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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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There is very little that can be done to affect intrinsic wrinkling other than attempting to limit normal muscular movement, a suggestion that is obviously ludicrous. One has to accept one's genetic inheritance.

On the other hand, extrinsic aging can be controlled to a great extent by limiting exposure to ultraviolet light and by not smoking. When the skin darkens in response to exposure to light, this is a sign that damage has occurred to the collagen in the deeper layers of the skin. This damage is cumulative so it is never too late to change one's behavior. The major wavelengths of light responsible for this damage are in the ultraviolet range and have been labeled "A" and "B." Sunlight is the major source of this type of radiation, but tanning parlors have light bulbs that produce wavelengths in this range. Ultimately, there is no such thing as a safe tan! Sunlight avoidance by wearing appropriate clothing, staying in the shade, and wearing a durable, effective sunscreen over exposed areas is a good strategy. Any health benefit produced by the synthesis of vitamin D by skin is overshadowed by the negative aspects of ultraviolet light exposure. Vitamin D requirements can be satisfied by taking almost any commercially available multivitamin (1,000 IU/day). Since the longer wavelengths of ultraviolet light can penetrate window glass, it might be reasonable for especially compulsive individuals to coat suitable windows with a transparent plastic film that absorbs those wavelengths.

Whichever combination of techniques is used reduce the appearance of wrinkles, the health care professional and their team are the most important variable in obtaining the most desirable result.

REFERENCE:

Farage, M.A., Miller, K.W., Elsner, P. and Maibach, H.I. "Intrinsic and extrinsic factors in skin ageing: a review." International Journal of Cosmetic Science 30 (2008): 87–95. doi: 10.1111/j.1468-2494.2007.00415.x

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