Wrinkle

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Wrinkles on the face and hands are a typical sign of aging Old Bangladeshi drinking tea cropped.jpg
Wrinkles on the face and hands are a typical sign of aging

A wrinkle, also known as a rhytid, is a fold, ridge or crease in an otherwise smooth surface, such as on skin or fabric. Skin wrinkles typically appear as a result of ageing processes such as glycation, [1] habitual sleeping positions, [2] loss of body mass, sun damage, [3] or temporarily, as the result of prolonged immersion in water. Age wrinkling in the skin is promoted by habitual facial expressions, aging, sun damage, smoking, poor hydration, and various other factors. [4] In humans, it can also be prevented to some degree by avoiding excessive solar exposure and through diet (in particular through consumption of carotenoids, tocopherols and flavonoids, vitamins (A, C, D and E), essential omega-3-fatty acids, certain proteins and lactobacilli). [5]

Contents

Skin

Causes for aging wrinkles

A woman of European origin with facial wrinkles Nose - Caisa.jpg
A woman of European origin with facial wrinkles

Development of facial wrinkles is a kind of fibrosis of the skin. Misrepair-accumulation aging theory suggests that wrinkles develop from incorrect repairs of injured elastic fibers and collagen fibers. [6] [7] [8] Repeated extensions and compressions of the skin cause repeated injuries of extracellular fibers in derma. During the repairing process, some of the broken elastic fibers and collagen fibers are not regenerated and restored but replaced by altered fibers. When an elastic fiber is broken in an extended state, it may be replaced by a "long" collagen fiber. Accumulation of "long" collagen fibers makes part of the skin looser and stiffer, and as a consequence, a big fold of skin appears. When a "long" collagen is broken in a compressed state, it may be replaced by a "short" collagen fiber. The "shorter" collagen fibers will restrict the extension of "longer" fibers, and make the “long" fibers in a folding state permanently. A small fold, namely a permanent wrinkle, then appears.

Sleep wrinkles

Sleep wrinkles are created and reinforced when the face is compressed against a pillow or bed surface in side or stomach sleeping positions during sleep. [9] They appear in predictable locations due to the underlying superficial musculoaponeurotic system (SMAS), and are usually distinct from wrinkles of facial expression. [10] As with wrinkles of facial expression, sleep wrinkles can deepen and become permanent over time, unless the habitual sleeping positions which cause the wrinkles are altered. [11]

Water-immersion wrinkling

A wrinkled finger after a warm bath Wrinkly fingers.jpg
A wrinkled finger after a warm bath

The wrinkles that occur in skin over prolonged exposure to water are sometimes referred to as pruney fingers or water aging. This is a temporary skin condition where the skin on the palms of the hand or feet becomes wrinkly. This wrinkling response may have imparted an evolutionary benefit by providing improved traction in wet conditions, [12] and a better grasp of wet objects. [13] These results were called into question by a 2014 study that failed to reproduce any improvement of handling wet objects with wrinkled fingertips. [14] However, a 2020 study of gripping efficiency found that wrinkles decreased the force required to grip wet objects by 20%, supporting the traction hypothesis. [15]

Prior to a 1935 study, the common explanation was based on water absorption in the keratin-laden epithelial skin when immersed in water, [16] causing the skin to expand and resulting in a larger surface area, forcing it to wrinkle. Usually the tips of the fingers and toes are the first to wrinkle because of a thicker layer of keratin and an absence of hairs which secrete the protective oil called sebum.

Adult sole showing water immersion wrinkling Adult sole showing water immersion wrinkling.JPG
Adult sole showing water immersion wrinkling

In the 1935 study, however, Lewis and Pickering were studying patients with palsy of the median nerve when they discovered that skin wrinkling did not occur in the areas of the patients' skin normally innervated by the damaged nerve. This suggested that the nervous system plays an essential role in wrinkling, so the phenomenon could not be entirely explained simply by water absorption. Recent research shows that wrinkling is related to vasoconstriction. [17] [18] Water probably initiates the wrinkling process by altering the balance of electrolytes in the skin as it diffuses into the hands and soles via their many sweat ducts. This could alter the stability of the membranes of the many neurons that synapse on the many blood vessels underneath skin, causing them to fire more rapidly. Increased neuronal firing causes blood vessels to constrict, decreasing the amount of fluid underneath the skin. This decrease in fluid would cause a decrease in tension, causing the skin to become wrinkly. [19]

