table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Botox gets a lot of attention for its ability to smooth forehead lines, crow’s feet, and the creases that start to form at the sides of the nose as we age. But though Botox is one option when you’re considering wrinkle removers, it’s far from the only treatment out there. Here’s what you need to know about all the options at your disposal.
Take $20 off a one month trial of custom skincare
Try our personalized prescription skincare from the comfort of your home.
What are wrinkles?
Essentially, wrinkles are just deeper fine lines. Wrinkles form when the skin creases—generally as a natural part of forming a facial expression—and has trouble returning to its original shape. This inability of your skin to bounce back like it did when you were younger is a natural part of the aging process. Although many things contribute to the formation of wrinkles, from lifestyle habits to genetics, the most significant external factor is photodamage from sun exposure (Strnadova, 2019; Shanbhag, 2019).
Thankfully, most of us don’t have to worry about these pesky lines until our late 20s or early 30s. As we age, the underlying structure of our skin starts to break down. Under the top layer of our skin, known as the epidermis, is the dermis, which contains fibers made of collagen and elastin responsible for giving our skin its firmness and elasticity by supporting the epidermis above (Shanbhag, 2019).
Unfortunately, elastin and collagen fibers degrade as we age. That means the dermis can no longer give the kind of support to the surface of your skin that it once did, resulting in the formation of fine lines.
But that’s not the only way our skin forms or increases the appearance of wrinkles as we age. The dermis is also home to glycosaminoglycans, or GAGs. These molecules act as natural moisturizers by pulling water into the cells, giving your skin volume and firmness (Ahmed, 2020).
The problem is, GAGs can’t do this job effectively in photodamaged skin. As we age, our epidermis also loses hyaluronic acid, another natural substance made by our bodies that holds onto water to keep tissues hydrated. Together, these two processes contribute to dry skin as we age, making wrinkles appear more prominent than they might in hydrated skin (Ahmed, 2020).
12 ways to get rid of wrinkles
With that many contributors to creases on our faces, how is anyone supposed to prevent or eliminate their crow’s feet? Luckily, a wide range of products, from face anti-wrinkle creams to eye creams, boast powerful active ingredients backed by research. Dermatologists have also developed procedures to counter those pesky lines. Here’s what you need to know about each to figure out what might be right for you and your skin type.
Retinoids are a class of substances related to vitamin A (retinol). Examples that you may have heard of include tretinoin and retinoic acid. They are frequently used in the clinical treatment of various skin conditions because of their ability to improve your skin’s appearance.
They work by increasing skin cell turnover, or how quickly your body makes new layers and sheds old dead skin cells. Using retinoid products regularly can help your skin look younger and healthier. But that’s not all—they also boost your skin cells’ ability to replenish collagen, keeping your skin plump and smooth (Yoham, 2020).
2. Vitamin C
Vitamin C (ascorbic acid) is a natural antioxidant. That means it’s great for combatting free radicals, which are substances that can cause all kinds of damage in our bodies, including skin aging and wrinkle formation. Studies show that vitamin C may help reduce the appearance of fine lines and wrinkles by protecting your skin against oxidative damage. It may also improve skin elasticity and firmness (Zasada, 2019).
3. Hydroxy acids
Alpha-hydroxy acids (AHAs) and beta hydroxy acids (BHAs), such as glycolic acid and lactic acid, are often used in chemical peels done by dermatologists to improve skin texture and even out skin tone. However, they are also available in over-the-counter skincare products at lower concentrations. Studies suggest that hydroxy acids may smooth wrinkles, increase skin cell turnover, and restore hydration (Ahmed, 2020).
How to build a skincare routine: basics, steps, products
Peptides are the building blocks of the elastin and collagen proteins that give your skin structure. One study done on human skin samples found that topical application of peptides successfully boosted collagen production. Researchers also believe these peptides are integral for maintaining the dermal-epidermal junction (DEJ), where the epidermis meets the dermis. The DEJ is critical both for providing structure and allowing nutrients to reach the skin. Breakdowns in the DEJ have previously been shown to cause sagging, decreased wound healing, and dry skin (Jeong, 2019).
