What can I do about wrinkles?

A number of surgical options are available.


Dermabrasion is a surgical procedure that involves the controlled wearing away, or abrasion, of the upper layers of skin with sandpaper or some other mechanical means.

Share on PinterestWrinkles are a natural part of aging, but treatments like Botox can put them off for a while.

Dermabrasion is used to remove fine wrinkles, tattoos, nevi, or moles, acne scars, and other types of scar.

It may cause scabbing, swelling, and redness. These generally fade after 2 weeks, but some pinkness may remain for several months. The desired results are not immediate, and may take several months.

Microdermabrasion uses a powerful vacuum to spray microcrystals of aluminum oxide across the surface of the skin. The procedure removes the outermost layers of skin cells, and it stimulates cell growth in the underlying layers of skin.

This type of treatment is said to help give a fresher and smoother appearance to the skin, as well as diminishing the appearance of lines and wrinkles, enlarged pores, coarse skin, and sun damage. The patient may have slight redness in the areas of treated skin.

Repeated treatments are required because results are temporary.

Laser therapy

Laser, light source, and radiofrequency (RF) treatments destroy the outer layer of skin with a laser beam, while the dermis, or underlying skin, is heated up. This stimulates the development of new collagen fibers.

In 2013, a study reported over 90 percent satisfaction one month after undergoing RF, and up to 75 percent satisfaction after 6 months, but the researchers called for further investigations into safety and effectiveness.

When the wound heals, the new skin is smoother and tighter, but ablative laser resurfacing can take several months to heal.

Newer therapies using laser technology may heal more quickly.

Non-ablative lasers, radiofrequency devices and pulsed light sources do not damage the epidermis. The underlying skin is heated, triggering the formation of new collagen and elastin.

The skin feels firmer and appears refreshed after several treatments, and recovery times are faster, but more treatments are needed and results are more subtle.


Botulinum toxin type A, commonly known as Botox, blocks the chemical signals that cause muscles to contract. It is used to treat a number of medical conditions, as well as wrinkles.

It is injected in small doses into targeted muscles. If the muscles can no longer tighten, the skin flattens, giving a less wrinkled and smoother appearance.

Botox can decrease the lines on the forehead, the frown lines between the eyes, and “crow’s feet,” around the corners of the eyes.

Treatments generally last 3 months, so repeated injections are needed.

Chemical peels

A chemical peel involves applying a chemical solution to wrinkly areas, causing the dead skin to shed and eventually peel off. The regenerated skin tends to be smoother and less wrinkled than the old skin.

Some types of chemical peels can be bought and used without a medical license, but it is advisable to consult a medical health care professional for the treatment.


A facelift, also known as a rhytidectomy, is a type of cosmetic surgery that aims to make people look younger. It usually involves removing excess facial skin and fat, with or without tightening the underlying tissues.

The skin of the face, neck, or both is redraped. Research suggests that after 5 1/2 years, a facelift is still effective, but that the neck starts to relapse. Healing times may be lengthy, and the patient will experience bruising and swelling for a few weeks after surgery.


Soft tissue fillers include collagen, hyaluronic acid, or fat. They are injected into deeper face wrinkles, plumping and smoothing them out and giving the skin more volume.

Patients may sometimes experience swelling, redness, and bruising in the treated areas for a short period. As with Botox treatment, for lasting results, the treatments will need to be repeated every few months.

The results are dependent on several factors, including where the wrinkles are and their depth.

Aging changes in skin

Skin changes are among the most visible signs of aging. Evidence of increasing age includes wrinkles and sagging skin. Whitening or graying of the hair is another obvious sign of aging.

Your skin does many things. It:

  • Contains nerve receptors that allow you to feel touch, pain, and pressure
  • Helps control fluid and electrolyte balance
  • Helps control your body temperature
  • Protects you from the environment

Although skin has many layers, it can generally be divided into three main parts:

  • The outer part (epidermis) contains skin cells, pigment, and proteins.
  • The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.
  • The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat.

Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.

Watch this video about:Components of skin

Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. You can see this by comparing areas of your body that have regular sun exposure with areas that are protected from sunlight.

Natural pigments seem to provide some protection against sun-induced skin damage. Blue-eyed, fair-skinned people show more aging skin changes than people with darker, more heavily pigmented skin.


With aging, the outer skin layer (epidermis) thins, even though the number of cell layers remains unchanged.

The number of pigment-containing cells (melanocytes) decreases. The remaining melanocytes increase in size. Aging skin looks thinner, paler, and clear (translucent). Large pigmented spots, including age spots, liver spots, or lentigos, may appear in sun-exposed areas.

Changes in the connective tissue reduce the skin’s strength and elasticity. This is known as elastosis. It is more noticeable in sun-exposed areas (solar elastosis). Elastosis produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors.

The blood vessels of the dermis become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura), cherry angiomas, and similar conditions.

Sebaceous glands produce less oil as you age. Men experience a minimal decrease, most often after the age of 80. Women gradually produce less oil beginning after menopause. This can make it harder to keep the skin moist, resulting in dryness and itchiness.

The subcutaneous fat layer thins so it has less insulation and padding. This increases your risk of skin injury and reduces your ability to maintain body temperature. Because you have less natural insulation, you can get hypothermia in cold weather.

Some medicines are absorbed by the fat layer. Losing this layer changes the way that these medicines work.

The sweat glands produce less sweat. This makes it harder to keep cool. Your risk for overheating or developing heat stroke increases.

Growths such as skin tags, warts, rough patches (keratoses), and other blemishes are more common in older people.


As you age, you are at increased risk for skin injury. Your skin is thinner, more fragile, and you lose the protective fat layer. You also may be less able to sense touch, pressure, vibration, heat, and cold.

Rubbing or pulling on the skin can cause skin tears. Fragile blood vessels can break easily. Bruises, flat collections of blood (purpura), and raised collections of blood (hematomas) may form after even a minor injury.

Pressure ulcers can be caused by skin changes, loss of the fat layer, reduced activity, poor nutrition, and illnesses. Sores are most easily seen on the outside surface of the forearms, but they can occur anywhere on the body.

Aging skin repairs itself more slowly than younger skin. Wound healing may be up to 4 times slower. This contributes to pressure ulcers and infections. Diabetes, blood vessel changes, lowered immunity, and other factors also affect healing.


Skin disorders are so common among older people that it is often hard to tell normal changes from those related to a disorder. More than 90% of all older people have some type of skin disorder.

Skin disorders can be caused by many conditions, including:

  • Blood vessel diseases, such as arteriosclerosis
  • Diabetes
  • Heart disease
  • Liver disease
  • Nutritional deficiencies
  • Obesity
  • Reactions to medicines
  • Stress

Other causes of skin changes:

  • Allergies to plants and other substances
  • Climate
  • Clothing
  • Exposures to industrial and household chemicals
  • Indoor heating

Sunlight can cause:

  • Loss of elasticity (elastosis)
  • Noncancerous skin growths (keratoacanthomas)
  • Pigment changes such as liver spots
  • Thickening of the skin

Sun exposure has also been directly linked to skin cancers, including basal cell cancer, squamous cell carcinoma, and melanoma.


Because most skin changes are related to sun exposure, prevention is a lifelong process.

  • Prevent sunburn if at all possible.
  • Use a good quality sunscreen when outdoors, even in the winter.
  • Wear protective clothing and a hat when needed.

Good nutrition and adequate fluids are also helpful. Dehydration increases the risk of skin injury. Sometimes minor nutritional deficiencies can cause rashes, skin lesions, and other skin changes, even if you have no other symptoms.

Keep skin moist with lotions and other moisturizers. DO NOT use soaps that are heavily perfumed. Bath oils are not recommended because they can cause you to slip and fall. Moist skin is more comfortable and will heal more quickly.


  • Aging changes in body shape
  • Aging changes in hair and nails
  • Aging changes in hormone production
  • Aging changes in organs, tissues, and cells
  • Aging changes in the bones, muscles, and joints
  • Aging changes in the breast
  • Aging changes in the face
  • Aging changes in the senses

Other Skin Changes

Gravity, facial movement, and sleep position are the secondary factors that contribute to changes in the skin. When the skin loses its elasticity, gravity causes drooping of the eyebrows and eyelids, looseness and fullness under the cheeks and jaw (jowls and “double chin”), and longer ear lobes.

Facial movement lines become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s). Lines may appear horizontally on the forehead, vertically on the skin above the root of the nose (glabella), or as small curved lines on the temples, upper cheeks, and around the mouth.

Sleep creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, starting above the eyebrows to the hairline near the temples, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse.

Smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure.

Dry skin and itching is common in later life. About 85% of older people develop “winter itch,” because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin (such as overuse of soaps or hot baths) will make the problem worse. If your skin is very dry and itchy, see a doctor because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medicines make the itchiness worse.

