Concern Over Wrinkled Skin

We usually define skin by what we see: our pigmentation, age spots, moles and, yes, wrinkles. Yet there’s much more than meets the eye. The skin is divided into two main layers: the exterior epidermis, including the stratum corneum (“horny” outer layer), and the dermis below, which contains capillaries, hair follicles, sebaceous glands and the fibers (collagen and elastin) that give the skin its strength and elasticity.

As you age, the dermis thins. Ultrasound and X-rays reveal that dermal thickness increases until age 20, then declines progressively, losing approximately 20% of its peak thickness, says Sheldon Pinnell, M.D., who teaches dermatology at Duke University. “Wrinkles are a surface reflection of changes in dermal structure,” he says. “With aging, collagen is lost and the dermis thins, resulting in wrinkling.” In fact, wrinkle lines are present not just on the surface, but below in the dermis as well, where they manifest as dermal grooves.

In the realm of anti-aging skin care, the name of the game is preserving and regenerating the underlying structure of your skin – collagen, which weakens with age, and elastin, whose fibers become less flexible. Although the hormones estrogen and testosterone slow skin collagen loss, a number of beauty treatments, including vitamin C and ceramide creams, can do the job without the side effects.

Curbing Sun Damage

Of all factors that contribute to wrinkle formation, none surpasses the destructive force of excessive sun exposure. You can do much to avoid looking older before your time by protecting your face and neck with a sunscreen of at least an SPF (sun protection factor) of 15 on a daily basis.

Shunning the two distinct yet equally harmful UV rays – A and B – is the first step to maintaining youthful skin. UVB rays are responsible for visible sunburn, yet UVA rays are just as damaging, even though they cause little skin redness. This type of radiation penetrates the skin, causing cellular damage that accumulates slowly over a period of time. UVA rays induce the formation of free radicals, which attack the skin’s lipids. The resulting damage gives rise to visible signs of aging such as wrinkles and leathery skin.

The skin’s natural defenses against these free radicals are vitamin C and vitamin E. These two antioxidants intercept free radicals before they can damage your skin. Vitamin C protects significantly better against UVA phototoxicity than vitamin E; vitamin E, on the other hand, is more efficient against UVB.

A new ingredient in some skin care products, beta-glucan, increases the skin’s resistance to oxidative stress induced by UVA rays. Beta-glucan, which like ceramides is isolated from yeast cell walls, appears to stimulate the skin’s immune defense mechanisms, promoting healing of sunburned skin and reducing cellular inflammation. Used in facial creams or foundation makeup, beta-glucan protects your skin from day-to-day exposure to the sun.

As with skin that is overexposed to sunlight, smoking causes thickening and fragmentation of elastin, the elastic fibers that are long and smooth in healthy skin. Smoking also depletes the skin’s oxygen supply by reducing circulation. It decreases the formation of collagen, the skin’s main structural component, and may reduce the water content of the skin, all of which increase wrinkling. Sometimes it is easy to spot someone with ‘smoker’s face’.

If you care for your skin throughout your life, your face will reap the rewards of that TLC. Even if you’ve got a few lines, it’s never too late to minimize them and to prevent more. Keep a positive attitude, eat plenty of antioxidant-containing fruits and veggies, don’t smoke, and rely on the revitalizing effects of natural beauty products as you grow older gracefully.


Risk factors for Concern Over Wrinkled Skin



Psoriasis can cause rapid skin aging.

Recommendations for Concern Over Wrinkled Skin



Conventional Drugs / Information

Lotions such as Retin-A, alpha hydroxy or Renova help to exfoliate dead cells from the skin making it smoother. Retina-A and Renova contain a chemical that can cause cell production, which has been mutated by the sun, to return towards normal.


Sun Exposure Reduction / Sunscreen

To delay the formation of wrinkles you should become aware of staying out of the sun as much as possible. If you must be in the sun, always use a sunscreen.


Tobacco Avoidance

Put simply, tobacco ages you. Female and male smokers age 40 and older are two to three times more likely to have moderate to severe wrinkling compared to nonsmokers.

