Wrinkle

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"Wrinkles" redirects here. For the film, see Wrinkles (film).

An elderly woman of Nepali origin with facial wrinkles

A wrinkle, also known as a rhytide, is a fold, ridge or crease in the skin or on fabric. Skin wrinkles
typically appear as a result of aging processes such as glycation,[1] habitual sleeping positions,[2] loss
of body mass, or temporarily, as the result of prolonged immersion in water. Age wrinkling in the skin
is promoted by habitual facial expressions, aging, sun damage, smoking, poor hydration, and
various other factors.[3]
Contents
[hide]

1Causes for aging wrinkles

2Treatments for aging wrinkles

o

2.1Tretinoin

2.2Glycosaminoglycans

2.3Dermal fillers

2.4Botulinum toxin

2.5Laser resurfacing

3Sleep wrinkles

4Water-immersion wrinkling

5Animals with wrinkles

6See also

7References

8External links

Causes for aging wrinkles[edit]

Development of facial wrinkles is a kind of fibrosis of the skin. Misrepair-accumulation aging theory
suggests that wrinkles develop from incorrect repairs of injured elastic fibers and collagen fibers. [4][5]
[6]
Repeated extensions and compressions of the skin cause repeated injuries of extracellular fibers in
derma. During the repairing process, some of the broken elastic fibers and collagen fibers are not
regenerated and restored but replaced by altered fibers. When an elastic fiber is broken in an
extended state, it may be replaced by a long collagen fiber. Accumulation of long collagen fibers
makes part of the skin looser and stiffer, and as a consequence, a big fold of skin appears. When a
long collagen is broken in a compressed state, it may be replaced by a short collagen fiber. The
shorter collagen fibers will restrict the extension of "longer" fibers, and make the long fibers in a
folding state permanently. A small fold, namely a permanent wrinkle, then appears.

Treatments for aging wrinkles[edit]

Wrinkles on the face and hands are a typical sign of aging

Tretinoin[edit]
Although the exact mode of action of tretinoin is unknown, current evidence suggests that tretinoin
decreases cohesiveness of follicular epithelial cells. Additionally, tretinoin stimulates mitotic activity
and increased turnover of follicular epithelial cells.[7] Tretinoin is better known by the brand
name Retin-A.

Glycosaminoglycans[edit]
Glycosaminoglycans (GAGs) are produced by the body to maintain structural integrity in tissues and
to maintain fluid balance. Hyaluronic acid is a type of GAG that promotes collagen synthesis, repair,
and hydration. GAGs serve as a natural moisturizer and lubricant between epidermal cells to inhibit
the production of matrix metalloproteinases (MMPs). Topical glycosaminoglycans supplements can
help to provide temporary restoration of enzyme balance to slow or prevent matrix breakdown and
consequent onset of wrinkle formation.

Dermal fillers[edit]

Dermal fillers are injectable products frequently used to correct wrinkles, and other depressions in
the skin. They are often a kind of soft tissue designed to enable injection into the skin for purposes of
improving the appearance. The most common products are based on hyaluronic acid and calcium
hydroxylapatite.

Botulinum toxin[edit]
Botulinum toxin is a neurotoxin protein produced by the bacterium Clostridium botulinum. Botox is a
specific form of botulinum toxin manufactured by Allergan for both therapeutic and cosmetic use.
Besides its cosmetic application, Botox is used in the treatment of other conditions including
migraine headache and cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving
the head and neck).[8]
Dysport, manufactured by Ipsen, received FDA approval and is now used to treat cervical dystonia
as well as glabellar lines in adults. In 2010, another form of botulinum toxin, one free of complexing
proteins, became available to Americans. Xeomin received FDA approval for medical indications in
2010 and cosmetic indications in 2011.
Botulinum toxin treats wrinkles by immobilizing the muscles which cause wrinkles. It is not
appropriate for the treatment of all wrinkles; it is indicated for the treatment of glabellar lines
(between the eyebrows) in adults. Any other usage is not approved by the FDA and is
considered off-label use.

