Wrinkles are irregularities in the body’s surface that present as creases, ridges, or folds in the skin.
The skin is comprised of multiple layers of tissue. The three most important components are the epidermis or surface layer of skin, the dermis lying immediately beneath the epidermis, and the hypodermis lying between deeper body tissues and the visible surface skin. Connective tissue (collagen), fat, hair follicles, sweat glands, nerves, and blood vessels lie within the dermis and provide skin tone. The supportive structure of the hypodermis is made of this fat and connective tissue. Loss of skin elasticity and tone occurs when collagen and fat deteriorates from environmental factors, ageing, or disease.
Skin grows from the bottom up. Cells in the hypodermis grow, mature, die, and fall from the body as skin flakes. They are replaced by cells in the dermis migrating outward toward the skin’s surface. These cells in turn are replaced by cells from the epidermis. Surface cells succumb to mitosis, the natural cell death process, and fall off the body. The regeneration cycle to go from dead cells to new surface skin cells (i.e., maturation of hypodermis to dermis and then to epidermis) takes about a month in our youth. The skin cells are nurtured by blood vessels rising within the hypodermis.
Determination of an Etiology for Wrinkles.
Skin can be damaged by a number of factors. Mechanical degenerative damage may relate to such factors as trauma, disease, wind, and environment, and each potentially causing wrinkles. The sun with its ultraviolet rays has long been associated with skin ageing. Alteration of body metabolism related to alcohol consumption and tobacco use have also been associated with skin wrinkle anomalies, but normal hormonal effects on metabolism related to pregnancy and menopause may also cause those wrinkles. “Family DNA” has also been associated with ageing effects and with these unwanted skin deformities.
Understanding the Mechanism Behind Wrinkle Formation.
Various factors cause the regenerative process of skins cells to lengthen and fail or skin support structures to weaken. The dermis thins with time and loses its elasticity. Lubricating cells within the dermis may fail to sustain adequate moisture and oils, inducing slower healing to damaged tissues. Habitual configurations of the face and routine voluntary muscle contortions of body parts may result in wrinkles at the eyebrows and eye corners, at the facial smile and frown lines, etc. Wrinkles, however, are not limited to facial features alone, but may also be found in non-facial body skin.
Determination of a Wrinkle Treatment Strategy.
Wrinkle management begins with assessing skin condition and determining its history. The skin’s history and wrinkle etiology may help determine specifics of treatment. Patients will present with concerns about specific portions of their bodies, often concerning the face. The skin clinician will note the presenting complaint and examine a given wrinkle.
The general skin condition will be evaluated. Variation in skin color will be assessed. Presence of freckles, birthmarks, hemangiomas, moles, skin tags, seborrheic keratoses, and non-cancerous lesions will be noted. Each skin lesion will be managed, but lesion-specific treatment is beyond this brief discussion of typical wrinkle management.
Chronic skin problems may be unidentified until this entry-level examination. Acne, eczema, psoriasis, rosacea, and the like may only be formally identified at the time of this evaluation. Acute skin problems, herpes simplex virus manifesting as recurrent cold sores, bacterial infections (e.g., boils, carbuncles, cellulitis, impetigo, staph, warts, etc.), fungal infections, “spotty” hair loss on the skin, blisters, chafing, calluses, sunburn, and a host of other superficial acute problems may be identified.
This cursory list of skin maladies suggests that there may be a variety of skin problems that relate to or contribute to skin wrinkles. Acute and chronic problems of the skin may be managed concomitantly with or separately from wrinkle management, depending on their interdependency as skin problems. Focus in this section is on wrinkle management. Topical cosmetics are a secondary strategy and not apropos to the following discussion and management of wrinkles with an injection strategy.
Intervention with Anti-Wrinkle Injections and Related Therapies.
Wrinkles generally do not resolve by themselves. Is there anything that can be done to ameliorate the problem? Strategies for resolution may seek to alter the skin at the epidermis, the dermis, or the hypodermis levels discussed above. Here are some options at Vein Solutions.
A Skin Peel (aka Chemical Peel).
Superficial wrinkles that do not extend deeply into the dermis may be managed by applying a mild acid, sometimes with addition of various enzymes, to the skin’s surface, followed by application of an acid neutralizer after several minutes. The body reacts with stimulation of both new skin growth, but also enhanced collagen generation. This half hour procedure results in a fresh, youthful skin when the dermis develops new epidermis. The half-hour procedure is painless and may involve slight skin swelling with “new” skin developing as the skin recovers from the treatment. This is typically a topical therapy, but microneedling using tiny inoculations of acid applied along the wrinkles has been utilized on occasion.
Dermabrasion and Microdermabrasion.
The top layer of skin may be abraded mechanically, essentially being “ground down.” The more aggressive version, i.e., “dermabrasion,” typically is preceded with numbing shots to desensitize the wrinkle area of focus for the procedure. After anaesthesia, the epidermis is abraded with an instrument using a brush or wheel to level the dermis, basically mechanically removing all superficial skin anomalies. “Microdermabrasion” is similar in practice, but utilizes crystal particles in a spray on the skin before application of a less aggressive abrading tool. The skin will feel “burned” for several days with full healing occurring in about a week and a half. Pinkish skin from the procedure fades slowly over the next two months. UVL protection will be advised when outdoors after the event.
Microneedling may be used along with other therapies. The tiny wounds introduced in the needling process cause the body to develop new skin cells, essentially inducing collagen and elastic repair to the skin. Patients will notice a filling of wrinkles as a result. The procedure takes about 20 minutes, needling being applied with a small, sterile tool.
A Thread Lift.
When skin wrinkling is accompanied by sagging tissue, the wrinkling is at a level deeper than the epidermis and sometimes deeper than the dermis. This therapy strategy involves use of surgical threads impregnated with the acid discussed above and inserted through the skin to beneath the hypodermis skin level. Threads are tightened. Acid within the threads is absorbed directly into the hypodermal structures. Collagen production is stimulated and the missing volume within the wrinkles is replaced, ameliorating lines and deep wrinkles. Actual procedure time is half an hour with treatment site recovery time being a couple days.
Deep wrinkles extending into the hypodermis may be filled with a material that is compatible with body tissues. A local anaesthetic is administered to the treatment area prior to the introduction of the dermal filler into the base of the wrinkle. At one time, only fats or tissues harvested from an animal or even the patient’s own body were used in the procedure. Fortunately, we now have a number of biodegradable materials developed for direct use as fillers, negating a need for harvesting patient material. This procedure results in smoother, softer wrinkle lines, and a fuller skin as missing subcutaneous fat is replaced. Patients may return to non-strenuous work immediately. Swelling or bruising from the procedure resolves within several days.
Frequency of Treatment
There are no typical patients for wrinkle management. Depending on patient treatment chosen, multiple clinic visits and appropriate complementary procedures may be required.
Contact Vein Solutions to discuss your specific needs, free on 0800 043 1997 or firstname.lastname@example.org