Many ways to firm sagging skin

It’s possible to tighten your skin without a facelift. Do you find yourself gently pulling back skin on your face when you look in the mirror and wishing it would stay there? Does the jiggle in your upper arms bother you?

A surgical lift, such as a facelift or eyelid surgery, will give you the most dramatic results, but you’ll find plenty of other skin-tightening options. These other options offer less downtime and lower cost. Another perk: Many can be used on just about any part of your body that needs a lift.

Here’s the lowdown on your other options.

Subtle (if any) tightening

Skin-firming creams and lotions You’ll find plenty of these products. Many come with such promising claims that you may feel you have to try them. Before you spend money on another skin-firming cream, here’s what you should know.

Bottom line: If you’re looking for facelift-like results from a jar, you’ll likely be disappointed. Despite the claims, the results you see from a skin-firming cream will be subtle at best. It’s also possible that you won’t see any results.

When you see immediate results, the product tends to be an effective moisturizer. A good moisturizer can plump up your skin, making fine lines and wrinkles less noticeable. This result is temporary. To continue seeing any benefit, you need to apply the product every day.

As for the claim that a cream or lotion can lift sagging skin, dermatologists say that’s not possible. A cream or lotion cannot penetrate the skin deeply enough to do this.

Still, you may see a small change if a product contains a retinoid, such as retinol, which can help your body make more collagen.

While creams and lotions produce subtle results at best, the demand for skin care products that can lift sagging skin continues to grow. This demand is fueling research, so researchers are experimenting with various ideas.

One idea they’re testing is using creams to create electrical charges in the skin. These painless charges might increase the amount of collagen in the skin, which would lead to tighter skin.

Modest tightening and lifting

Non-invasive skin tightening procedures These procedures are called non-invasive because they leave your skin intact. You won’t have a puncture wound, incision, or raw skin afterward. You may see some temporary redness and swelling, but that’s usually the only sign that you had a procedure.

Here’s what you can expect from a non-invasive skin-tightening procedure:

  • Results: Tend to appear gradually, so they seem natural

  • Downtime: Little or none

  • Colorblind: Safe for people of all skin colors

  • Body-wide use: Can tighten skin just about anywhere on your body

  • Side effects: Usually some redness and swelling, but little risk of other side effects when performed by a board-certified dermatologist

  • Time commitment: Most procedures take 1 hour or less

  • Pain: May have some discomfort during the procedure, but that’s usually it

  • Makeup: Can often apply immediately after the procedure

  • Cost: Varies and not covered by insurance, so ask how much it will cost

If you opt for a non-invasive skin tightening procedure, you’ll likely have one of the following:

Ultrasound Dermatologists are using ultrasound to send heat deep into the skin.

Bottom line: The heat can cause your body to produce more collagen. With 1 treatment, most people see modest lifting and tightening within 2 to 6 months. You may get more benefit from having additional treatments.

Radiofrequency During this treatment, your dermatologist places a device against your skin, which heats the tissue beneath.

Bottom line: Most people have 1 treatment and feel some tightening right away. It takes time for your body to make collagen, so you’ll see the best results in about 6 months. Some people benefit from having more than 1 treatment.

Results can last 2 to 3 years with the right skin care.

Laser treatment Some lasers can send heat deep into the skin without wounding the top layer of your skin. These lasers are used to tighten skin all over the body and can be especially helpful for tightening loose skin on the belly and upper arms.

Bottom line: You may need 3 to 5 treatments to get results, which gradually appear between 2 and 6 months after the last treatment.

Most tightening and lifting without surgery

Minimally invasive skin tightening procedures While these procedures can give you more noticeable results, they still cannot give you the results of a surgical procedure like a facelift, eyelid surgery, or neck lift. Minimally invasive skin tightening, however, requires less downtime than surgery. It also carries less risk of side effects.

You will be sedated during this type of procedure and will have a few days of downtime.

If you have a minimally invasive skin tightening procedure, here’s what you can expect.

Radiofrequency When you have this type of radiofrequency, a thin tube (or needles), is inserted into your skin to heat up the tissue beneath. This allows your dermatologist to provide heat exactly where you need it to tighten loose skin. Dermatologists often use this procedure to tighten the neck or upper arms.

Bottom line: Putting the heat where it’s needed allows you to see results faster — usually in about 1 month. In some research studies, patients see gradual tightening and lifting for close to 1 year.

After the procedure, you’ll need someone to drive you home and you may need to wear a compression garment for 4 or 5 days. You’ll also need to care for the wound.

Laser resurfacing This is the most effective procedure for tightening loose skin. Unlike the laser treatment described above, this procedure requires some downtime. You’ll need to stay home for 5 to 7 days.

Laser resurfacing also gives you the fastest results. After you heal, you’ll see tightening and fewer wrinkles within 2 weeks.

Bottom line: Laser resurfacing can tighten skin, usually better than any other skin-tightening procedure. It can also diminish fine lines, wrinkles, and dark spots on the skin, such as age spots. The tradeoff is that it requires downtime and has a greater risk of possible side effects, such as scarring.

Who’s a good candidate for non-surgical skin tightening?

Many people can safely have a skin-tightening procedure. You’re likely to get the best results if you:

  • Are at a healthy weight and maintain your weight

  • Eat a healthy diet

  • Quit smoking

  • Drink little alcohol

  • Protect your skin from the sun and never tan indoors

  • Have a small amount of sagging skin

A skin-tightening procedure isn’t right for anyone who is pregnant, has a skin infection, or takes certain medications.

Do you have lots of sagging skin? If so, skin-tightening may not be helpful.

Ask a board-certified dermatologist

Seeing a board-certified dermatologist is the safest way to find out what skin tightening can do for you. With so many skin-tightening options available, you want to see an expert who is familiar with the different treatments and can determine the best option for your concerns.

You can find a board-certified dermatologist in your area by going to, Find a dermatologist. Select the specialty Cosmetic Dermatology.

Getty Images

Alam M, White LE, et al. “Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study.” J Am Acad Dermatol. 2010;62(2):262-9.

American Academy of Dermatology:

  • “New and improved laser and light treatments take aim at cellulite, fat, tattoos, wrinkles and sagging skin.” News release issued Mar 21, 2014. Last accessed Nov 30, 2017.

  • “Electricity sparks interest in new technologies and cosmeceuticals for aging skin.” News release issued Mar 15, 2011.

Fabi SG, Massaki A, et al. “Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage.” J Am Acad Dermatol. 2013;69(6):965-71.

Hilton L. “The real deal with nonsurgical skin tightening.” Dermatology Times. November 2017. 76-8.

MacGregor JL and Tanzi EL. “Microfocused ultrasound for skin tightening.” Semin Cutan Med Surg. 2013;32(1):18-25.

Tanaka Y. “Long-term nasal and peri-oral tightening by a single factional noninuslated microneedle radiofrequency treatment.” J Clin Aesthet Dermatol. 2017;10(2):45-51.

Tierney EP, Hanke CW, et al. “Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature.” J Am Acad Dermatol. 2011;64(4):730-40.

What Causes Wrinkles?

There’s no getting around it – skin is bound to age. While some may accept this with grace, most try to prevent the onslaught of aging. We all know those telltale signs: wrinkles, fine lines, dark spots, pigmentation. These indications of age are particularly bothersome when they come prematurely, causing us to look older than we act and feel. Although we can’t freeze time, we can slow down the clock.

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Aging can’t be stopped, its physical side effects can be delayed. In order to understand how to prevent the signs of age, you first need to learn what causes wrinkles. Understanding the science behind wrinkles will make you better equipped to avoid their formation. First, let’s take a look at the structure of the skin.

The Three Layers of Skin

Human skin is composed of three layers: the epidermis, dermis, and subcutaneous tissue.

  1. Epidermis:
    The epidermis is the skin’s outer layer. It’s rich in keratin, which is provides roughness and water-resistance. It’s within this layer of skin that dead skin cells are shed and where melanin (a dark pigment) is found. The epidermis acts as a barrier for the underlying layers, and is the first line of defense in our body’s immune system.

  2. Dermis:
    Beneath the epidermis lies the thick dermal layer. The dermis is composed of nerves, fats, blood vessels, elastin, and collagen fibers. Collagen – which occupies about 80% of the dermis – is a protein that accounts for the primary component of body’s connective tissue. Collagen provides the skin’s strength, whereas elastin (as its name implies) gives your skin its elastic quality and enables it to stretch back and forth.

  3. Subcutaneous Tissue:
    The subcutaneous layer is composed of fat. It’s mostly responsible for keeping us warm and holding our internal organs in place.

The structural changes that take place within these three layers of skin are responsible for producing the visible signs of aging. There are two different processes that induce such changes and lead to wrinkles: intrinsic aging and extrinsic aging.

