Wrinkle treatments
Your health expert: Dr Camilo Diaz , Consultant Dermatologist
Content editor review by Liz Woolf, October 2020.
Next review due April 2026
Wrinkles are the lines that develop on your skin as you get older. Whether it’s frown lines or crow’s feet, getting wrinkles is normal and a natural part of ageing. Wrinkles aren’t harmful and many people accept them as part of growing older. But others find ageing harder to accept. Many explore treatment to help their skin look more youthful.
About wrinkles
Everyone gets wrinkles as they age. They vary in how they look – you may have fine creases or deeper lines. Wrinkles usually develop in places where your skin is frequently exposed to the sun. So your face, neck and the backs of your hands are where you’re most likely to see them.
How your skin ages depends on your genetics and your skin type. But it’s also affected by whether you smoke and how much you protect your skin from the sun. People who smoke and those who sunbathe are more likely to develop wrinkles.
If you have fair skin, you’re more likely to have wrinkles than someone who has Asian or Black skin.
Wrinkle treatments
There are lots of different treatments for wrinkles, from skin creams to surgery. Below is information on the most common treatments. And suggestions for things to think about if you’re considering them.
Skin creams and gels
There are many creams that claim to reduce the appearance of fine lines. But it's important to be realistic. If a claim sounds too good to be true, it usually is.
Creams and gels contain retinoids. These are forms of vitamin A that can improve fine lines, make your skin smoother and your skin colour more even. They do this by repairing damage to skin cells and tightening your skin, so fine lines are less visible.
Vitamin A is an antioxidant. Doctors sometimes recommend taking or using other antioxidants alongside retinoid creams. Vitamins C and E are also antioxidants, as is coenzyme Q10. You can use antioxidants as a cream or lotion, or take them as tablets. They work by helping to stop skin damage caused by the sun and pollution.
Some retinoid creams are available to buy over the counter. Others are only available on prescription from a dermatologist. Be aware that they can have side-effects. For example, the creams can irritate your skin and make it more prone to burning in the sun. It’s important to use sunscreens, including lip balm, from the start of your treatment. Specialists recommend that you start with a low concentration cream and build up gradually. This helps to avoid skin irritation. Always read the patient information leaflet that comes with your cream or gel. If you have any questions, ask your pharmacist or private consultant for advice.
Chemical peels
Chemical peels aim to improve and smooth the texture of the skin on your face. They can help to reduce lines and fine wrinkles by removing damaged outer skin layers. This encourages your body to produce a new layer of skin.
There are different types of chemical peels. You can buy milder ones over the counter. These can improve your skin’s appearance if you have fine lines. For deeper chemical peels, you need to see an experienced clinician or doctor in a clinic or hospital.
You shouldn’t use a chemical peel if you have a skin infection or skin condition such as psoriasis . With medium and deep chemical peels, there can be a risk of scarring or changes in skin colour (pigmentation).
For fine lines and wrinkles, you can use the milder over-the-counter chemical peels more than once. You can do a peel every month for a few months and the effects can last from six months to a year.
Medium and deep chemical peels are usually only done once. The deeper the peel the more effect it has. But there’s a higher chance of side-effects such as a change in skin pigmentation.
Dermabrasion and microdermabrasion
Dermabrasion means removing the top layers of your skin using a hand-held mechanical instrument. This smooths the skin surface and over the following week or so, new skin cells grow and the skin heals. It’s most often used for lines around your mouth. You may have a local anaesthetic for this procedure. Or your doctor may use a painkilling injection called a nerve block.
Dermabrasion can sometimes cause changes in skin colour, scarring or infection. As with peels, the greater the depth of treatment, the greater the effect, but also the higher the chance of side-effects. If you have deep wrinkles, you can have the procedure repeated after six to 12 months.
Microdermabrasion uses small crystals or other rough and grainy substances. The doctor blows these onto your skin, where they affect the structure of the surface layer. This leaves your skin looking and feeling smoother and can help a little with sun damage. You don’t need an anaesthetic to have microdermabrasion.
Laser resurfacing
Laser resurfacing can treat fine-to-moderate lines and wrinkles. It can also help with small scars, such as those that develop after chickenpox or acne.
A laser is a beam of high-energy light. A plastic surgeon can use this to remove the outer layers of facial skin. This damages the skin and as it heals, new skin forms that’s tighter and firmer. Doctors most often use lasers to treat wrinkles around the eyes and mouth.
Side-effects include pain and swelling, itching and tightness. Your doctor may cover the area with a dressing or leave it open and give you creams to keep the area moist.
There are different types of laser treatment. As with other wrinkle treatments, the more intense the treatment, the greater the effect. But more intense treatments also take longer to heal and have a greater risk of side-effects. Long-term complications are not common but can include skin colour changes and scarring.