Niacinamide, a form of vitamin B3, may have anti-aging properties when applied topically. It works as an antioxidant, protecting your skin from oxidative damage. Niacinamide also helps with dark spots that result from sun damage. These features enable it to potentially improve fine lines and wrinkles and even out your skin tone. Even better? Niacinamide may be used as an acne treatment and may help prevent breakouts caused by excess oil (Zhen, 2019; Forbat, 2017).
6. Hyaluronic acid
As we mentioned, hyaluronic acid is naturally produced by the body and keeps the skin moisturized. But as we age, our skin makes less of this hydrating compound, which is one of the factors leading to age-related dry skin. Fortunately, it’s widely available in over-the-counter topical skincare products and is generally well-tolerated by a wide range of skin types (Ahmed, 2020).
There is a wide range of laser surfacing treatments available, but the main difference is how harsh they are on the skin and the downtime they require for recovery; the main types include non-fractionated and fractionated lasers.
Non-fractionated lasers counter photodamage and improve the skin’s appearance by helping the body reconstruct some of the supportive structures, such as collagen fibers. They treat the entire area of targeted skin. As a result, they also come with more extended downtimes (roughly four weeks) and an increased risk of side effects, such as discoloration and scarring. Fractionated lasers only treat potions of the target area, limiting the downtime and the risk of side effects while providing similar benefits (Verma, 2021).
Both types of lasers create controlled stress that triggers the wound healing response, prompting the body to resurface the damaged area (Verma, 2021).
You likely know this treatment as Botox or botulinum toxin, though that’s far from the only neuromodulator on the market. These injections act on the nerves in the facial muscles, effectively freezing them and smoothing wrinkles in the process. Botox, in particular, can be effective on frown lines, crow’s feet, horizontal forehead creases, and wrinkles around the mouth (Satriyasa, 2019).
This treatment is just what it sounds like: a dermatologist uses tiny needles to create thousands of pricks in the skin during this procedure, sometimes adding serums designed to address specific skin concerns.
Microneedling may boost the production of elastin and collagen fibers as well as the blood vessels leading to these supportive skin structures. This can result in firmer, younger-looking skin. But you may see even better results if your dermatologist uses tretinoin, a retinoid, or vitamin C serum during the procedures (Singh, 2016; Litchman, 2021).
You can think of this as the professional-grade version of your at-home exfoliation. When your body creates new epidermal (skin) cells, they’re added as the bottom-most layer of your skin and slowly work their way toward the surface as the dead cells on the top are shed (Zasada, 2019).
Microdermabrasion: what is it, benefits, costs
To reveal younger, tighter-looking skin, a dermatologist will remove the topmost layers of old and dead skin cells through abrasion or exfoliation. Research has found that more than just the top layer of skin may be affected by this treatment. Microdermabrasion causes an increase in collagen fiber density in the lower layers of skin, which may improve the suppleness of the skin and smooth the look of fine lines and wrinkles (Shah, 2021).
11. Acid peels
There are three different types of chemical peels: superficial peels, medium-depth peels, and deep peels. They each use the same active ingredients but at different concentrations to remove different amounts of the top layers of skin.
Deep peels have been shown to increase collagen fibers, water, and GAGs in the dermis. Restoring some of these structural elements of the skin may help decrease the appearance of wrinkles (Pathak, 2020).
12. Surgical options
There are several surgical procedures available to smooth wrinkles, including brow and facelifts. Different areas of the face are involved in each procedure, but they all involve manipulating the tissue and removing excess skin. There are several methods for both of these treatments, some less invasive than others.
Wrinkle creams vs. procedures
Wrinkle creams, anti-aging creams, and other topical skincare products designed to target creases in the skin are a great first line of attack. Although deeper-set wrinkles may require a combination of skincare products and dermatological treatments, consistent application of these products may help prevent future lines or deepening of current creases. It’s best to look for products that contain ingredients like retinoids, vitamin C, hydroxy acids, peptides, and others.
Which topical wrinkle treatment is right for you? Consider which skin concerns bother you the most and opt for creams or lotions that address these issues specifically. A dermatologist can also help you craft a skincare routine that fits your unique needs and skin type. Consider the potential side effects, especially if you’re debating between a product (like a retinoid) that comes in an over-the-counter version and prescription strength.
Prescription treatments may cause more side effects since the concentration of their active ingredients may be higher. But you can also weigh the cost. Although over-the-counter products may use a lower concentration of an active ingredient and, therefore, may offer less dramatic results, it may be worth the time tradeoff based on how much money you’ll save compared to prescription medications.