Intrinsic Aging

Intrinsic aging, also known as chronological aging, occurs over the span of your lifetime regardless of external factors. Intrinsic aging is a natural process, and although most bodies mature along a similar timeline, it varies from person to person based on heredity:

  • After age 20, our bodies produce 1% less collagen each year. As collagen and elastin fibers become thicker and looser, the skin becomes inelastic and brittle; the signs of the skin’s attempt to stretch back and forth turns into visible wrinkles. Also in our 20s, the exfoliation process decreases, causing dead skin cells to accumulate and stick together for longer periods of time.

  • In our 30s, the transfer of moisture between the dermis and epidermis slows and fat cells start to shrink, making the skin appear dull. As the body ages, the skin produces less sebum (oil). This causes the texture of the skin to become dry and for wrinkles to become more visible – which is why you might notice those Crow’s Feet around your eyes, since this area has very few sebaceous glands.

  • Collagen production stops at age 40, and wrinkles form as the fibers begin to break and stiffen. Skin cell turnover slows, and it becomes more difficult for the cells to regenerate themselves.

  • By age 50, we start losing the fat stored in the subcutaneous tissue, which makes the skin thinner. The loss of estrogen following menopause also contributes to thinness, and results in the skin becoming more easily damaged. A decline in blood vessels and decrease in circulation also works against our complexion.

All of these intrinsic factors contribute to wrinkles, sagging, and pigmentation issues. This aging process is very slow, and only contributes to a small percentage of wrinkles. Most wrinkling is due to the effects of extrinsic aging.

Extrinsic Aging

Ever wake up one morning to be greeted in the mirror with a wrinkle that you swear wasn’t there the night before? It was most likely due to extrinsic aging. This type of aging refers to environmental influences that lead to wrinkles, and they’re responsible for creating the most dramatic signs of age. Here are a few of the most common sources of extrinsic aging.

  • Repeated facial expressions and sleeping positions:
    When you smile, creases form at the corners of your mouth as your lips pull up into your cheeks. Such repeated facial expressions can eventually form wrinkles known as expression lines. While everyone should be proud of their signs of smiling, other expression lines are not so welcome. Be sure to be careful every time you rub those sleepy eyes in the morning, and try to switch up which side of your face you sleep on to reduce the risk of deepened creases along the side of your nose.

  • Smoking:
    Stop smoking! It’s bad for your health and it’s what causes wrinkles on your face. Each time you take a drag from a cigarette, you’re pulling on what’s called your Purse String muscles. This repeated motion has the same effect as expression lines: premature wrinkles which betray your age. Furthermore, the nicotine found in cigarettes causes a narrowing of the blood cells within the outer most layer of the epidermis. If blood flow decreases, the skin becomes deprived of oxygen and vital nutrients, such as vitamin A. As a result, the skin begins to sag and wrinkle prematurely.

  • Pollution:
    Free radicals (or harmful, electron-hungry molecules) cause damage when they pull electrons from other molecules in our body. This action alters chemical structures and biological functioning, thereby accelerating the aging process, as seen on our skin in the form of wrinkles. Pollution in the environment is a major source of free radical exposure, and although antioxidant enzymes can help protect against free radicals, their damage will occur regardless.

  • Exposure to the sun:
    Photoaging, or changes that occur due to the sun, is by far the biggest culprit in the causation of wrinkles. The National Center for Biotechnology Information asserts that photoaging is responsible for 80 percent of wrinkles. When UVA rays penetrate deep into the skin’s dermal layer, it causes the breakdowns of our much-needed collagen and elastin. As these essential proteins break down, the skin begins to sag and wrinkle. Wrinkles are just one effect stemming from sun damage; photoaging also causes sun spots, rough texture, pigmentation problems, and can even lead to the development of deadly skin cancer.

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Until we find the fountain of youth, we can’t stop aging – but we can control it. If you know the causes of wrinkles, you can begin to avoid their sources. To keep your complexion looking youthful and radiant, follow a few simple steps.

  • Wear sunscreen every day:
    We cannot stress the harm sun poses to your delicate skin enough. It’s imperative that you wear a broad-spectrum SPF sunscreen. Every. Single. Day. It doesn’t matter how long you plan on being outside; its harmful rays can do their damage in a matter of minutes. Remember that the majority of UV rays are able to penetrate clouds, so wear your SPF regardless of temperature and weather conditions. Furthermore, UVA rays have the capability to penetrate glass and affect you while indoors, meaning sunscreen should be a part of your daily skin care routine— especially if you’re concerned about what causes face wrinkles.

  • Keep your skin hydrated:
    To counteract the loss of moisture associated with intrinsic aging, be sure to pick up a high-quality moisturizer. Dry skin is among leading wrinkles causes; it doesn’t matter if you’re dry due to sun damage, low humidity, or even too much coffee. Wrinkles display themselves more easily when the skin is dry and brittle, so keep your complexion soft, supple, and strong with a daily moisturizer and makeup for dry skin.

  • Drink more water:
    It’s equally important to hydrate yourself from the inside by drinking at least 8 cups of water per day. Our bodies are composed mostly of water, and keeping it abundantly supplied with H2O has multifarious health benefits. Drinking more water is one of the best tips for a youthful complexion, and because it flushes out so many toxins and free radicals, it’s one of the best means to avoid what causes facial wrinkles.

  • Get plenty of sleep:
    When your body rests, the body increases blood flow to the skin, helping assist in the regeneration of skin cells. Get plenty of beauty rest every night, and never fall asleep without taking your makeup off. While we’re at it, try to sleep on your back to make sure those sleep lines don’t become permanently etched into your face and cause wrinkles.

Now that you know what causes wrinkles, you’re better able to prevent their arrival. Set yourself up for success and do your best to proactively fight the causes of wrinkles. Trying to correct damage from years of smoking and extensive sun exposure is a much more difficult path to follow; begin implementing these tips today to make sure your face is free of fine lines.

5 Myths and Facts About Your Sagging Face

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Let’s face it: Sagging’s only cute if you’re a Shar Pei. For most of us, our jangly jowls and hanging cheeks are a source of chagrin as we age. Here, five myths and facts about facial sagging, plus ways to stop the droop:

Running causes your face to sag

FALSE. Sagging skin is due to two age-related reasons: loss of collagen, which gives skin its elasticity, and loss of facial fat, the absence of which causes skin to droop. While your whole body bounces up and down while you’re jogging, it’s highly unlikely that you’re jostling around enough to damage collagen, points out Las Vegas-based plastic surgeon Michael Edwards, MD, president of the American Society for Aesthetic Plastic Surgery.

A more likely cause? Long hours exercising outdoors equals more UV exposure, which over time breaks collagen down. Make sure you slather up with plenty of sunscreen before venturing outside, even in colder weather.

RELATED: The Best Over-the-Counter Retinol Creams, According to Dermatologists

Sleeping on your stomach causes sagging

FALSE. Your sleep position won’t actually cause sagging, but it can lead to sleep wrinkles: those creases and fine lines you see each AM in your bathroom mirror. They’re caused by your pillow tugging at delicate facial skin as you sleep. When you’re younger, it’s not an issue, as fresh, elastic skin bounces back easily, but as you age, skin becomes less resilient and can settle into these lines. Your best way to avoid this is to sleep on your back, says Dr. Edwards.

But if you’re a die hard tummy sleeper or flip flop through the night (some studies have found sleepers switch positions 11 times a night on average) you can try the Night Pillow ($150; This specially formulated pillow helps minimize wrinkles while you sleep thanks to its gentle fabric.

RELATED: Sleep on This: Our Top Pillow Picks

You can do facial exercises to reduce skin sagging

TRUE. But with a catch. They increase the size of facial muscles, which, while theoretically taking away some of the slacking skin, also causes expression lines, points out Dr. Edwards. So while a few workout moves might help relieve basset hound-like eyes, they’ll probably also worsen crow’s feet. If you’re not opposed to getting some help from a dermatologist or plastic surgeon, you may get better results from Botox.

RELATED: 7 Genius Ways to Prevent Wrinkles While You Sleep

Weight loss causes skin sagging

TRUE. When you gain weight, the skin on your face stretches to go along with your extra padding, just like it does everywhere else. But if you’ve finally lost it, you may notice that you’re sporting under eye bags and a slack jaw. As you age and your skin loses elasticity, when you stretch it out it won’t bounce back the same way it did when you were younger, explains Dr. Edwards. But don’t despair: products like Retin-A can help, as can injectable fillers such as Voluma.

There are products that may help fight sagging skin

TRUE. You can slow down the sag from the outside in: Try topical products like over-the-counter retinols (our pick: Roc Retinol Correxion Deep Wrinkle Night Cream) or prescription retinoids, which boost collagen production, and vitamin C serums (we love Sunday Riley C.E.O. Rapid Flash Brightening Serum), which help restore elasticity, advises Dr. Edwards. In one study, a daily supplement of pycnogenol, a French pine bark extract, increased skin elasticity and hydration and increased production of hyaluronic acid, a skin plumping ingredient, by 44%, according to a 2012 German study (which was funded by the maker of the raw material used in the supplements).

