Wrinkles

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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Wrinkles Overview and Causes
• When to Seek Medical Care for Wrinkles
• Treatment for Wrinkles
• Collagen for Wrinkles
• Home Remedies for Wrinkles
• Surgery for Wrinkles
• Wrinkles Prevention

Wrinkles are normally found in healthy skin. Even newborn babies have wrinkles in the areas of the joints where flexion and contraction tend to occur in the womb. In the elderly, the skin in sun-protected areas is likely to have normal wrinkles that have deepened over time. Wrinkles do not resolve spontaneously except under very unusual circumstances, such as infiltration of abnormal cells or other substances into the skin as part of a systemic disease process.

Wrinkles also tend to occur in areas of muscle contraction. For example, the frontalis, corrugator, and orbicularis oculi muscles of the upper face are intimately connected to the superficial fascia and characteristically produce permanent horizontal furrows on the forehead and vertical skin wrinkles between and around the eyes. This type of wrinkling has been labeled intrinsic aging.

Extrinsic aging is associated with the exposure to environmental factors such as ultraviolet radiation and firsthand cigarette smoke. This type of wrinkling is confined to sun-exposed areas and appears as diffuse fine, shallow wrinkling. Microscopic examination of the skin involved in extrinsic aging shows tinctorial (stained) and structural changes in the normal collagen called elastotic degeneration (degenerative change in the elastic tissue). The predisposition to this sort of change is in some way related to genetic predisposition. Certain ethnic groups, the Scottish, Irish, and English people, for example, seem to be much more susceptible than those darkly pigmented ethnic groups.

There is a special type of wrinkling popularly known as "cellulite." This is most common in women but may also be present in some men. Cellulite is often associated with obesity. It typically appears in the hips or buttocks. Affected skin appears to have an "orange peel" appearance. Cellulite is related to fat tissue deposited in the lower deep layer of the skin (dermis).

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