If you’re looking for more dramatic results or have deeper-set wrinkles, dermatological procedures may be the way to go. Some of these treatments require minimal downtime—neuromodulators, for example, like Botox, can be done over your lunch break—whereas others, like a facelift, require hospitalization and significant recovery time. In short, you have a lot of choices.
Is there a difference between Retin-A and tretinoin?
How to prevent wrinkles
Since sun damage is the most significant external contributor to skin aging, limiting sun exposure and wearing sunscreen with an SPF of at least 30 on exposed skin when going outside can make a big difference. Maintaining the structural integrity of the collagen and elastin fibers may go a long way toward preventing wrinkles. Past research has found that roughly 80% of facial skin aging is due to damage from ultraviolet (UV) rays in natural light (Shanbhag, 2019).
Another major player in skin aging is cigarette smoke (Krutmann, 2017). Staying healthy by eating a balanced diet, drinking enough water, and exercising may improve your overall health, including your skin’s appearance.
Neuromodulators such as Botox or Xeomin have been proven to improve the appearance of fine lines and wrinkles. They halt their progression by preventing repetitive movements of facial muscles that could cause future lines. These treatments must, however, be administered by a healthcare professional. Talk to your dermatologist to see if you’re a good candidate.
- Ahmed, I. A., Mikail, M. A., Zamakshshari, N., & Abdullah, A. H. (2020). Natural anti-aging skincare: role and potential. Biogerontology, 21(3), 293–310. doi: 10.1007/s10522-020-09865-z. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32162126/
- Forbat, E., Al-Niaimi, F., & Ali, F. R. (2017). Use of nicotinamide in dermatology. Clinical and Experimental Dermatology, 42(2), 137–144. doi: 10.1111/ced.13021. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28052374/
- Jeong, S., Yoon, S., Kim, S., Jung, J., Kor, M., Shin, K., et al. (2019). Anti-wrinkle benefits of peptides complex stimulating skin basement membrane proteins expression. International Journal of Molecular Sciences, 21(1), 73. doi: 10.3390/ijms21010073. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981886/
- Litchman, G., Nair, P. A., Badri, T., et al. (2021). Microneedling. [Updated Sept. 28, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 8, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK459344/
- Pathak, A., Mohan, R., & Rohrich, R. J. (2020). Chemical peels: role of chemical peels in facial rejuvenation today. Plastic and Reconstructive Surgery, 145(1), 58e–66e. doi: 10.1097/PRS.0000000000006346. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31881607/
- Satriyasa, B. K. (2019). Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: A literature review of clinical use and pharmacological aspect. Clinical, Cosmetic and Investigational Dermatology, Volume 12, 223-228. doi: 10.2147/ccid.s202919. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489637/
- Shah, M., & Crane, J. S. (2021). Microdermabrasion. [Updated July 18, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 8, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK535383/
- Shanbhag, S., Nayak, A., Narayan, R., & Nayak, U. Y. (2019). Anti-aging and sunscreens: paradigm shift in cosmetics. Advanced Pharmaceutical Bulletin, 9(3), 348-359. doi: 10.15171/apb.2019.042. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773941/
- Singh, A., & Yadav, S. (2016). Microneedling: advances and widening horizons. Indian Dermatology Online Journal, 7(4), 244. doi: 10.4103/2229-5178.185468, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/
- Strnadova, K., Sandera, V., Dvorankova, B., Kodet, O., Duskova, M., Smetana, K., et al. (2019). Skin aging: the dermal perspective. Clinics in Dermatology, 37(4), 326–335. doi: 10.1016/j.clindermatol.2019.04.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31345320/
- Verma, N., Yumeen, S., & Raggio, B. S. (2021). Ablative laser resurfacing. [Updated Aug. 13, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 8, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557474/
- Zasada, M., & Budzisz, E. (2019). Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology, 36(4), 392-397. doi: 10.5114/ada.2019.87443. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/
- Zhen, A. X., Piao, M. J., Kang, K. A., Fernando, P., Kang, H. K., et al. (2019). Niacinamide protects skin cells from oxidative stress induced by particulate matter. Biomolecules & Therapeutics, 27(6), 562–569. doi: 10.4062/biomolther.2019.061. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824628/