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9 Ways You Could Be Giving Yourself Wrinkles Without Even Knowing It

Aging is absolutely beautiful, and a natural part of life. However, you may not want to have wrinkles before you have to. Wrinkles are a sign that the skin is losing it’s elasticity, which is only natural. However, there are a few things that can speed up this process. Whether it’s too much time in the sun, or even your own diet, there are several sneaky ways that wrinkles can creep upon your skin. Don’t worry, though; there are many ways that you can combat premature wrinkles. You just have to know the causes in order to prevent them.

Wrinkles happen to everyone (well, maybe not Cindy Crawford). It’s a part of life, and one you should certainly embrace. However, there are many things you can do while you are young in order to avoid unnecessary aging and improve the overall health of your skin. Preventing wrinkles isn’t about looking young, but instead, keeping your skin as healthy as possible. Besides leading a healthy lifestyle, there are several tricks that can keep your skin looking smooth and radiant. It’s a completely easy way to look your best for as long as possible. Wondering how you can keep wrinkles at bay? Here are a few sneaky things that can cause premature wrinkles on your skin.

1. Eating Sugary Treats

The old saying, “You are what you eat” couldn’t be more true in this particular case. Eating super sugary food and foods with high glycemic index can actually make you look older. Sugar molecules can attach to proteins in the skin, and can cause them to become deformed. Think skin that sags, and, of course wrinkles.

2. Chewing Gum

Think about it. Constantly chewing gum can stretch, and deform your facial muscles. In the name of saving your skin, choose to freshen your breath with mints instead.

3. Puling On Your Skin To Apply Makeup


Whether it’s lining your waterline or pulling up on your brows to apply mascara, this stretching of the skin can cause wrinkles down the line. Move your face in different directions in order to apply your makeup. Keep your hands off of your face as much as possible.

4. Your Pillowcase

Satin and silk are always a lady’s best friend. Cotton can tug on the skin, which causes wrinkles. Satin and silk are more fluid, and can cause less resistance.

5. Not Eating Dark Chocolate

This is your excuse to eat more chocolate! Dark chocolate can positively effect the skin’s hydration as well as improve circulation. Basically, you can eat your way to smoother skin!

6. Your Sleep Position

Sleeping with your face on your pillow case can cause sleep lines. These are the lines of demarcation you see on your face after a long night of sleep. Avoid these by trying to sleep on your back. This will cause less resistance and tugging on your face overtime.

7. Not Wearing You Glasses

Whether it’s not wearing your prescription glasses or your sunglasses, this can cause wrinkles. Think about it. Squinting can cause wrinkles between your eyebrows, and in the corners of your eyes. Prevent this by protecting your eyes, and wearing your glasses.

8. Washing Your Face Too Much

Over-washing your face can strip your skinof important hydrating oils. This type of dryness can cause wrinkles on your face. Make sure to cleanse your skin twice a day in order to avoid these types of wrinkles.

9. Constantly Wearing Falsies

False eyelashes weigh down your eyelids. Over time this can cause your lids to sag, and wrinkle prematurely. Wear for falsies for special occasions only in order to keep your eyes looking their youngest.

Images: Pexels (1); (5); Getty Images (1); die_eine_frau; graceemonroe; freya_austin/ Instagram

does crying cause wrinkles?

Hello, I may be late for this question but I just wanted to share my experience for the future readers.

I went through a very hard time. By then I hadn’t have any wrinkles under my eyes, not even single break out on my face. I was very happy and eating healthy. I was only 23 then. Unfortunately, I lost a very close love one and so the sad days started for me. Every day, all day long I cried, it lasted for hours. It wasn’t something for 30 min, or an hour, or even a week; it was like endless, and it went on and on. Only time I didn’t cry was when I was sleeping. It felt like my heart was burning. I wanted to put my hands inside my chest and take it out, just to stop the pain. I wanted to close my eyes and die. Pain was unbearable. It lasted for 6 months. My eyes started twitching uncontrollably. My vision went very bad, I started seeing everything blurry, even with my glasses on. My skin under the eyes became very red, like I got punched on the face. It was burning so bad. I hardly washed my face, it hurt so much. I had days without eating, all I wanted was to sleep. I think that my body got into recovery mode then, and wanted to sleep all the time. I was 150lb, and became 90lb in a month. Then I started drinking ensure or boost so that my stomach wouldn’t eat itself. I had pain all over my body. After that, I started having lots of wrinkles under my eyes.

I think, crying itself is not the problem; but when you cry for a long time, the tears (salty water) burns your skin. The area becomes thinner. We also use tishue to dry our tears, so this also causes problems as the skin is already very sensitive. As far as I know, rubbing eyes causes wrinkles too. When we cry we do all kind of things to our eyes. So all of these together finally causes wrinkles. Don’t forget about the depression either. I had a lot of break out on my face. My body started having allergic reactions to some certain type of foods. That’s the extra results.

After, I went through all of these problems, I mean after I survived through this stage, I was reborn from my ashes. I hit the ground, but with God’s help, I bounced back. So I started living from the beginning. I started eating healthy again and trying to gain some weight. Then I started looking for ways to get rid of all the problems that I had during that sad time. Believe me, reversing time is not easy, I mean gaining all your health back; almost impossible. It is like a glass, once it is broken, it is broken. You can glue the pieces together but you still see the marks. You have to find rational answers to your problems, of course if technology allows you. I was lucky, it took a very long time but I have already started seeing some results. I am 27 now, and I am still having treatments. I got rid of all my break outs, although I still have the allergic reactions to some food and products. I gained some weight, I try to eat but it is habit, I forget sometimes. I take vitamins. I also got rid of some of my wrinkles. Any how, I hope that no one will go through what I went through. Finally, I think the answer is yes; although it is not directly, some how crying causes wrinkles.

Thank you for taking time to read my answer. Hope it helps.

Kind regards…

9 Causes of Wrinkles—That Have Nothing to Do With Aging

People usually associate crow’s feet and laugh lines with getting older. After all, as your skin ages, it loses elasticity and can start to show wrinkles and fine lines.

But these physical signs of aging sometimes have nothing to do with aging at all. Other lifestyle and environmental factors can take a toll on your physical appearance, including a poor diet, lack of sleep, and chronic stress. It’s not just your imagination; those wrinkles in the mirror could have more to do with your daily habits than you think. To turn back the clock, be sure to address these major causes of wrinkles, and avoid the foods that age you 20 years.


The Sun

It should come as no surprise that the biggest culprit for wrinkles is exposure to the sun. Both UVA rays, which penetrate the skin’s deepest layers, and UVB rays, which cause sunburn, can lead to premature aging and wrinkles. Not only does staying out of the sun (and out of tanning beds!) protect you from skin cancer, but it will also keep you looking young.

“The first and most common type is from chronic sun damage,” Jerome Potozkin, MD, board-certified dermatologist, says. “Sun damage results in loss of collagen and elastin resulting in wrinkling of the skin.” To protect your skin, be sure to wear at least an SPF 30 daily. When going out in the sun, especially if you’ll be exposed to water, be sure to reapply your sunblock often and load up on these foods to prevent sunburn.



You may not think much about the environment that you live in, but it can play a major impact on those deep wrinkles and fine lines. “Pollution is another environmental factor- contributing to free radical damage,” explains Maral K. Skelsey, MD, board-certified dermatologist and Director of the Dermatologic Surgery Center of Washington.

In fact, a 2010 study published in the Journal of Investigative Dermatology found that women who lived in urban settings had more wrinkles and age spots than those living in rural areas over a 24-year period. If you live in a heavily populated city, be sure to wash your face at night before bed to remove the pollution particles.


Lack of Sleep

You know getting enough sleep is essential to help you feel your best and can even help you lose weight. But did you know it can also help your skin stay smooth? “Lack of sleep contributes because the pH of the skin is altered by not sleeping enough and that skin cells’ ability to remain hydrated,” Skelsey explains. “Additionally, it’s during sleep that toxins are flushed from the body.” Be sure to get the recommended 6-8 hours a night for maximum health benefits; it’s called beauty sleep for a reason.



A busy work schedule or personal drama not only takes a toll on your mental and emotional well-being; it can affect you physically, too. “Stress increases cortisol levels which will reduce the skin’s ability to hold moisture,” Skelsey says. “Additionally elevated blood sugar damages the collagen and elastin fibers in the skin. These are the critical support structures that keep skin from sagging and developing wrinkles.” Try to find ways to de-stress, whether that’s going for walks after dinner, hanging out with friends, or seeing a therapist.



You already know that sugar causes weight gain, especially in your belly; it’s why readers have found so much success with the Zero Sugar Diet after eliminating it. But there’s another reason to put down the sweets and the soda—they age your skin.