This insight resulted in bedside tests for nerve damage and vasoconstriction. Wrinkling is often scored with immersion of the hands for 30 minutes in water or EMLA cream with measurements steps of 5 minutes, and counting the number of visible wrinkles in time. Not all healthy persons have finger wrinkling after immersion, so it would be safe to say that sympathetic function is preserved if finger wrinkling after immersion in water is observed, but if the fingers emerge smooth it cannot be assumed that there is a lesion to the autonomic supply or to the peripheral nerves of the hand. [20]

Other animals with wrinkles

Examples of wrinkles can be found in various animal species that grow loose, excess skin, particularly when they are young. Several breeds of dog, such as the Pug and the Shar Pei, have been bred to exaggerate this trait. In dogs bred for fighting, this is the result of selection for loose skin, which confers a protective advantage. [21]

Techniques for reducing the appearance of aging wrinkles

A man receiving a botox injection Dr Braun Performs a Botox Injection (4035273577).jpg
A man receiving a botox injection

Current evidence suggests that tretinoin decreases cohesiveness of follicular epithelial cells, although the exact mode of action is unknown. Additionally, tretinoin stimulates mitotic activity and increased turnover of follicular epithelial cells. [22] Tretinoin is better known by the brand name Retin-A.

Topical glycosaminoglycans supplements can help to provide temporary restoration of enzyme balance to slow or prevent matrix breakdown and consequent onset of wrinkle formation. Glycosaminoglycans (GAGs) are produced by the body to maintain structural integrity in tissues and to maintain fluid balance. Hyaluronic acid is a type of GAG that promotes collagen synthesis, repair, and hydration. GAGs serve as a natural moisturizer and lubricant between epidermal cells to inhibit the production of matrix metalloproteinases (MMPs).

Dermal fillers are injectable products frequently used to correct wrinkles, and other depressions in the skin. They are often a kind of soft tissue designed to enable injection into the skin for purposes of improving the appearance. The most common products are based on hyaluronic acid and calcium hydroxylapatite.

Botulinum toxin is a neurotoxin protein produced by the bacterium Clostridium botulinum . Botox is a specific form of botulinum toxin manufactured by Allergan for both therapeutic and cosmetic use. Besides its cosmetic application, Botox is used in the treatment of other conditions including migraine headache and cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving the head and neck). [23]

Dysport, manufactured by Ipsen, received FDA approval and is now used to treat cervical dystonia as well as glabellar lines in adults. In 2010, another form of botulinum toxin, one free of complexing proteins, became available to Americans. Xeomin received FDA approval for medical indications in 2010 and cosmetic indications in 2011.

Botulinum toxin treats wrinkles by immobilizing the muscles which cause wrinkles. It is not appropriate for the treatment of all wrinkles; it is indicated for the treatment of glabellar lines (between the eyebrows) in adults. Any other usage is not approved by the FDA and is considered off-label use.

Laser resurfacing is FDA-cleared skin resurfacing procedure in which lasers are used to improve the condition of the skin.[ citation needed ] Two types of lasers are used to reduce the appearance of fine lines and wrinkles on the face; laser ablation, which removes thin layers of skin, and nonablative lasers that stimulate collagen production. Nonablative lasers are less effective than ablative ones but they are less invasive and recovery time is short. After the procedure people experience temporary redness, itching and swelling.

See also

Related Research Articles

<span class="mw-page-title-main">Botulinum toxin</span> Neurotoxic protein produced by Clostridium botulinum

Botulinum toxin, or botulinum neurotoxin, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin causes the disease botulism. The toxin is also used commercially for medical and cosmetic purposes. Botulinum toxin is an acetylcholine release inhibitor and a neuromuscular blocking agent.

<span class="mw-page-title-main">Scar</span> Area of fibrous tissue that replaces normal skin after an injury

A scar is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in some degree of scarring. An exception to this are animals with complete regeneration, which regrow tissue without scar formation.

Intense pulsed light (IPL) is a technology used by cosmetic and medical practitioners to perform various skin treatments for aesthetic and therapeutic purposes, including hair removal, photorejuvenation as well as to alleviate dermatologic diseases such as acne. IPL is increasingly used in optometry and ophthalmology as well, to treat evaporative dry eye disease due to meibomian gland dysfunction.

