take care of your appearance, so you can feel like yourself when you look in the mirror.

This article originally appeared in the Mayo Clinic Health Letter.