“Eating too much sugar will surely lead to premature aging. After sugar is ingested it goes through a process called glycation, which involves binding to different proteins in our bodies,” Kristina Goldenberg, MD, board-certified dermatologist of Goldenberg Dermatology, explains. “Unfortunately, these proteins include collagen and elastin. By binding to these building blocks of the skin, sugar weakens collagen and elastin and will lead to an appearance of fine lines and wrinkles. Glycation also produces toxic products that further cause premature aging.”

For maximum health and beauty benefits, try cutting out sugar for two weeks. You’ll have more energy, lose weight, and start to turn back the clock on fine lines and wrinkles.



If you’ve been wearing the same old pair of glasses for years and are desperately in need of a new prescription, you’re not just hurting your eyes. “Squinting and other facial expressions are the result of muscle contraction. The more the muscles are used, the stronger they become,” Goldenberg explains. “These muscle movements cause skin cells to be squeezed and wrinkles to form. Excessive squinting will, therefore, lead to deeper wrinkles and loss of skin elasticity.” Visit your optometrist to get a proper prescription ASAP, and wear sunglasses whenever you’re in the sun.


Drinking Out of a Straw

Sure, drinking darker liquids such as iced tea and cold brew out of a straw can protect your teeth from being stained, but it can also cause wrinkles to develop around your mouth. Similar to how squinting causes wrinkles around the eyes, drinking out of a straw creates fine lines on and around your lips. “Drinking out of a straw involves muscle contraction around the lips. If this is done repeatedly, the muscles will become stronger and wrinkles will become deeper and more apparent,” Goldenberg explains.


Dry Skin

Dry skin isn’t just uncomfortable; it can add years onto your life. “Skin that is chronically dry is also more susceptible to wrinkles,” Skelsey explains. “A dry environment can result in the skin losing some of its ‘scaffolding’ and succumbing to wrinkles.”

Make sure you moisturize day and night, especially on your face. Investing in a nourishing under-eye cream is also a good idea since the skin underneath the eyes is thinner and more susceptible to fine lines.



This should come as no surprise: after the sun, smoking is one of the biggest culprits for wrinkles. Not only does the position of a cigarette in your mouth lead to fine lines, but the toxins from the cigarette itself can age your skin.

“Nicotine in cigarettes causes narrowing of the blood vessels in the skin, which leaves it more prone to wrinkling because vital nutrients cannot reach the epidermis,” Skelsey explains. Plus, smoking is linked to lung cancer and cardiovascular disease. You’ve probably heard this before, but it bears repeating: quit smoking ASAP!

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4 Different Types of Wrinkles and My Tips for Treating Them

Crow’s feet. Laugh lines. Creases.

No matter what you call them, we all know them as one thing.


And, unless you’ve discovered some rip in time, we’re all going to experience wrinkles at some point in our lives.

It’s a natural part of aging.

In fact, it’s one of the defining attributes of aging! But what causes wrinkles?

A survey of 2,000 women by Superdrug, a beauty and health retailer, found that women start worrying about signs of aging on average at the tender age of 29, with wrinkles and sagging being the top two concerns.

According to a study by Allergan, most of us ladies are noticing the appearance of fine lines.

Did you know that not all wrinkles are created equal?

It was traditionally believed that wrinkles fell into just two categories:

Dynamic Wrinkles – Those lines that result from repeated facial movements (such as smiling) that form creases in the skin.

Static Wrinkles – The lines that occur from your skin losing elasticity and collagen and that eventually sag.

However, in a study published by the International Journal of Cosmetic Science (2006), researchers at the University Hospital of Liege, Belgium actually identified four different categories of wrinkles!

Each type of wrinkle has their own internal and external causes, which I’ll elaborate on.

Today, I’m going to give you a breakdown of different types of wrinkles, what causes wrinkles and my best tips to treat them so you can have healthy, youthful skin for years to come!

4 Different Types of Wrinkles and What Causes Them

These wrinkles are those little parallel lines that disappear when your skin is stretched taut.

They can occur on your face, or anywhere on your body (think of those little wrinkles you may have on your chest.)

What Causes Them

These lines are a result of a loss of collagen and elasticity which leads to skin sagging.

The main culprit?

Sun damage.

UV exposure unleashes free radicals in our skin that break down collagen and elastin, the building blocks that give our skin firmness and structure.

Make sure you wear daily SPF sun protection, especially on your face, neck, and chest (as well as other exposed areas)!

2. Permanent Elastic Creases

These are crease lines that end up becoming permanent wrinkles as we age.

These little guys tend to show up on our cheeks, upper lip, and the base of our necks.

What Causes Them

As with the last type, repeated sun exposure can make these lines worse.

Smoking is also a big factor in deepening these creases, like those lines you get around your lips from repeatedly pursing your mouth.

But that’s not all.

Whenever you smoke, you expose the surface of your skin to all kinds of chemicals and carcinogens.

Plus, when you inhale, you inhibit your body’s ability to circulate oxygen to your skin, which it needs to heal and form healthy skin cells (one of the reasons smoking often results in a dull complexion).

Stop smoking already!

Your complexion and your body will thank you.

One stunning study looked at twins who aged differently as a result of different lifestyle habits.

In this example, Brenda (left) smokes ½ a pack per day and has had 7 times as much sun exposure as her twin counterpart, Barb (right), leaving her looking years older.

Dr. Bahman Guyuron, plastic surgeon at Cleveland’s Case Western Reserve University, notes that Brenda’s wrinkles around her mouth and under her eyes are telltale signs of a smoker.

3. Dynamic Expression Lines

These fun lines are the ones I mentioned up top that you get from repeated facial muscle movements that cause creases in the skin that become more permanent.

They usually show up around the mouth, eyes, and forehead.

What Causes Them

You get these lines from basically living your life and being a human being.

They’re like a collection of little moments from every time you’ve squinted on a sunny day, laughed at an inside joke, or frowned when a character gets killed off on your favorite show.

Unless you want to become a robot and stop expressing yourself, you’re gonna get these lines and creases on your face.

Wear those lines with pride! They’re badges of honor from the experiences of a life lived!

4. Gravitational Folds

These are those wrinkles that occur naturally with age as our skin loses structure and starts to fold and sag.

What Causes Them

As the name suggests, time + gravity = gravitational folds.

You can chalk this one up to good ol’ aging.

As we get older, our skin starts to lose collagen and elastin leading to wrinkling and sagging.

Researchers found that these lines are more apparent on a lean face with thinner skin and that a plumper face with thicker skin will show less of these types of folds.

What Can I Do About Wrinkles?

One of your best bets to guard against wrinkles is to prevent rather than treat.

Don’t wait until you start seeing little lines pop up to start using anti-aging products in your skincare.

Incorporate those youth-boosting formulas now to stop wrinkles before they start!

Let’s look at some of my top tips for skincare habits that will give you smooth, youthful skin.

Not today, wrinkles!


According to, 90% of visible skin aging is caused by sun exposure and subsequent damage.

When our skin is damaged by UV exposure, free radicals age skin by causing hyperpigmentation, compromising our skin’s texture, and breaking down collagen and elastin which leads to sagging and, yes, wrinkles.

All you have to do to avoid sun aging is make sure and wear daily SPF protection!

A study published by the Annals of Internal Medicine looked at the effects of using sunscreen on the reg.

And, this does mean every day!

Even on cloudy days. Even when you’re not lying out to get a tan.

You accumulate a lot of sun exposure from doing things like driving and walking outside, and that exposure adds up.

SPF Tips

  • Use a daily moisturizer that includes broad-spectrum UVA/UVB protection of at least SPF 30.
  • Apply SPF at least 15 minutes before heading outside to give it time to absorb into the skin.
  • Don’t forget your neck and chest. They benefit from skincare just as much as your face.
  • Don’t skimp! Slather on that goodness for optimal protection.
  • Reapply SPF every 1-2 hours if you’re outside for a while or sweating a lot. And, it’s always a good idea to rock a hat and sunglasses, and seek shade during peak UV hours (10:00 am – 4:00 pm).

Look for These Anti-Aging Ingredients

If you want to get some wrinkle-smoothing power out of your skincare, look for formulas that include these age-defying ingredients!


The vitamin A derivative, retinol, smooths skin by gently exfoliating to lift away dead skin cells and encourage new cell turnover.

This, in turn, also encourages collagen production to firm up skin and diminish fine lines.

Pro Tip: Retinol and retinoids can make skin sensitive to sunlight, so I always recommend using it in your PM skincare routine.

It also may cause some slight skin irritation and may take a bit of time for the skin to adjust.

Make sure to consult the directions which will likely recommend that you start by using it just a couple times a week.

Hyaluronic Acid

Fine lines and wrinkles are made more apparent when your skin is dry or dehydrated.

