Wrinkle treatments

Expert reviewer, Mr Anthony Attwood, Consultant Plastic Surgeon
Next review due August 2020

Whether it’s laughter lines, frown lines or crow’s feet – getting wrinkles (the folds or creases in your skin) is quite normal. Wrinkles aren’t harmful and many people just accept them as a natural sign of ageing. However, you may decide you don’t like the way they look, and so be considering ways to reduce them.

There are lots of different treatments which aim to reduce the appearance of wrinkles, and make your skin look smoother and more youthful. Here we cover the most common ones and highlight things to think about if you’re considering having treatment.

Wrinkle treatments are available privately, not on the NHS. For each treatment, ask the practitioner or doctor who is offering it how well it might work for you. There is more scientific proof for some treatments than others. They’ll also be able to discuss with you the possible risks of each treatment.

Middle-aged woman drinking tea

Skin creams and gels

There are many creams that claim to reduce the appearance of fine lines but they can’t actually remove wrinkles.

Creams and gels that contain retinoids (a form of vitamin A) can improve fine lines and some milder signs of ageing skin. They do this by tightening your skin so fine lines are less visible.

You’ll need a prescription from a doctor for creams containing retinoids. And be aware that they have side-effects. The creams can irritate your skin and make it more prone to burning in the sun, for example. Always carefully 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 use various chemicals to remove the damaged outer layers of your skin, and may help reduce lines and fine wrinkles. Chemical peels range from mild chemical peels that you can buy over the counter, to deeper chemical peels.

Over-the-counter peels can be used to improve your skin’s appearance if you have fine lines. You’ll need an experienced clinician or doctor to do a deeper chemical peel for you in a clinic or hospital. There’s a chance with deep chemical peels that you may get some scarring or changes in the colour of your skin. The deeper the peel, the more effect it has. But also remember, the deeper the peel the greater the risks and the longer time needed for recovery and before sun exposure again.

Dermabrasion and microdermabrasion

Dermabrasion may be used mostly for lines around your mouth. It’s a treatment which involves scraping or ‘sanding down’ the surface of your skin with a hand-held mechanical instrument. You’ll be given a local anaesthetic for this procedure, or your practitioner will use a painkilling injection called a nerve block. When the surface layer is removed the skin then heals, leaving it smoother and firmer than before. Dermabrasion may occasionally cause changes in the colour of your skin, and scarring. As with peels, the greater the depth of treatment, the greater the effect and the longer time required for recovery.

If your wrinkles are deep, you may choose to have the procedure repeated after six to 12 months.

In microdermabrasion, your practitioner blows crystals or other abrasive substances onto your face. These affect the structure of the very surface layer of your skin, leaving it feeling smoother.

Laser facial resurfacing

Laser facial resurfacing aims to reduce mild scars, or lines and fine wrinkles caused by sun damage and general ageing.

A laser (a beam of high-energy light) is used to remove the outer layers of the skin on your face. It also stimulates the growth of new collagen fibres. As the area heals, new skin forms that’s tighter and firmer. The more intense the laser treatment then the greater the effect, but also the greater the time for healing and the risks involved.

If you want to know more about laser procedures for reducing wrinkles see our topic on laser resurfacing.

Botulinum toxin injections

Botulinum toxin injections may reduce some types of wrinkles. This is commonly called ‘Botox’ but this is actually the trade name of just one type of botulinum toxin.

Botulinum toxin injections are often used to treat forehead and frown lines that come from making facial expressions. They can also reduce lines at the corners of your eyes (crow’s feet). Botulinum toxin can only reduce what are called active wrinkles which are caused by muscle activity. It won’t work for wrinkles, creases or lines that don’t change with your facial expressions.

If you have botulinum toxin treatment, your clinician or doctor will inject it into specific muscles in your face. It will relax or paralyse these muscles to reduce their effect on lines and wrinkles. It may take one to three days for the treatment to take effect and the best results will be after around a week or two. The treatment should last for three to six months. You’ll need to have botulinum toxin injections repeated if you want to keep the effects.

Problems that may occasionally happen with botulinum toxin injections include some partial facial weakness. This is because of excessive paralysis of the injected muscles, or those nearby. This is temporary. Botulinum toxin injections aren’t suitable if you’re pregnant or breastfeeding or have a neurological disorder, such as myasthenia gravis.

Dermal filler injections

Dermal fillers aim to plump up your skin and make it appear fuller and smoother. Dermal fillers are often used to reduce lines around your nose and your lips, and to enhance the shape of your lips. There is a range of dermal fillers available that work in different ways, and they can be temporary or permanent.

Permanent fillers, such as silicone, were used in the past but are no longer recommended for use on the face. Your clinician will usually recommend using a non-permanent dermal filler. These are either synthetic, or made from a material that closely resembles a naturally occurring substance in your body. Your clinician will inject the dermal filler into the required area with a tiny needle.

The effects from dermal filler treatment usually last from three to 18 months, depending on the type of filler and the area you have treated. You’ll need to have repeat treatments if you want the effects to last longer.