Laser resurfacing[edit]
Laser resurfacing is FDA-cleared skin resurfacing procedure in which lasers are used to improve the
condition of the skin.[citation needed] Two types of lasers are used to reduce the appearance of fine lines and
wrinkles on the face; an ablative laser that removes thin layers of skin and a nonablative laser that
stimulates collagen production.
Nonablative lasers are less effective than ablative ones but they are less invasive and recovery time
is short. After the procedure people experience temporary redness, itching and swelling.

Sleep wrinkles[edit]
Sleep wrinkles are created and reinforced when the face is compressed against a pillow or bed
surface in side or stomach sleeping positions during sleep. [9] They appear in predictable locations
due to the underlying superficial musculoaponeurotic system (SMAS), and are usually distinct from
wrinkles of facial expression.[10] As with wrinkles of facial expression, sleep wrinkles can deepen and
become permanent over time, unless the habitual sleeping positions which cause the wrinkles are
altered.[11]

Water-immersion wrinkling[edit]

A wrinkled finger after a warm bath

Adult sole showing water immersion wrinkling

The wrinkles that occur in skin after prolonged exposure to water are sometimes referred to
as pruney fingers or water aging. This is a temporary skin condition where the skin on the palms of
the hand or feet becomes wrinkly. This wrinkling response may have imparted an evolutionary
benefit by providing improved traction in wet conditions,[12] and a better grasp of wet objects.
[13]
However, a 2014 study attempting to reproduce these results was unable to demonstrate any
improvement of handling wet objects with wrinkled fingertips. Furthermore, the same study didn't find
any connection between fingertip wrinkling and touch sensation.[14]
In the recent past[when?] the common explanation was based on water absorption in the keratinladen epithelial skin when immersed in water,[15] causing the skin to expand and resulting in a larger
surface area, forcing it to wrinkle. Usually the tips of the fingers and toes are the first to wrinkle
because of a thicker layer of keratin and an absence of hairs which secrete the protective oil
called sebum.
In 1935, however, Lewis and Pickering were studying patients with palsy of the median nerve when
they discovered that skin wrinkling did not occur in the areas of the patients' skin normally innervated
by the damaged nerve. This suggested that the nervous system plays an essential role in wrinkling,
so the phenomenon could not be entirely explained simply by water absorption. Recent research
shows that wrinkling is related to vasoconstriction.[16][17] Water probably initiates the wrinkling process
by altering the balance of electrolytes in the skin as it diffuses into the hands and soles via their
many sweat ducts. This could alter the stability of the membranes of the many neurons that synapse
on the many blood vessels underneath skin, causing them to fire more rapidly. Increased neuronal
firing causes blood vessels to constrict, decreasing the amount of fluid underneath the skin. This
decrease in fluid would cause a decrease in tension, causing the skin to become wrinkly.[18]
This insight resulted in bedside tests for nerve damage and vasoconstriction. Wrinkling is often
scored with immersion of the hands for 30 minutes in water or EMLA cream with measurements
steps of 5 minutes, and counting the number of visible wrinkles in time. Not all healthy persons have
finger wrinkling after immersion, so it would be safe to say that sympathetic function is preserved if
finger wrinkling after immersion in water is observed, but if the fingers emerge smooth it cannot be
assumed that there is a lesion to the autonomic supply or to the peripheral nerves of the hand. [19]

Animals with wrinkles[edit]

Examples of wrinkles can be found in various animal species that grow loose, excess skin,
particularly when they are young. Several breeds of dog, such as the Pug and the Shar Pei, have
been bred to exaggerate this trait. In dogs bred for fighting, this is the result of selection for loose

skin, which confers a protective advantage. Wrinkles are also associated with neoteny, as they are a
trait associated with juvenile animals.

See also[edit]

Botulinum toxin

Injectable filler