Hyaluronic acid is a mega moisture humectant, which means it grabs moisture and holds it to your skin’s surface to deliver hydration.

This moisture action also helps plump skin to fill out fine lines and restore suppleness to your complexion!


Remember when I mentioned that sun damage can cause free radicals to break down collagen?

Well, antioxidants are the superheroes that swoop in to defeat them.

Antioxidants work to stop free radical damage and support skin healing by encouraging cell repair and rebuilding collagen and elastin.

Believe me, you want these guys on your skincare team!


Peptides are chains of amino acids which make up the skin protein, collagen.

By helping your skin restore peptides, you’re rebuilding blocks of collagen to fortify skin and bring back its firmness.

Think of it as building a fortress to defend against wrinkles!

Eat Skin-Boosting Foods

Did you know you can help repair and nourish skin from the inside too?

Make your nosh sessions work for your complexion too by eating a balanced diet full of vitamins and antioxidant-rich yummy fruits and vegetables.

A 2007 study of women between the ages of 40-74 found that those who had a high intake of vitamin C (a natural antioxidant) had fewer wrinkles and less age-related dry skin.

Ensure you’re getting lots of nutritious whole foods so you can feed your skin!

Exercise, Sleep, Repeat

When we get stressed or overwhelmed, say when you remember that you signed up to make four dozen of your famous chocolate chip cookies for a bake sale TOMORROW, our bodies flood with cortisol.

When this happens regularly, cortisol can host an inflammation party in our bodies that breaks down collagen and elastin.

This is one of the reasons you feel like your complexion looks dull and tired when you’re super stressed.

Two great ways to neutralize cortisol are to get regular exercise and plenty of good sleep. (They don’t call it beauty rest for nothing!)

Shoot for at least 30 minutes of heart-pumping exercise 2-3 times a week and 6-8 hours of solid sleep per night.

Bonus: Exercise helps you sleep, and sleep helps you recover from exercise. It’s the ciiiirrrrccle of liiiiiiiffe!

My Top Picks to Say Goodbye to Wrinkles

Daily Vitamin C Moisturizer

Clayton Shagal Collagen Gel and Elastin Gel Set

Dermaquest Retinol Peptide Youth Serum

Epicuren Retinol Anti-Wrinkle Complex

Alana Mitchell Anti-Aging Peptide Eye Cream

Dermalogica Overnight Retinol Repair

Rhonda Allison Antioxidant Complex Serum

Image Skincare Prevention+ Tinted Moisturizer SPF 30

Final Thoughts

At some point, it’s likely that we’ll all have wrinkles. You can thank time and your genes for that!

However, you can choose to take steps to prevent and treat them, or you can leave them alone and wear them with pride as mementos of a life full of experiences.

No matter which you choose, as long as you have healthy skin, you can’t lose!

Wondering which wrinkle treatment is best for you? We’d love to help! Share your questions with us in the comments section.

Last updated by Alana Mitchell at January 17, 2019.

What Causes Wrinkles & Fine Lines?

Wrinkles and Fine Lines Explained

Wrinkles and fine lines on the face are one of the most visible signs of ageing. They’re caused by the breakdown of collagen and elastin in the skin – as we age, our bodies can’t produce enough collagen to replenish what has been lost, so the skin begins to lose its strength and elasticity over time.
Other factors can play into lines and wrinkles too. Smoking, for example, can speed up the skin’s ageing process, and sun exposure can put you on a fast track to increased wrinkles all over the face.

Why does my skin need collagen?

Collagen is a Greek word which means ‘glue-producing’. Though the collagen in our bodies isn’t exactly sticky, it does help tissues like the skin and tendons to hold together by forming a vast network of fibres. Collagen fibres strengthen the skin, while elastin helps the skin stretch and still return to its original shape.

As we age, the body loses its ability to produce collagen and elastin, causing skin to become less firm and lose its flexibility. This is when fine lines and wrinkles start to appear. While there’s no way to halt the ageing process entirely, there are products and treatments you can use to slow down the process and enjoy a more youthful appearance:

Use a good SPF

Exposure to UV rays can weaken collagen fibers further, with research showing that most wrinkles are caused or exacerbated by sun damage. Use a broad-spectrum sunscreen with a sun protection factor of at least 15 to shield your skin from UVA and UVB rays.

Get your vitamins and minerals

Vitamin E can help protect the skin against UVB damage, while retinol, a form of vitamin A, can reduce the visual effects of decreased collagen production. Minerals like copper and zinc can also improve the appearance of skin affected by decreases in elastin production, particularly around the eyes. Soy is also a very powerful antioxidant which can counteract collagen loss in the body.

Although fine lines and wrinkles are a totally natural part of the skin’s ageing process, you can determine how quickly or slowly they progress. By taking the right steps now, you can help your skin to remain healthy-looking and maintain a glowing, youthful appearance for longer.

We recommend that you consult your dermatologist or physician for proper diagnosis and treatment.



Ethnic patients have natural features that are unique, and what constitutes beauty is determined by racial, cultural, and environmental influences.20,21 The most significant difference between people of color and Caucasians is the amount of melanin in the skin.21

Melanin is the major determinant of color in the skin, and the concentration of epidermal melanin in melanosomes is double in darker skin types compared to lightly pigmented skin types.22 In addition, melanosome degradation within the keratinocyte is slower in darkly pigmented skin. Overall, darker skin has singly dispersed, large melanosomes that contain more melanin compared with the smaller, aggregated, less melanin containing melanosomes that occur in lighter persons (Table 1). The melanin content and melanosomal dispersion pattern is thought to confer protection from accelerated aging induced by ultraviolet (UV) radiation.19,23 In fact, Kaidbey et al19 demonstrated that black epidermis, on average, provided a SPF of 13.4. Although the increased melanin provides protection from many harmful effects of UV radiation, including photodamage and skin cancers, it also makes darkly pigmented skin more vulnerable to dyspigmentation. Therefore, inconsistent pigmentation with both hypopigmentation and hyperpigmentation is a sign of photoaging in people with skin of color.


Key characteristics in ethnic skin and the dermatologic implications

Increased tyrosinase activity leading to increased melanin content Greater photoprotection, lower incidence of skin cancer, less pronounced photoaging, dyschromias
Larger, nonaggregated melanosomes Greater photoprotection, lower incidence of skin cancer, less pronounced photoaging, dyschromias
Labile melanocytes and slower melanin degradation Dyschromias
Thick dermis Preserved skin elasticity, less pronounced photoaging
Larger, more numerous, multinucleated fibroblasts Preserved skin elasticity, greater prevalence of hypertrophic scarring and keloids

On a molecular level, there are multiple defined pigmentation genes, such as tyrosinase-related protein (TRP) family members, melanocyte-stimulating hormone (MSH), melanocyte-stimulating hormone receptor, and the melanocortin-l-receptor, that also contribute to ethnic differences in pigmentation.21 TRP1 has been shown to increase tyrosinase activity, melanin synthesis, and melanosome size.21 This increase in tyrosinase activity and melanin synthesis can explain differential responses to UV light. Also on a molecular level, MSH increases DNA repair proteins, which protects against sun-induced DNA damage.21,24

Another component of skin color is hemoglobin located at the dermal-epidermal junction in the papillary dermis. It is thought that skin color is due to the balance between hemoglobin and melanin with the redness associated with hemoglobin being concealed by melanin to different extents.2

Skin aging is also associated with progressive atrophy of the dermis and changes in the architectural organization leading to folds and wrinkles.25 Asian and black skin has thicker and more compact dermis than white skin, with the thickness being proportional to the degree of pigmentation.26 This likely contributes to the lower incidence of facial rhytides in Asians and blacks. In addition, darker skin types are thought to have more cornified cell layers and greater lipid content compared to white stratum corneum.27,28

The major cell type of the dermis is the fibroblast, which synthesizes the main structural elements of the dermis. Black skin has been found to have more numerous, larger, and more nucleated fibroblasts, smaller collagen fiber bundles, and more macrophages than white skin.29 Chronological aging reduces the life span of fibroblasts; their potential for division being lower in the elderly.25 Fibroblast functionality and reactivity likely contribute to both the aging phenomena and abnormal scarring.

Structural facial aging. Aging in regards to structural changes is caused by the volumetric loss of fat, bone resorption, and redistribution of soft tissue. Superficial and deep fat has an even distribution in younger faces; however, as the face ages, fat atrophy and hypertrophy cause irregular topographic contouring.21 With age, atrophy develops on the temples, cheeks, and lateral chin. These gradual, yet dramatic, changes cause narrowing and elongation of the forehead with widening and shortening of the lower face.30 There is also loss of lip volume and bone resorption of the mandible. Increased shadowing under the eyes and increased protrusion of the infraorbital fat pads also occur and contribute to an aged appearance. All of these underlying soft tissue changes contribute to the sagging appearance of overlying skin.31 These are general principles, and the aging process does have ethnocentric variability in regards to both facial structure and perceptions of beauty (Table 2). Anthropometry is the quantitative measurement and ratio of facial features to guide standards of attractiveness. A full discussion of anthropometry is beyond the scope of this article; however, a brief analysis of ethnic facial structure variation is provided (Figures 1 and ​and22).


