Skin Care and Aging - continued -
Over time, the sun’s ultraviolet (UV) light damages the fibers in
the skin called elastin. The breakdown of these fibers causes the skin
to lose its ability to snap back after stretching. As a result, wrinkles
form. Gravity also is at work, pulling at the skin and causing it to sag,
most noticeably on the face, neck, and upper arms.
Cigarette smoking also contributes to wrinkles. People who smoke tend
to have more wrinkles than nonsmokers of the same age, complexion, and
history of sun exposure. The reason for this difference is not clear.
It may be because smoking also plays a role in damaging elastin. Facial
wrinkling increases with the amount of cigarettes and number of years
a person has smoked.
Many products currently on the market claim to “revitalize aging
skin.” According to the American Academy of Dermatology, over-the-counter
“wrinkle” creams and lotions may soothe dry skin, but they
do little or nothing to reverse wrinkles. At this time, the only products
that have been studied for safety and effectiveness and approved by the
Food and Drug Administration (FDA) to treat signs of sun-damaged or aging
skin are tretinoin cream and carbon dioxide (CO2) and erbium (Er:YAG)
Tretinoin cream (Renova), a vitamin A derivative available by prescription
only, is approved for reducing the appearance of fine wrinkles, mottled
darkened spots, and roughness in people whose skin doesn’t improve
with regular skin care and use of sun protection. However, it doesn’t
eliminate wrinkles, repair sun-damaged skin, or restore skin to its healthier,
younger structure. It hasn’t been studied in people 50 and older
or in people with moderately or darkly pigmented skin.
The CO2 and Er:YAG lasers are approved to treat wrinkles. The doctor
uses the laser to remove skin one layer at a time. Laser therapy is performed
under anesthesia in an outpatient surgical setting.
The FDA currently is studying the safety of alpha hydroxy acids (AHAs),
which are widely promoted to reduce wrinkles, spots, and other signs of
aging, sun-damaged skin. Some studies suggest that they may work, but
there is concern about adverse reactions and long-term effects of their
use. Because people who use AHA products have greater sensitivity to the
sun, the FDA advises consumers to protect themselves from sun exposure
by using sunscreen, wearing a hat, or avoiding mid-day sun. If you are
interested in treatment for wrinkles, you should discuss treatment options
with a dermatologist.