Topical retinoids. Derived from vitamin A, retinoids — such as tretinoin (Renova, Retin-A) and tazarotene (Avage, Tazorac) — that you apply to your skin may reduce fine wrinkles, splotches and skin roughness.
Because retinoids can make your skin burn more easily, you must use a broad-spectrum sunscreen and wear protective clothing daily. Retinoids may cause redness, dryness, itching, and a burning or tingling sensation.
Nonprescription wrinkle creams. The effectiveness of anti-wrinkle creams depends in part on the active ingredients. Retinol, alpha hydroxy acid, antioxidants and some peptides may result in slight to modest improvements in wrinkles.
Nonprescription wrinkle creams, however, contain less of the active ingredients than do prescription creams. Therefore results, if any, are limited and usually short-lived.
Surgical procedures and other techniques
A variety of skin-resurfacing techniques, injectables, fillers and surgical procedures are available to smooth out wrinkles. Each has its own set of potential results and side effects. Some studies indicate that a combination of treatments may yield the most satisfying results.
Laser, light source and radiofrequency treatments. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis), stimulating the growth of new collagen fibers. As the wound heals, smoother, tighter skin forms.
It can take up to several months to fully heal from ablative laser resurfacing. Risks include scarring and lightening or darkening of skin color.
Newer developments in laser technology, such as nonablative fractional laser resurfacing, have decreased healing time and reduced risks. Nonablative lasers are better suited to people with moderate wrinkles because results are subtle. Nonablative laser treatment typically needs to be repeated more often than does ablative treatment.
There's also a device that uses radiofrequency instead of light for nonablative treatment that achieves mildly to moderately tighter skin.
Chemical peel. Your doctor applies an acid to the affected areas, which burns the outer layer of your skin to remove age spots and freckles, as well as wrinkles.
Depending on the depth of the peel, you may need several before you see a difference. Redness lasts up to several weeks.
Dermabrasion. This procedure involves sanding (planing) the surface layer of skin with a rotating brush. The planing removes the skin surface, and a new layer of skin grows in its place.
Redness, scabbing and swelling generally last a couple of weeks. It may take several months for pinkness to fade and for you to see results.
Microdermabrasion. Similar to dermabrasion, this technique removes only a fine layer of skin. This technique usually requires a series of treatments to produce results, possibly as many as 16.
You may notice a slight redness or stinging sensation on the treated areas. Microdermabrasion produces modest, temporary results.
Botulinum toxin type A (Botox). When injected in small doses into specific muscles, Botox keeps the muscles from contracting. When the muscles can't tighten, the skin appears smoother and less wrinkled.
Botox works well on frown lines between the eyebrows and across the forehead and on crow's-feet at the eye corners. Results typically last about three to four months. Repeat injections are needed to maintain results.
Soft tissue fillers. Soft tissue fillers, which include fat, collagen and hyaluronic acid gel (Restylane, Juvederm, others), can be injected into deeper wrinkles on your face. They plump and smooth wrinkles and furrows. You may experience temporary swelling, redness and bruising in the treated area. The procedure may need to be repeated every few months, as the effect of most fillers is temporary.
Skin tightening. Several devices use heat to tighten the skin. This noninvasive treatment produces mild to modest results, which usually develop gradually over four to six months. There's no recovery time for this procedure.
Face-lift. The face-lift procedure involves removing excess skin and fat in your lower face and neck and tightening the underlying muscle and connective tissue. The results typically last five to 10 years. Healing times can be lengthy after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.
Keep in mind that results vary depending on the location and depth of your wrinkles. However, nothing stops the aging process of skin, so you'll likely need repeated treatments to maintain benefits.
Also, any of the procedures can have side effects, so be sure to discuss them with your doctor. Make sure your dermatologist or plastic surgeon is specially trained and experienced in the technique you're considering.
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