Ethnic groups and highlighted key differences in facial structure

Caucasian face Narrower nasal base and larger tip projection, intercanthal widths identical to the African face, lips with less volume
East Asian face Weaker facial skeletal framework, wider and rounder face, higher eyebrows, fuller upper lid, lower nasal bridge with horizontally placed flared ala, flatter malar prominence and midface, more protuberant lips, and more receded chin
Latino/Hispanic face Increased bizygomatic distance, bimaxillary protrusion, broader nose, broad rounded face, and a more receded chin
African-American face Broad nasal base, decreased nasal projection, bimaxillary protrusion, orbital proptosis, increased soft tissue of the midface, prominent lips, and increased facial convexity

Women, all over 60 years of age, with characteristic features of facial aging, from left to right: Caucasian, East Asian, Latino/Hispanic, and African.

Features of facial aging in (A) Caucasian; (B) East Asian; (C) Latino/Hispanic; and (D) African American women.

The Caucasian face. Although the purpose of this article is to highlight aging in ethnic skin, the authors briefly discuss the key attributes of the Caucasian face as a point of reference. The term Caucasian is commonly used to refer to the combination of physical attributes of individuals of European, Northern African, and southwest Asian ancestry.32 This group comprises those of lightly pigmented skin, demonstrated by small, aggregated melanosomes along with reduced amounts of melanin. The decreased epidermal melanin component predisposes Caucasians to develop earlier signs of photoaging than other populations. European Americans with low constitutive pigmentation have considerably higher burn response and lower tanning ability compared with Hispanics and East Asians.33 In addition, Caucasian skin is exemplified by a thinner and less cohesive stratum corneum, reduced skin extensibility, along with loss of collagen and disorganization of the elastic fibers in the dermis with increasing age.15 These attributes result in clinically fragile skin and contribute to the aging process.

A large anthropometric study comparing different ethnic groups with North American Caucasians revealed that the most significant differences in facial proportions were in the orbital region, nasal heights, and nasal widths.34 Caucasian intercanthal widths were identical to the African ethnic group, in contrast with the Middle Eastern and Asian groups that showed greater intercanthal widths with smaller eye opening. A narrower nasal base and larger tip projection was noted in Caucasians compared to Asians and African Americans.34

The Caucasian aged face has somewhat specific features and is typified by fine perioral and periorbital rhytides, skin sagging, and jowling of the neck with effacement of the cervicomental angle secondary to skin laxity.35 On the upper face, the aging process presents as fine and deep rhytides in the forehead and glabella. In general, aging of the midfacial region occurs as the result of laxity of the upper and lower eyelids, pseudoherniation of the orbital fat pads, increased redundancy of soft tissue, and descent of the melolabial fat pad toward the nasolabial fold.36 Bone remodeling of the superomedial and inferolateral orbital rims likely also contributes to brow ptosis and formation of crow’s feet and lower lid lag, respectively.37 The end result of these many changes is dermatochalasis or excessive skin of the upper lid, lengthening of the lower lid, prominence of the nasolabial folds, and a double convexity of the midface.36 On the lower face and neck, the Caucasian face demonstrates sagging and jowling due to skin laxity, resulting in blurring of the cervicomental angle.30,37 Decreased lip volume and perioral lip lines are also more pronounced in Caucasian skin, likely due to a combination of muscle action and the deleterious effects of UV exposure on lighter skin.

The Asian face. The Asian population is quite diverse. Literature is limited and has typically focused on a particular ethnicity or a small number of outcomes in several Asian populations, mostly from East Asia. Although literature is limited and without a full, thorough comparison, there are many differences that have been noted. East Asians typically have less wide mouths, elongated intercanthal width, and wider lower nasal margins.38 Studies suggest that Asians have a weaker facial skeletal framework, which results in greater gravitational soft-tissue descent of the mid-face, malar fat pad ptosis, and tear trough formation. It has also been proposed that the facial structure of Asians is similar to that of an infant, including a wider and rounder face, higher eyebrow, fuller upper lid, lower nasal bridge with horizontally placed flared ala, flatter malar prominence and midface, fuller and more protuberant lips, and more receded chin.39,40

Despite the large South East Asian population, limited studies have been conducted assessing facial structure. Overall, there is tremendous variability over such a large geographic area and diverse population. Despite this, it is generally accepted that those from the Indian subcontinent share more Caucasoid than Mongoloid anatomical traits of the skull and face. Compared to East Asians, South Asians typically possess eyelids that are on a more highly exposed platform, have well-developed nasal bridge with tip projection, and have comparatively darker and more uneven skin tones. Also, South Asians tend to have fuller lips and higher cheek bones with more buccal fat, often giving the lower cheek a more rounded contour. These features often provide physical support for the aging face more so than other Asian ethnicities.

Galzote et al41 evaluated facial skin of various Asian populations (from China, India, South Korea, Japan, and the Philippines) in different age groups. In regards to particular groups, they found that subjects from Japan generally had greater skin surface moisture across all age groups, while subjects from China had the highest average levels of transepidermal water loss (TEWL), indicating poorer stratum corneum barrier function.41 Across all Asian populations, skin surface moisture and TEWL generally decreased with increasing age (except for teenagers) with skin of subjects from the Philippines and India having the least variation with age.41 Those from Seoul, South Korea, and Calicut, India, had the highest sebum readings. Sebum content decreased with age, with the exception of subjects in the 25- to 40-year age group.41 With increasing female age, hormones such as estrogen lead to less sebum production by the sebaceous glands and reduced stratum corneum barrier function resulting in drier skin.41-43 In regards to skin color, they found that subjects from Calicut, India, had the darkest skin while those from Sendai, Japan had the lightest, with correlations of both melanin and erythema indices suggesting that skin color may be a reflection of both the melanin content and hemoglobin level in the skin, both higher in those with darker skin tones.41 Interestingly, with age, the melanin index increased, while the erythema index stayed the same in all Asian populations studied.41

The Latino or Hispanic face. Akin to Asians, there is a wide variety of skin types and ethnicities comprising the term “Latinos” and/or “Hispanics.” The diversity of skin type plays a large role in skin response and facial structure differences. This group also has increased melanization, which provides enhanced protection against photoaging; however, they do develop skin mottling, jowl formation, infraorbital hollowness, and shadowing.21,44 Central and South American women often have similar anthropometric measurements to Caucasian women, while Caribbean women measurements are often more similar to African American women.45,46 Those persons of Mexican descent often exhibit a broad face with prominent malar eminence and broad nose with widened alar base, short columella, horizontally oriented nostrils, and thick nasal skin.47,48 Overall, persons of Hispanic descent have increased bizygomatic distance, bimaxillary protrusion, broader nose, abbreviated nasal length, broad rounded face, and a recessed chin.21,49 They tend to have more sebaceous skin than Caucasian women and typically have rounder faces, with heavy eyelids and prominent midface area.35,50 Similar to African American facial aging, the midcheek area becomes thicker and heavier with fat pad accumulation and more prominent nasolabial folds, which is combined with eyebrow and eyelid drooping and lower lid fat herniation.35

The African American face. The term African American encompasses multiple ethnicities and represents persons with a mixture of African, Caucasian, Afro-Caribbean, and Native American descent.36 Generalizations on a global scale are often quite hard to make for this group as all these lineages will display unique facial structures and qualities. There are, however, some key features that do distinguish those of African ancestry from other racial groups. Those of African descent have more non-aggregated melanosomes that are more widely dispersed and carry more melanin. In addition to differences in pigmentation, the epidermis contains a thicker stratum corneum with more active fibroblasts when compared to Caucasian skin.36 The increased fibroblast activity leads to collagen bundles that are compact and in a more parallel orientation, creating skin that maintains its structural integrity and youthful appearance longer than those of lighter skin types.23,36

Given the increased melanization of richly pigmented African American skin, this population does not develop as much UV-induced photoaging as those with lightly pigmented skin. However, these persons can exhibit pronounced sagging of the malar fat pads, soft-tissue laxity, and jowl formation of the mid-face.21 African Americans typically have a broad nasal base, decreased nasal projection, bimaxillary protrusion, orbital proptosis, increased soft tissue of the midface, prominent lips, and increased facial convexity.21,49 Of note, there is interethnic variability, with studies revealing two types of African American nasal structure, one with a high dorsum and one with a low dorsum.51

The unique skeletal morphology leads those of African descent to show facial aging in the periorbital region and midface more prominently than the upper face and brow.36 It has been suggested that brow ptosis occurs to a lesser degree in those of African descent.52 The upper eyelids in African Americans are prone to soft tissue fullness, which is related to the position of the upper lid crease, being 6 to 8mm from the lid margin compared with 8 to 10mm in Caucasians.36,53 The relative ocular proptosis predisposes to infraorbital shadowing, which can contribute to the appearance of aging. In addition, opposed to the Caucasian face, which has a malar eminence that is in alignment with the corneal surface, the African face exhibits malar hypoplasia, created by a negative corneal surface. Soft-tissue jowling is also a sign of aging; however, as opposed to the laxity and descent of Caucasian skin, it is the thickness and weight of African skin that contribute to jowling.36,53 Accumulation of submental fat and protuberant thick skin on the neck soften the cervicomental angle.35 Lip aging occurs less so in African Americans as these persons have a decreased propensity to lose lip volume and form perioral rhytides.36

“If you had a pill that could stop biological aging in its tracks, when would you take it?” asks Dr. Olshansky, a professor at UIC School of Public Health in Chicago.

