What are wrinkles?

Wrinkles occur in ageing skin that has lost its elasticity. As we age, three substances in the dermis (inner layer of the skin) begin to decrease or become dysfunctional causing it to thin.

These are collagen (the major structural protein in skin), elastin (protein that causes tissue to stretch), and hyaluronic acid (provides the skin with structure and volume).

Fat that covers muscles underneath the dermis begin to diminish, so that skin begins to look thinner and wrinkles more evident.

As a result, the epidermis (outer layer of skin) loses its ability to retain moisture, becomes drier, scalier, and is slower to heal.

Once skin has lost its fluidity, skin will no longer spring back to its initial position but instead sag and form wrinkles.

Prolonged sun exposure prematurely ages the skin (known as photo-ageing).

Both the ageing process and in particularly photo-ageing damages the skin’s natural protection barrier, meaning that there are fewer antioxidants to fight the free radicals that damage the skin on a daily basis.

What lines can you identify with?

Different types of wrinkles require different treatment. Here are the different categories:

Lines produced by persistant muscle activation: Repetitive skin folding from facial expressions eventually causes lines to become entrenched in the skin, such as frown lines, squints, cheek lines, and crow’s feet (lines that radiate from corners of the eyes).

Sag lines

These include folds such as from the corner of the nose to the corner of the mouth. These are caused due to loss of elasticity, collagen and volume

Solar elastosis

Sun damage causes the skin to take on a tough, crepey appearance.

Did you know? Smoking also accelerates skin ageing by damaging several parts of the skin including its elasticity and support. These visible changes may take years or decades to occur.

Taking action:


Although most of the sun damage to our skin already occurred in our teens (which will start to show up 15+ years later), it’s never too late to prevent further wrinkles.

“Stay out of the sun as much as possible, wear a hat and sunglasses, and use a broad spectrum sunscreen or moisturiser,” says Dr Calfas.

Skin care regime

Maintain the use of a gentle cleanser, and a hydrating moisturiser, which will reduce flaking and scaling changes.

Interestingly, Dr Goodman advises against using an exfoliator. Instead opt for Alpha Hydroxy Acids (AHAs) to chemically shed the dead skin layers.

“An exfoliator tends to wreck the barrier function of the skin and does not encourage the natural skin shedding process,” he says.

Ingredients to look for in your anti-ageing products include:

Alpha hydroxy acids (AHAs)

If you have sun damaged skin, this is for you. Prolonged exposure to the sun damages the epidermis by slowing down the production of skin cells, causing the skin to become thin and look lifeless.

AHAs improve the skin appearance shedding the dead skin layers and encouraging the production of collagen.


Many over the counter products now contain AHAs, however Dr Goodman claims that the concentration might be too low to have an effect (should be above over 5 per cent). He also says that many formulations do not have the correct pH balance (should be acidic), which neutralises any acid content and its beneficial effect.


Long term use of this vitamin A derivative have shown to reduce wrinkles by boosting collagen and improving elasticity of the skin.

It also helps to reverse photo-ageing, and normalise the top layer of the skin.

There are two types of product that contain vitamin A derivatives, prescription only products that contain retinoic acids, and over the counter products which contain milder forms of Vitamin A such as retinol or retinol palmitate.

Being stronger in concentration, the retinoic acid is much more effective at reducing wrinkles but causes irritation. The latter although not as effective is less irritating and may have some benefit, according to Dr Calfas.


Vitamin C, E, and B5 are important in protecting skin cells against damage (including ultraviolet damage),” says Dr Calfas. Antioxidants may work by not only protecting the skin against sun damage but in promoting the formation and repair of collagen.

Watch out for:

Collagen and elastin creams: These creams claim to restore collagen and elastin however Dr Calfas says that they are of no benefit as the molecules are too large to penetrate the skin.

More expensive products won’t necessarily produce better results. Instead you need to choose a product specific for your skin type, and Dr Calfas says that this is best done under the supervised care of a professional.

Stay tuned for Part 2 on surgical and non-surgical treatments next week.