Writer's cramp or focal hand dystonia (FHD) is an idiopathic movement disorder of adult onset, characterized by abnormal posturing and movement of the hand and/or forearm during tasks requiring skilled hand use, such as writing. Overcontraction of affected muscles, cocontraction of agonist and antagonist pairs, and activation of muscles inappropriate to a task all impair use of the affected hand.

<span class="mw-page-title-main">Hyperhidrosis</span> Excessive sweating

Hyperhidrosis is a medical condition in which a person exhibits excessive sweating, more than is required for the regulation of body temperature. Although it is primarily a physical burden, hyperhidrosis can deteriorate the quality of life of the people who are affected from a psychological, emotional, and social perspective. In fact, hyperhidrosis almost always leads to psychological as well as physical and social consequences. People suffering from it present difficulties in professional fields, more than 80% experiencing a moderate to severe emotional impact from the disease and half are subject to depression.

<span class="mw-page-title-main">Stretch marks</span> Form of scarring

Stretch marks, also known as striae or striae distensae, are a form of scarring on the skin with an off-color hue. Over time, they may diminish, but will not disappear completely. Striae are caused by tearing of the dermis during periods of rapid growth of the body, such as during puberty or pregnancy, in which they usually form during the last trimester. Usually on the belly, these striae also commonly occur on the breasts, thighs, hips, lower back, and buttocks. Pregnancy-related striae are known as striae gravidarum. Striae may also be influenced by the hormonal changes associated with puberty, pregnancy, bodybuilding, or hormone replacement therapy. There is no evidence that creams used during pregnancy prevent stretch marks. Once they have formed, there is no clearly effective treatment, though various methods have been attempted and studied.

<span class="mw-page-title-main">Procerus muscle</span> Small pyramidal slip of muscle deep to the superior orbital nerve, artery and vein

The procerus muscle is a small pyramidal slip of muscle deep to the superior orbital nerve, artery and vein. Procerus is Latin, meaning tall or extended.

<span class="mw-page-title-main">Mentalis</span> Muscle that raises the central portion of the lower lip

The mentalis muscle is a paired central muscle of the lower lip, situated at the tip of the chin. It originates from the mentum of the mandible, and inserts into the soft tissue of the chin. It is sometimes referred to as the "pouting muscle" due to it raising the lower lip and causing chin wrinkles.

Facial rejuvenation is a cosmetic treatment, which aims to restore a youthful appearance to the human face. Facial rejuvenation can be achieved through either surgical and/or non-surgical options. Procedures can vary in invasiveness and depth of treatment. Surgical procedures can restore facial symmetry through targeted procedures and facial restructuring and skin alterations. Non-surgical procedures can target specific depths of facial structures and treat localized facial concerns such as wrinkles, skin laxity, hyperpigmentation and scars.

<span class="mw-page-title-main">Spasmodic torticollis</span> Medical condition

Spasmodic torticollis is an extremely painful chronic neurological movement disorder causing the neck to involuntarily turn to the left, right, upwards, and/or downwards. The condition is also referred to as "cervical dystonia". Both agonist and antagonist muscles contract simultaneously during dystonic movement. Causes of the disorder are predominantly idiopathic. A small number of patients develop the disorder as a result of another disorder or disease. Most patients first experience symptoms midlife. The most common treatment for spasmodic torticollis is the use of botulinum toxin type A.

<span class="mw-page-title-main">Liver spot</span> Age-related skin blemish

Liver spots are blemishes on the skin associated with aging and exposure to ultraviolet radiation from the sun. They range in color from light brown to red or black and are located in areas most often exposed to the sun, particularly the hands, face, shoulders, arms and forehead, and the scalp if bald.

<span class="mw-page-title-main">Skin care</span> Range of practices that support skin integrity

Skin care or skincare is a range of practices that support skin integrity, enhance its appearance, and relieve skin conditions. They can include nutrition, avoidance of excessive sun exposure, and appropriate use of emollients. Practices that enhance appearance include the use of cosmetics, botulinum, exfoliation, fillers, laser resurfacing, microdermabrasion, peels, retinol therapy, and ultrasonic skin treatment. Skin care is a routine daily procedure in many settings, such as skin that is either too dry or too moist, and prevention of dermatitis and prevention of skin injuries.