He asks his university students this question. Many think 30 is old, so they would take the pill in their 20s. He asked his father, then 95 years old. His father said 50 was the best year because the kids were grown and he was in good health. Dr. Olshanky, 63, says life is good for him now, but if he had to pick a perfect year, it would probably be 50, too, because that was before he started having little aches and pains.

Illustration: Jon Krause

Researchers like Dr. Olshansky are trying to understand the mysteries of longevity and at what ages we feel our best and why. They measure worry and stress levels at different times in our life and peak years for having fun, the hope being that if people reach satisfaction with life at a certain age, they might have advice for the rest of us. Such exploration in the world of science and health is putting a more concrete focus on the seemingly inscrutable question of the perfect age.

Some of their findings might surprise us. Many people in their 50s don’t want to be 30. Seventy-year-olds are among the most satisfied, perhaps because they are also among the group seen as “time affluent.” Less surprising is that no one, regardless of age, wants to look or feel old, which is why anti-aging creams that promise to remove wrinkles and eye bags sell so well.

But is there an age that is better than all the rest?

No, says Laura Carstensen, director of the Stanford Center on Longevity. “There are too many variables,” she says. For some people, the perfect age is when our opportunities are greatest, which would skew younger. For others, it’s when life satisfaction is greatest, which skews older. Others say it’s when they are at their physical peak or have the most friends—in their 20s or 30s.

It’s easier, though also not without pitfalls, to determine the best age for specific things like getting married, for instance, because researchers can look at evidence such as divorce rates. One study says the best age to wed is between 28 and 32. If you want to have children, it’s best to start before the age of 32, according to fertility data from the American College of Obstetricians and Gynecologists. Apparently, 36 is the age that women want to look, based on the photos they bring in, says New York City-based dermatologist Gervaise Gerstner. The optimum age for marathon performance is 27 for men and 29 for women, according to a study by Spanish researchers Plataforma SINC on

The Numbers Game

Looking for the best age to get married, have a child or make a big financial decision? So are a lot of researchers and here’s a sampling of findings.

Getting Married: 28-32

Waiting to wed reduces the odds of divorce—by 11% a year—but waiting too long increases the odds by 5% annually, says Nicholas Wolfinger, a sociologist at the University of Utah, who looked at divorce rates in a 2015 study Those who wait longer may be “congenitally cantankerous” people who put off marriage because they can’t find anyone to marry them, he says.

Having Children: before 32

That’s the age when fertility starts to drop off, according to the American College of Obstetricians and Gynecologists. The decline becomes precipitous after 37.

Making financial decisions: peak around 50

To measure financial literacy, researchers at Texas Tech University in a study published in 2016 asked 16 questions about borrowing, investing and insurance. They found the average scores increased within each year up to roughly age 50. After 60, financial literacy begins to fall.

Getting a cell phone: 12

It’s a hot topic that is getting increasing scrutiny. One 2016 survey by American Express found parents judged the average acceptable age for a cell phone was 12, consistent with findings the previous three years.

Mastering Vocabulary:
late 60s, early 70s

Neuroscientists at MIT and Massachusetts General Hospital gathered data from nearly 50,000 subjects and found that this age group is tops at mastering vocabulary—all those years of reading paying off.

Processing Information: 18-19

The MIT/Massachusetts General Hospital study cited for mastering vocabulary also found younger people, while not the top wordsmiths, superior at raw speed in processing information.

Bodybuilding: 25

Physical strength peaks at around 25 years of age, about when muscle mass peaks, too, according to an article on the website Strength plateaus from 35-40, then falls, with a 25% loss of peak force by the age of 65.

The perfect age at which to live is trickier. A 2013 survey by Allure magazine put it at 31, based on responses from 2,000 people, men and women ages 18 to 69, across the U.S. (More recently, Allure decided to stop using the term “anti-aging” in its coverage.) If people could live forever in good health at a particular age, it would be 50, according to a 2013 Harris Poll. Gender and geography play a role: In the poll, men said the perfect age is 47, and women 53. In the Midwest, the perfect age is 50. In the East, it’s 53 and the West it’s 47.

Even the perfect age can age. Blair Welch, a 27-year-old certified public accountant in Washington, D.C., says each year gets better, in part because it’s taking her further away from the unsettling early 20s. “I think your 20s are a very confusing and insecure time,” she says.

Many people say it’s not a number but a certain feeling or stage of life. When the children were little, say some. When the children were gone, say others.

Joe Cimperman, president of Global Cleveland, a non-profit economic development group, says the perfect age is the “exact time that you realize how absolutely short life is” and “how completely lucky you are.” He realized that this year at the age of 47 after two dear friends died, one a father of seven who died in a car accident and the other, a mentor, who died from cancer.

Jennifer Barker of Pittsburgh, who has four children, turned 40 in September and thinks that is perfect. “You are old enough to realize what is important,” she says, and young enough to look forward to future years and discoveries. At the same time, her 20-month-old is full of curiosity and joy and seems at a perfect age, and her grandfather seemed the perfect age at 85 when he was in good health and told inspiring stories. “So the perfect age?” I don’t believe there is one,” she says. “For me, my perfect age is my age now.”

Seventy is good when it comes to psychological well-being and life satisfaction, according to Arthur Stone, a professor of psychology at the University of Southern California. In a 2015 study, Dr. Stone, along with researchers from Stony Brook University, Princeton University and University College London, found that worry follows us from ages 20 to 50. That is likely due to the expected anxieties during those years about money, job, and children.

Those worries, along with stress, begin to diminish starting at about age 50, and well-being climbs to about age 70, when people are less anxious but still healthy, he says. “People settle into who they are and accept and make the best of it,” he says.

Dr. Stone says he often asks people in their late 50s and 60s if they would prefer to be in their 30s. Except for one person, a radio talk-show host, no one wanted to be younger again. “That was fascinating to me,” he says. “People didn’t want it. There was too much confusion and stuff going on.”

What You Think

We asked readers to share their own opinions on this question. Here is a selection of responses sent to us via email or left as comments on our website.

Ken Dychtwald, founder and CEO of Age Wave, a California-based consulting firm specializing in aging-related issues, says he would love to have his body “in my 30s for 100 years but I don’t want to be 30 again.” At 30, he had not yet fallen in love, had his children, or established his career. Nor did he have as much self-knowledge, resilience or compassion. “I’m so much wiser at 60 than I was at 40,” says the 63-year-old.

He’s also enjoying himself. People at 65 to 74, the so-called time affluent, reported having more fun than any other age group, according to a 2016 study of 3,712 adults 25 and older released by Age Wave and Merrill Lynch.

The ones having the least fun were those ages 35 to 54.

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Write to Clare Ansberry at [email protected]

Do some races generally age better than others?

First of all there is only one human race.

I have known a friend of mine who is “interested” right now for 15 years and today shocked to find that he is still in his 40s when he looks as if he is in his mid to late 50s. He is white skinned of Scottish descent and I am brown skinned of West African decent and I could pass for mid 30s although I am in my early 50s.

I worked in a bar when I was in my late teens. I left that job and when I returned for a drink there, bar staff did not serve me before consulting with the manager to ascertain that I was age appropriate. Also in discussions when I state my opinion of things, people assumed I was being arrogant because they thought I was much, much younger then them…After a while they kind of get shocked by my wisdom and work out that somehow I must be older than they thought.

It is genetic inheritance, melanin, collagen, because my mum did not have wrinkles or cellulite. It is also an energetic thing. Some people’s just do not have ‘ageing’ energy. I can’t explain it…. Unless you are like us then it’s hard to explain. Just to say that it is much, much, much deeper than just the physical.

Believe it or not, I have gone through my paper work to check that I am the age that I am because often I am quite shocked to meet people my age because I know I don’t look like or feel anything like my peers. I am not petite. I am 5′7″ and medium build.

What ages your skin?

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