Botulinum toxin injections
Botulinum toxin is produced by a type of bacteria. It’s often called ‘Botox’, but this is actually the trade name of one particular type of botulinum toxin.
When a clinician or doctor injects the toxin into your skin, it temporarily reduces the power of the muscles in your face. This makes your wrinkles less obvious if they usually look worse when you frown or smile. But it won’t help with wrinkles that are there when you aren’t smiling or frowning. It’s used mostly to treat lines in the forehead and crow’s feet.
It may take one to three days for the injection to work and the best results will be after a week or two. The treatment should last for three to four months. You’ll need to have the injections repeated if you want to keep the effects. But if you have it done too often, you can become resistant to the treatment.
The injections sometimes cause muscle weakness or bruising. These side-effects are usually temporary and will gradually wear off.
You shouldn’t have botulinum toxin injections if you’re pregnant or breastfeeding or have a neurological disorder such as MS or myasthenia gravis.
Dermal filler injections
Dermal fillers plump up your skin to make it appear fuller and smoother. You have them as an injection, using a fine needle.
There are lots of dermal fillers that work in different ways. Depending of the type, they can reduce the look of all kinds of wrinkles, from deep wrinkles to fine lines.
The effects can be temporary or permanent. Temporary fillers usually last from three months to two years, depending on the type of filler and the area you have treated. You need to have repeat treatments if you want the effects to last longer.
Cosmetic surgery
Cosmetic surgery can reduce deep wrinkles and sagging skin. There are two types: fat grafting and rhytidectomy (commonly called facelift). For best results, you may have either or both of these and also any of the treatments above.
Fat grafting can fill out your cheeks and the lines from your nose to the corners of your mouth. The surgeon takes the fat from your thighs or stomach area using liposuction. This treatment works better for patients under 40 than for those over 60.
A facelift aims to smooth your face by tightening and lifting the skin. A facelift is really surgery to lift the skin below your eyes. Lifting the skin above your eyes is a browlift. You can also have the skin on your neck lifted and tightened.
A facelift can make you look younger but it may be six to nine months before you can fully judge how well it’s worked. The effects may last for up to 15 years. Best results are usually in people who have good skin elasticity and a strong bone structure.
As with any surgery, a facelift has some risks. Side-effects and complications include scarring, bruising, hair loss and nerve damage. Always talk to your surgeon about risks and benefits before you commit to any operation.
Deciding on treatment for wrinkles
You can buy some wrinkle treatments over the counter, such as antioxidant creams and mild chemical peels. For most other treatments, you’ll need to see a practitioner or doctor. These treatments aren’t available on the NHS, so you’ll need to see a doctor privately.
It’s important to see a specialist practitioner who is suitably qualified. Wrinkle treatments are available in many different places, from beauty therapists to plastic surgery clinics. Some treatments, such as Botox and fillers aren’t currently regulated. Do ask about the qualifications, training and experience of whoever will be carrying out your treatment. A good practitioner or doctor will be happy to share these with you.
While lots of people are satisfied with the result of their procedure, there’s always a risk that it might not meet your expectations. Don’t rush into a decision until you’ve checked all the facts. Whatever treatment or procedure you’re considering having, make sure you know the pros and cons and how well it’s likely to work.
Prevention of wrinkles
Wrinkles are part of the natural ageing process. You can’t really avoid them, but there are things you can do to try and minimise them.
Protect your skin from the sun
Wrinkles usually develop on your face, neck or the back of your hands. These areas are the most exposed to the sun. Ultraviolet radiation from sunlight damages the DNA in your skin cells. This causes your skin to age and become less elastic.
You can protect your skin from sun damage by:
- seeking shade when possible, particularly between 11am and 3pm when the sun is strongest
- not using tanning beds or sun lamps
- wearing a sunscreen with UVA and UVB protection – at least factor 30 and preferably factor 50 – especially on face and hands
- wearing a wide-brimmed hat to shade your face
- wearing sunglasses to help prevent crow’s feet
Stop smoking
Smokers develop wrinkles earlier than non-smokers, as smoking speeds up the ageing process. Second-hand smoke, from sharing a house with a smoker, can also make wrinkles more likely.
If you smoke and you want to reduce or delay the onset of wrinkles, the best thing to do is to stop smoking. Of course, that’s good for your general health as well as your skin.
Ask your pharmacist, practice nurse or GP for advice and support. There’s also lots of NHS information online about stopping smoking.
Eating a healthy balanced diet, staying active and using skin creams with antioxidants may also help minimise skin damage over time.
There are many muscles in the forehead, cheeks, chin and around the eyes and lips. These create smiles and frowns and help to give your face tone and plumpness. So, it seems reasonable that exercising them could help to reduce wrinkles. But research evidence isn’t clear. Some studies show that facial exercises can improve wrinkles, others don’t.
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