Artefill is a permanent injectable wrinkle filler, for the correction of smile lines. Artefill was approved by the U.S. Food and Drug Administration (FDA) as a medical device in October 2006. A prior version of the product called Artecoll has been marketed in Canada and Europe since the 1990s.

<span class="mw-page-title-main">Acetyl hexapeptide-3</span> Chemical compound

Acetyl hexapeptide-8 or acetyl hexapeptide-8 amide is a synthetic anti-wrinkle cosmetics ingredient. It is a peptide which is a fragment of SNAP-25, a substrate of botulinum toxin (Botox). Acetyl hexapeptide-8 is marketed as Argireline® peptide by Lubrizol.

Kyrle disease is identified as a form of an acquired perforating disease. Other major perforating diseases are elastosis perforans serpiginosa and reactive perforating collagenosis. Recently, however, there is a controversy on categorizing Kyrle disease with perforating dermatosis or a subtype of acquired perforating collagenosis.

<span class="mw-page-title-main">Photoaging</span> Ultraviolet light-induced biological development over time

Photoaging or photoageing is a term used for the characteristic changes to skin induced by chronic UVA and UVB exposure. Tretinoin is the best studied retinoid in the treatment of photoaging.

Aesthetic medicine is a branch of modern medicine that focuses on altering natural or acquired unwanted appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, spider veins and or any unwanted externally visible appearance. Traditionally, it includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery, surgical procedures, non-surgical procedures, and a combination of both. Aesthetic medicine procedures are usually elective. There is a long history of aesthetic medicine procedures, dating back to many notable cases in the 19th century, though techniques have developed much since then.

<span class="mw-page-title-main">Mitchel P. Goldman</span> American dermatologic surgeon (born 1955)

Mitchel P. Goldman, is an American dermatologic surgeon, cosmetic surgeon, dermatologist, and phlebologist, and the founder and director of Cosmetic Laser Dermatology. He is also a past president of the American Society for Dermatologic Surgery, the American College of Phlebology, the San Diego County Dermatology Society, and the Sonoran Dermatology Society.

<span class="mw-page-title-main">Fredric Brandt</span> American physician (1949–2015)

Fredric Sheldon Brandt was an American physician, researcher, lecturer, author, and radio host specializing in cosmetic dermatology. Among the first to use botulinum toxin ("botox") and fillers, Brandt was noted for his role in the FDA approval of numerous fillers and botulinum toxins for cosmetic use in the United States.

<span class="mw-page-title-main">Dermatologic surgical procedure</span> Skin surgery