Cosmetic surgery

Cosmetic surgery can help reduce deep wrinkles and sagging skin. In facelift surgery, your surgeon will lift up the skin and soft tissues of your face. This will make your face tighter and smoother. The operation can be done on your whole face (a full facelift) or on your brow area (brow lift), lower face and neck.

Your face will continue to age after you have a facelift. The best results are achieved in people who have skin with good levels of elasticity and have a strong bone structure. 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. Surgery is the most aggressive treatment and usually has the greatest effect, but it also has a greater recovery time and risks.

For more information, see our topic on facelift surgery.

Deciding on treatment for wrinkles

Don’t rush into a decision until you’ve gathered all the facts. Have a look at our section ‘other helpful websites’ below for some organisations which have lots of useful information.

It’s really important that you see a specialist practitioner who is suitably qualified. Many different places, from clinics to beauty therapists, offer wrinkle treatments and some treatments aren’t regulated. Don’t be afraid to 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. And don’t forget that treatments have health risks and complications. Talk these through with a qualified practitioner.

Before you decide to have treatment, think carefully about what you’re hoping to gain from the treatment and the result you can realistically expect. It’s important to understand that some of these treatments are designed for specific things only.

  • Botulinum toxin injections will only improve wrinkles caused by muscle activity.
  • Dermal fillers can be used for fine lines and deeper wrinkles but can’t correct sagging skin.
  • Laser facial resurfacing can cause changes in your skin pigment (colour), so the treatment may not be suitable if you have darker skin.
  • Cosmetic surgery isn’t recommended for mild lines. It’s only a suitable option if you want to remove sagging skin, extra fat and deep wrinkles.

It’s important to remember the following.

  • Smoking can reduce the effectiveness of your treatment.
  • Botulinum toxin injections are only available with a doctor’s prescription.
  • Clinics that offer laser facial resurfacing must be registered with the Care Quality Commission. Always ask for proof of registration before you have any treatment.

We have some information and guidance on choosing a cosmetic surgeon in the FAQs of our factsheets on facelift surgery and breast enlargement.

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 help prevent them.

Protect your skin from the sun

Wrinkles usually appear in areas that are most exposed to the sun, such as your face, neck or the back of your hands. This is because UV radiation from the sun damages the DNA in your skin cells, which causes your skin to age and become less elastic.

Some sunlight is important because your skin uses it to produce vitamin D, which helps to build and maintain strong bones. However, too much sun is harmful. If you’re going to be out in the sun for long periods of time, cover up your skin, use sunscreen and seek shady areas. Wear a wide-brimmed hat and sunglasses. Avoid sun beds as these can harm your skin too.

Stop smoking

Smoking dries your skin out and narrows your blood vessels. This reduces the supply of oxygen and vital nutrients to your skin and can cause changes to how firm your skin is. So people who smoke are more likely to have facial wrinkles at a younger age. Puckering up your lips when you smoke also causes lines to form around your mouth.

If you smoke, try to give up. This will be good for your general health, as well as good for your skin. Ask your pharmacist, practice nurse or GP for advice and support, and there’s also lots of information online from the NHS about stopping smoking.

Choose a healthy lifestyle

There are a number of changes you can make to your lifestyle to help your skin stay youthful. The good news is that these help keep you generally healthier too.

  • Eat a healthy, well-balanced diet. Your skin needs a good supply of vitamins and minerals to stay healthy.
  • Drink plenty of water to keep your skin hydrated. It may help to use a daily moisturiser.
  • If you drink alcohol, keep to the guidelines (see our topic on sensible drinking). Alcohol can dehydrate your skin, leading to wrinkles.
  • Keep active. Simple activities, such as walking, improve circulation and help deliver more oxygen to your skin.

Frequently asked questions

  • Stress can cause psychological and physical symptoms such as poor sleep, irritability and feeling anxious. Research suggests that long-term stress can also make people look older, although it’s by no means clear why or how. If you find that you’re turning to alcohol or smoking to ease your stress, then these may be causing your skin to age faster. See our section on preventing wrinkles above.

    Extreme or prolonged stress can harm your health. For some advice around what you can do to treat stress have a look at the treatment section in our stress topic.

  • Your face is made up of a complex arrangement of muscles in your forehead, cheeks, around your eyes, in your chin and around your lips. These muscles let you create facial expressions. Like other muscles in your body, they slacken with age and your face can start to sag.

    Facial exercises may help tone the muscles in your face so it’s possible they may delay the appearance of fine lines and wrinkles. However, there isn’t any strong evidence to prove this.

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Related information

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    • Chemical peels. Medscape., updated 26 July 2017
    • Skin resurfacing – laser surgery. Medscape., updated 30 October 2015
    • Carbon dioxide laser skin resurfacing. Medscape., updated 17 March 2016
    • Dermabrasion. Medscape., updated 8 September 2016
    • Dermatologic use of botulinum toxin. Medscape., updated 8 January 2016
    • Dermal fillers. Medscape., updated 17 April 2017
    • Facial anatomy in cutaneous surgery. Medscape., updated 21 July 2015
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    • Personal communication, Mr Anthony Attwood, Consultant Plastic Surgeon, August 2017
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, August 2017
    Expert reviewer, Mr Anthony Attwood, Consultant Plastic Surgeon
    Next review due August 2020