Physical Medicine  

Topical Applications

There are an abundance of preparations available for topical application to help slow skin aging and improve its appearance. One such product is Trienelle Daily Renewal Creme. Others include prescription products from ApotheCure, such as:

Spider Vein Cream.

Youth ReBorn: 20% Ascorbic Acid Cream.

Dermaheal Essence.

There is a new generation facial peel that should be available in late 2006 developed by Dr. Kalil. It can be used on all skin types, is easy to apply and is painless. It is called the V.I. Peel. Product and training will be available for doctors through ApotheCure Compounding Pharmacy.


Cosmetics / Moisturizers

Skin looks more wrinkled when it is dry. Although a moisturizer does nothing to chemically alter the skin, it can make skin appear younger. As skin ages, it loses its ability to retain water, and the use of moisturizers becomes more appropriate.


Hyaluronic Acid

Hyaluronic acid injections can improve the skin’s contour and reduce depressions in the skin due to acne, scars, injury or lines. This augmentation usually lasts between 6-9 months. This effect seems to last considerably longer than collagen implants.



Dark chocolate rich in flavonoids — plant-based antioxidants — appears to protect against skin cancer and promote healthy skin, a study by German researchers found. The study involved 24 women who added hot cocoa to their breakfasts daily for about three months. Half received cocoa that contained 329 milligrams of flavanols while the rest received a placebo cocoa that contained only 27 mg of flavanols per serving.

At the end of the study results showed that women who drank the flavonoid-rich cocoa:


Vitamin Niacinamide

In a double-blind study of 50 women with signs of aging skin, use of niacinamide cream significantly improved skin appearance and elasticity as compared to placebo cream. [Bissett DL, Oblong JE, Berge CA et al. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005;31:860-5; discussion 865]


Vitamin C (Ascorbic Acid)

Ascorbic acid reserves are often depleted in older people, who tend to need more vitamin C in their diet. Ascorbic acid increases the synthesis of collagen more than five-fold in cultures of human skin. By replenishing ascorbic acid in the skin, collagen synthesis may be stimulated, and the loss of dermal substance associated with aging might be delayed or even reversed.

The skin’s natural defenses against the free radicals produced by UV light are vitamin C and vitamin E. These two antioxidants intercept free radicals before they can damage your skin. Vitamin C protects significantly better against UVA phototoxicity than vitamin E; vitamin E, on the other hand, is more efficient against UVB.

Twenty healthy female volunteers (average age of 55 years) with skin damage due to chronic sun exposure were randomly and blindly assigned to apply, in double-blind fashion, a 5% vitamin C cream on one side of their lower neck and arms, and a placebo on the other side, once each day for 6 months. Clinical examination by a dermatologist, as well as self-assessment by the volunteers, revealed a significant improvement on the vitamin C-treated side compared with the control side. Application of vitamin C resulted in a significant improvement in both fine and coarse wrinkles.[Exp Dermatol 2003;12: pp.237-244]


Weak or unproven link
May do some good
Likely to help
Highly recommended


Age Spots

Also called "liver spots", these are flat, brown areas usually found on the face, hands, back and feet. They vary in size from 1/8 of an inch to several inches (0.3cm to several cm) and are associated with aging, but long-term sun exposure is also a major cause.


The outer layers of the skin, made up of an outer, dead portion and a deeper, living portion. Epidermal cells gradually move outward to the skin surface, changing as they go, until they become flakes.


The primary protein within white fibers of connective tissue and the organic substance found in tendons, ligaments, cartilage, skin, teeth and bone.


A protein that is similar to collagen and is the chief constituent of elastic fibers.


Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.


One of the female sex hormones produced by the ovaries.


The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.

Vitamin C

Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Free Radical

A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.


Fat-soluble substances derived from animal or vegetable cells by nonpolar solvents (e.g. ether); the term can include the following types of materials: fatty acids, glycerides, phospholipids, alcohols and waxes.

Vitamin E

An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.


A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.


A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.


An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.

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