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References

  1. ↑ Danby, FW (Jul–Aug 2010). "Nutrition and aging skin: sugar and glycation". Clin Dermatol. 4. 28 (4): 409–411. doi:10.1016/j.clindermatol.2010.03.018. PMID   20620757.
  2. ↑ American Academy of Dermatology. "Causes of Aging". AgingSkinNet. American Academy of Dermatology. Retrieved 5 March 2013.
  3. ↑ Cosmetic Procedures for Wrinkles
  4. ↑ Anderson, Laurence. 2006. Looking Good, the Australian guide to skin care, cosmetic medicine and cosmetic surgery. AMPCo. Sydney. ISBN   0-85557-044-X.
  5. ↑ Schagen, S. K.; Zampeli, V. A.; Makrantonaki, E.; Zouboulis, C. C. (2012). "Discovering the link between nutrition and skin aging". Dermato-Endocrinology. 4 (3): 298–307. doi:10.4161/derm.22876. PMC   3583891 . PMID   23467449.
  6. ↑ Wang, Jicun; Michelitsch, Thomas; Wunderlin, Arne; Mahadeva, Ravi (2009). "Aging as a consequence of Misrepair—a novel theory of aging". arXiv: 0904.0575 [q-bio.TO].
  7. ↑ Wang-Michelitsch, Jicun; Michelitsch, Thomas (2015). "Aging as a process of accumulation of Misrepairs". arXiv: 1503.07163 [q-bio.TO].
  8. ↑ Wang-Michelitsch, Jicun; Michelitsch, Thomas (2015). "Tissue fibrosis: a principal evidence for the central role of Misrepairs in aging". arXiv: 1505.01376 [q-bio.TO].
  9. ↑ Sarifakioglu, Nedim; Terzioglu, A.; Ates, L.; Aslan, G. (2004). "A New Phenomenon: 'Sleep Lines' on the Face". Scan J Plast Reconstr Surg Hand Surg. 38 (4): 244–247. doi:10.1080/02844310410027257. PMID   15370809. S2CID   25307487.
  10. ↑ Fulton, James E.; Gaminchi, F. (1999). "Sleep Lines". Dermatol Surg. 25 (1): 59–62. doi:10.1046/j.1524-4725.1999.08073.x. PMID   9935097.
  11. ↑ Sarifakioglu, Nedim; Terzioglu, A.; Ates, L.; Aslan, G. (2004). "A New Phenomenon: 'Sleep Lines' on the Face". Scan J Plast Reconstr Surg Hand Surg. 38 (4): 244–247 [246]. doi:10.1080/02844310410027257. PMID   15370809. S2CID   25307487.
  12. ↑ Mark Changizi; Romann Weber; Ritesh Kotecha; Joseph Palazzo (2011). "Are Wet-Induced Wrinkled Fingers Primate Rain Treads?". Brain, Behavior and Evolution. 77 (4): 286–90. doi: 10.1159/000328223 . PMID   21701145.
  13. ↑ Kareklas, Kyriacos; Nettle, Daniel; Smulders, Tom V (January 9, 2013). "Water-induced finger wrinkles improve handling of wet objects". Biol. Lett. 9 (2): 20120999. doi:10.1098/rsbl.2012.0999. PMC   3639753 . PMID   23302867.
  14. ↑ Haseleu, Julia; Omerbašić, Damir; Frenzel, Henning; Gross, Manfred; Lewin, Gary R. (2014). Goldreich, Daniel (ed.). "Water-Induced Finger Wrinkles Do Not Affect Touch Acuity or Dexterity in Handling Wet Objects". PLOS ONE. 9 (1): e84949. Bibcode:2014PLoSO...984949H. doi: 10.1371/journal.pone.0084949 . PMC   3885627 . PMID   24416318.
  15. ↑ Davis, N. (8 November 2020). "Water-immersion finger-wrinkling improves grip efficiency in handling wet objects". bioRxiv   10.1101/2020.11.07.372631 .
  16. ↑ "Dr Karl's Homework – Skin Wrinkles in Water (26/1/2000)". Abc.net.au. 2000-01-26. Retrieved 2019-04-30.
  17. ↑ Einar P.V. Wilder-Smith; Adeline Chow (2003). "Water-immersion wrinkeling is due to vasoconstriction". Muscle & Nerve. 27 (3): 307–311. doi: 10.1002/mus.10323 . PMID   12635117. S2CID   45193684.
  18. ↑ Einar P. V. Wilder-Smith (2004). "Water immersion wrinkling". Clinical Autonomic Research. 14 (2): 125–131. doi:10.1007/s10286-004-0172-4. PMID   15095056. S2CID   44938772.
  19. ↑ H. Zhai, K.P. Whilem H. L. Maibach (2007). Dermatotoxicology. pp. 280–281.
  20. ↑ G Alvarez, J Eurolo; P Canales (1980). "Finger wrinkling after immersion in water". British Medical Journal. 281 (6240): 586–587. doi:10.1136/bmj.281.6240.586-a. PMC   1713922 . PMID   7427379.
  21. ↑ The Dog Encyclopedia: The Definitive Visual Guide. Penguin. 15 August 2023. p. 84. ISBN   978-0-7440-8513-6.
  22. ↑ Stefanaki C, Stratigos A, Katsambas A (June 2005). "Topical retinoids in the treatment of photoaging". J Cosmet Dermatol. 4 (2): 130–4. doi:10.1111/j.1473-2165.2005.40215.x. PMID   17166212. S2CID   44702740.
  23. ↑ Brin MF, Lew MF, Adler CH, Comella CL, Factor SA, Jankovic J, O'Brien C, Murray JJ, Wallace JD, Willmer-Hulme A, Koller M (1999). "Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia". Neurology. 53 (7): 1431–8. doi:10.1212/WNL.53.7.1431. PMID   10534247.
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