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Wrinkle treatments


Expert reviewers, Jo Skillman, Consultant Plastic, Reconstructive and Aesthetic Surgeon and Dr Adrian Raby, General Practitioner
Next review due October 2023

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 aging. Wrinkles aren’t harmful and many people accept them as part of growing older. However, not everyone feels that way and many people explore treatment to help their skin look more youthful.

Middle-aged woman drinking tea

About wrinkles

Everyone gets wrinkles as they get older. They vary in how they look – you may have fine creases or deeper lines. Wrinkles usually develop in places where your skin is exposed to the sun. Your face, neck and the back of your hands are the places where you’re likely to see wrinkles. This is because these are the areas that see the sun again and again.

How your skin ages depend on your genetics and your skin type. But it’s also affected by whether or not 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. Examples include skin creams, chemical peels, dermabrasion and microdermabrasion, laser resurfacing, derma filler injections and botulinum toxin. Here, we cover the most common ones and highlight things to think about if you’re considering having treatment.

Skin creams and gels

There are many creams that claim to reduce the appearance of fine lines. But not all of them work and if a claim sounds too good to be true, it probably is.

Creams and gels that contain retinoids (a form of vitamin A) 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.

Taking or using an antioxidant alongside these creams is sometimes recommended. Antioxidants include green tea, vitamins C and E, and coenzyme Q10; you can use antioxidants as a cream or lotion, or take them as a tablet. 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. 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, helping to reduce lines and fine wrinkles. They use various chemicals to remove the damaged outer layers of your skin, after which your body produces a new layer of skin. Chemical peels range from mild chemical peels that you can buy over the counter, to deeper chemical peels.

You can use an over-the-counter peel 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.

You shouldn’t use a chemical peel if you have a skin infection or skin condition such as psoriasis or eczema. There’s also a chance with medium and deep chemical peels that you may get some scarring or changes in the colour (pigmentation) of your skin.

You can use over-the-counter chemical peels for fine lines and wrinkles more than once. You can do a peel every month for a few months and the effects can last for up to a year. Medium and deep chemical peels are usually only done once. The deeper the peel the more effect it has – which also means there’s a higher chance of side-effects such as a change in skin pigmentation.

Dermabrasion and microdermabrasion

Dermabrasion is where the top layers of your skin are removed using a hand-held mechanical instrument. This smooths the surface of your skin and over the next week or so new skin cells grow and the skin heals. It’s mostly used for lines around your mouth. You may be given a local anaesthetic for this procedure or your practitioner may use a painkilling injection called a nerve block.

Dermabrasion can sometimes cause changes in the colour of your skin, and scarring and infection. As with peels, the greater the depth of treatment, the greater the effect but the higher the chance of side-effects such as scarring. 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 which are blown onto your skin. These affect the structure of the surface layer of your skin, leaving it looking and feeling smoother. Microdermabrasion can be done without the need for an anaesthetic.

Laser resurfacing

Laser resurfacing can be used to treat fine to moderate lines and wrinkles and small scars, such as those that develop after chickenpox or acne.

A laser (a beam of high-energy light) is used to remove the outer layers of the skin on your face. This damages the skin and as it heals, new skin forms that’s tighter and firmer. It’s often used to treat wrinkles around the eyes and mouth.

The more intense the laser treatment, the greater the effect but the longer the time for healing and the greater the risks involved. Side-effects can include swelling and itching as well as redness and skin colour changes which can take months to improve.

Botulinum toxin injections

Botulinum toxin is a toxin produced by a type of bacteria. A clinician or doctor injects it into your skin and it temporarily reduces the power of the muscles in your face. This will make your wrinkles less obvious if they usually look worse when you frown or smile. However, if you have wrinkles even when you are not smiling or frowning, botulinum toxin won’t be as effective. Although this toxin is often called ‘Botox’, this term is actually the trade name of one particular type of botulinum toxin.

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 six months. You’ll need to have the injections repeated if you want to keep the effects.

The injections can sometimes cause side-effects such as muscle weakness, bruising and pain. This is 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.

