All About Wrinkles

By Greg Ruff, MD | Apr 19, 2019

It’s the moment everyone dreads—you look in the mirror and see crow’s feet fanning out from the corners of your eyes, or maybe those laugh lines are starting to permanently stick around even after you’ve stopped smiling. While aging is inevitable and we all do it, there are products available that can minimize the appearance of wrinkles. So while you may be getting older and wiser, your skin doesn’t have to show it.

            Wrinkles are formed when grooves in the skin develop over muscles of the face that you use frequently. These grooves start out as fine lines but deepen over the years. Your face has over 40 muscles that contract every time you smile, squint, or frown. As you age, the muscles stay in a contracted state and your skin loses its ability to snap back into place. This is why you often hear wrinkles referred to as “laugh lines” or “frown lines.” 

            Collagen is an important protein that helps your skin remain flexible and retain its shape. As you age, your skin makes less collagen. Sun exposure further damages your skin’s ability to make collagen and speeds the breakdown of collagen. The deep wrinkles and leathery appearance of the skin that is caused by sun damage is called photoaging.

            While you may be diligent about daily moisturizing and treatments for your face, the neck is an area that is often ignored. The deep horizontal lines that form on your neck can give away your age even if your face is smooth. These neck lines are caused by repeatedly sitting in a position where you are looking down or tilting your head forward, like when you look at a computer screen all day. Neck lines can also be caused by excess fat and sagging that occurs when collagen production slows down.

            So what are the best ways to prevent wrinkles?  Well, you could try never smiling, laughing, or frowning, but you probably wouldn’t want to go through life like that. Applying daily sunscreen, wearing a hat and sunglasses when outside, and avoiding tanning will go a long way towards preventing photodamage. Staying hydrated, eating plenty of fruits and vegetables, and getting enough sleep will also help prevent wrinkles. For neck lines, performing exercises to stretch out the neck throughout the day will help inhibit the formation of these lines. 

            Prevention is important, but how do you treat the visible wrinkles you already have? Creams and serums containing peptides, when used daily, can reduce wrinkles and improve the appearance of your skin. Peptides are small protein molecules that easily penetrate the skin. Some peptides increase collagen production in your skin, while other peptides block signals from your nerves to your muscles telling your muscles to contract. When these signals are blocked, the muscle relaxes and deep lines in your face are smoothed out. Peptides achieve an effect like Botox injections, without the pain and potential side effects.  The best peptides available include Argireline, Snap-8, Leuphasyl, and Syn-Ake. Since peptides block muscle contractions in different ways, it is best to look for a product that contains a combination of peptides.

When people look at your face, they see shadows that make your wrinkles look deeper. Daily use of peptides has been shown to reduce the depth of wrinkles by 30-70%. However, even a 30% reduction in wrinkle depth will improve your appearance dramatically since the shadows on your face will be less prominent.

Treatments that stimulate the production of collagen in the skin will give your skin a firmer appearance. Matrixyl 3000 is a relatively new peptide that has been found to stimulate collagen production by 2.5-3.5 times in the skin. Vitamin A (retinyl, retinoids) also stimulates the production of collagen in the skin when used daily.

Antioxidants such as vitamin E and vitamin C decrease the amount of free radicals in your skin when used in daily skin care. Free radicals are molecules that can damage your cells and magnify the signs of aging in your skin. Hyaluronic acid is another important antioxidant that helps your skin retain moisture and firmness.  

More invasive treatments are available to address the appearance of wrinkles. Botox, a purified form of bacteria, is injected under the skin to treat wrinkles, particularly around the eyes, forehead, and cheeks. The muscles are paralyzed, which causes the wrinkles to smooth out. The effects of Botox injections last for 3-6 months. The risks of Botox injections include bruising, pain, facial weakness and drooping, flu-like symptoms, headache, nausea, redness.

Facelift surgery can correct wrinkles, lines, and sagging skin. However, the cost and recovery time may be significant. It is important that you discuss the risks and benefits with a board-certified plastic surgeon to determine if surgery is the right treatment for you.

While we can’t stop ourselves from aging, you no longer have to show your age on your face. There are many cutting edge products available that you can incorporate into your daily skin care routine that will minimize wrinkles, fine lines, and sagging skin. 


Greg Ruff, MD

Board Certified Plastic Surgeon

Read Greg Ruff, MD's bio