Several wrinkle treatment options are available to help smooth wrinkles or make them less noticeable.
Topical retinoids. Derived from vitamin A, retinoids — such as tretinoin (Renova, Retin-A) and tazarotene (Avage, Tazorac) — that you apply to your skin may reduce fine wrinkles, splotches and skin roughness.
Because retinoids can make your skin burn more easily, you'll need to use a broad-spectrum sunscreen and wear protective clothing daily. Retinoids may cause redness, dryness, itching, and a burning or tingling sensation.
Nonprescription wrinkle creams. The effectiveness of anti-wrinkle creams depends in part on the active ingredients. Retinol, antioxidants and some peptides may result in slight to modest improvements in wrinkles.
With nonprescription wrinkle creams, your results, if any, are limited and usually short-lived because these creams contain less of the active ingredients than do prescription creams.
Surgical procedures and other techniques
A variety of skin-resurfacing techniques, injectables, fillers and surgical procedures are available to smooth out wrinkles. Each has its own set of potential results and side effects. Some studies indicate that a combination of treatments may yield the most satisfying results.
Laser, light source and radiofrequency treatments. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis), stimulating the growth of new collagen fibers. As the wound heals, smoother, tighter skin forms.
It can take up to several months to fully heal from ablative laser resurfacing. Risks include scarring and lightening or darkening of skin color.
Other laser techniques, such as nonablative laser fractional resurfacing, have decreased healing time and reduced risks. Nonablative lasers are better suited to people with moderate wrinkles because results are subtle. Nonablative laser treatment typically needs to be repeated more often than does ablative treatment.
There's also a device that uses radiofrequency instead of light for nonablative treatment that achieves mildly to moderately tighter skin.
- Chemical peel. Your doctor applies an acid to the affected areas, which burns the outer layer of your skin to remove age spots and freckles, as well as wrinkles. Depending on the depth of the peel, you may need several before you see a difference. Redness lasts up to several weeks.
Dermabrasion. Also called dermaplaning, this procedure involves sanding (planing) the surface layer of skin with a rotating brush. The planing removes the skin surface, and a new layer of skin grows in its place.
Redness, scabbing and swelling generally last a couple of weeks. It may take several months for pinkness to fade and for you to see results.
Microdermabrasion. Similar to dermabrasion, this technique removes only a fine layer of skin. This technique usually requires a series of treatments to produce results.
You may notice a slight redness or stinging sensation on the treated areas. Microdermabrasion produces modest, temporary results.
Botulinum toxin type A (Botox). When injected in small doses into specific muscles, Botox keeps the muscles from contracting. When the muscles can't tighten, the skin appears smoother and less wrinkled.
Botox works well on frown lines between the eyebrows and across the forehead and on crow's-feet at the eye corners. Results typically last about three to four months. Repeat injections are needed to maintain results.
- Soft tissue fillers. Soft tissue fillers, which include fat, collagen and hyaluronic acid (Restylane, Juvederm, others), can be injected into deeper wrinkles on your face. They plump and smooth wrinkles and furrows. You may experience temporary swelling, redness and bruising in the treated area. The procedure may need to be repeated every few months.
- Skin tightening. Several devices use heat to tighten the skin. This noninvasive treatment produces mild to modest results, which usually develop gradually over four to six months. There's no recovery time for this procedure.
- Face-lift. The face-lift procedure involves removing excess skin and fat in your lower face and neck and tightening the underlying muscle and connective tissue. The results typically last five to 10 years. Healing times can be lengthy after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.
Keep in mind that results vary depending on the location and depth of your wrinkles. Nothing stops the aging process of skin, so you'll likely need repeated treatments to maintain benefits.
These procedures aren't usually covered by insurance. Also, any of the procedures can have side effects, so be sure to discuss them with your doctor. Make sure your dermatologist or plastic surgeon is specially trained and experienced in the technique you're considering.
Many over-the-counter wrinkle creams and lotions promise to reduce wrinkles and prevent or reverse damage caused by the sun. But these products are not likely to make a noticeable difference in your skin.
The Food and Drug Administration (FDA) classifies these creams and lotions as cosmetics, which are defined as having no medical value. So the FDA regulates them less strictly than it does drugs. This means that products don't need to undergo rigorous testing for safety and effectiveness before approval to go on the market.
Because the FDA doesn't evaluate cosmetic products for effectiveness, there's no guarantee that any over-the-counter product will reduce your wrinkles.
Preparing for your appointment
When you make an appointment with a dermatologist, it's a good idea to prepare for your appointment by making a list of questions you want your doctor to answer. For wrinkles, some basic questions to ask your doctor include:
- What is the best course of action?
- What are my treatment options and the pros and cons of each?
- What will the treatments cost? Does medical insurance usually cover these treatments?
- What results can I expect?
- How often will I need to repeat the treatment?
- What kind of follow-up, if any, will I have?
Don't hesitate to ask any other questions you have.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- What products, such as cleansers and moisturizers, do you use on your skin?
- Do you use sunscreen?
- Did you expose your skin to sun when you were younger?
- Do you smoke or have you ever smoked?