Dermal filler injections

Dermal fillers aim to plump up your skin and make it appear fuller and smoother. They’re put in as an injection using a fine needle. Depending of the type of filler used, dermal fillers can reduce the look of all kinds of wrinkles, from deep wrinkles to fine lines. There are lots of dermal fillers available that work in different ways, and they can be temporary or permanent.

The effects usually last from three months to two years, 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. It means having an operation to tighten and lift your skin. This will make the skin on your face smoother. An operation to lift the skin below your eyes is called a facelift to lift the skin above your eye, it is called 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. The best results are usually in people who have skin with good levels of elasticity and have a strong bone structure.

As with any kind of operation, cosmetic surgery can have risks as well as benefits. Side-effects and complications can include scarring, bruising, hair loss and nerve damage. Always talk to your surgeon about the risks and benefits before you commit to any operation.

Deciding on treatment for wrinkles

Wrinkle treatments aren’t available on the NHS but you can get them privately. You can buy some wrinkle treatments over the counter; examples include antioxidant creams and mild chemical peels. For most other treatments, you’ll need to see a practitioner or doctor.

It’s important to 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.

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 the treatment is likely to work.

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 remember that most treatments have health risks and complications as well as benefits. Talk these through with a qualified practitioner.

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 appear on your face, neck or the back of your hands. These areas are the most exposed to the sun and the UV radiation in 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:

  • not spending too much time in the sun – stay out of the sun if you can between 11am and 3pm and seek shade when possible
  • not using tanning beds or sun lamps
  • putting on a high factor sunscreen (SPF 30), especially on your face and hands
  • wearing a wide-brimmed hat to shade your face
  • wearing sunglasses to help prevent crow’s feet

Stop smoking

Smoking speeds up the ageing process and causes wrinkles to develop earlier than they do in a non-smoker. Being exposed to second-hand smoke, as when you share 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 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, and there’s lots of information online from the NHS about stopping smoking.

Eating a healthy balanced diet, staying active and using skin creams with antioxidants may also help reduce skin damage over time.

Frequently asked questions

  • 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 create facial expressions such as a smile or a frown and help to give your face tone and plumpness. So, it would seem to be common sense that exercising them could help to reduce wrinkles. But the evidence from research isn’t very clear. Some studies have shown an improvement in wrinkles following facial exercises, whereas others have not.



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Related information

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    • Bowker LK, Price JD, Shah KS, et al. Skin. Oxford Handbook of Geriatric Medicine (3rd edn). oxfordmedicine.com, published online 2018
    • How to select anti-aging products. American Academy of Dermatology Association. www.aad.org, accessed December 2019
    • Tretinoin. British National Formulary. bnf.nice.org.uk, last updated November 2019
    • Isotretinoin. British National Formulary. bnf.nice.org.uk, last updated November 2019
    • Chemical peels. Medscape. emedicine.medscape.com, updated July 2017
    • Dermabrasion. Medscape. emedicine.medscape.com, updated May 2018
    • Microdermabrasion. Medscape emedicine.medscape.com, updated March 2018
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    • Dermatologic use of botulinum toxin. Medscape. emedicine.medscape.com, update February 2019
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    • Facelift and necklift. British Association of Aesthetic Plastic Surgeons. baaps.org.uk, accessed December 2019
    • Think over before you makeover. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed December 2019
    • Ways to enjoy the sun safely. Cancer Research UK. www.cancerresearchuk.org, last reviewed April 2019
    • Sunscreen. British Association of Dermatologists. www.bad.org, accessed 9 October 2020
    • Facial Anatomy in Cutaneous Surgery. Medscape. emedicine.medscape.com, updated July 2015
    • Hwang UJ, Kwon OY, Jung SH, et al. Effect of a facial muscle exercise device on facial rejuvenation. Aesthet Surg J. 2018; 38(5):463–76. doi:10.1093/asj/sjx238
  • Reviewed by Sarah Smith, Freelance Health Editor and Natalie Heaton, Specialist Health Editor, Bupa Health Content Team, October 2020
    Expert reviewers, Jo Skillman, Consultant Plastic, Reconstructive and Aesthetic Surgeon and Dr Adrian Raby, General Practitioner
    Next review due October 2023

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