Rhytides

Introduction

The appearance of rhytides (wrinkles) is a natural part of the aging process and can be seen as creases, folds or ridges in the skin.

  • Wrinkles are most prominent on sun-exposed skin, such as the face, neck, hands and forearms.

Rhytides



Causes

Several factors can contribute to wrinkles, including

  • Aging - Wrinkles develop due to the skin becoming thinner and less elastic over time.
  • Sun exposure - a major cause, especially for people with light skin.
  • Smoking
  • Air pollutants, e.g. lead, particulate matter (soot, exhaust, industry), nitrogen oxide (car exhaust), sulphur dioxide (industry plants)
  • Repeated facial expression, such as frowning, squinting or smiling



Prevention

To minimize the appearance of wrinkles,

  • Photoprotection, such as always wear protective clothing or using sunscreen
  • Use moisturizer
  • Remove makeup at the end of the day with a cleanser to prevent the blockage of the skin pores, which can hinder the body's ability to produce collagen proteins.
  • Do not smoke
  • Living a healthy lifestyle, such as regular exercise, healthy diet, sufficient sleep



Treatment

While wrinkles do not require treatment, there are several options to help smooth wrinkles or make them less noticeable.

  • Medications
    • Topical retinoids
      • It takes 3-6 months of regular use before improvements in wrinkles are apparent and the best results take 6-12 months.
      • Can cause skin dryness and irritation.
      • Treatment with topical retinoids should not be started or continued during pregnancy because retinoids are known teratogens.
  • Cosmeceuticals
    • Refers to a heterogenous category of non-prescription topical products including antioxidants, vitamins, retinol, hydroxyacids and plant extracts, that may have some activity in the treatment of photoaging.
    • Limited evidence from clinical studies to suggest that they are beneficial or that one particular preparation is better than another.

Cosmeceuticals

  • Cosmetic procedures
    • Soft tissue fillers
      • Include collagen, hyaluronic acid or fat
      • To fill in or lift up folds or deep wrinkles.
    • Botulinum toxin type A (Botox)
      • Blocks the chemical signals that cause muscles to contract and cause wrinkles.
    • Chemical peel
      • Applying a chemical solution to the desired areas, causing the dead skin to shed and eventually peel off. The regenerated skin tends to be smoother than the old skin.
  • Surgical procedures
    • Laser ablative resurfacing
    • Microdermabrasion or dermabrasion
    • Face-lift surgery (rhytidectomy)
      • Usually involves removing excessive facial skin and fat, with or without tightening the underlying tissue layers.



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