Beyond creams, the dermatologist may recommend a treatment to remove damaged layers of skin and expose smoother, more even skin:
- Chemical peels are meant to smooth out wrinkles and improve uneven skin tone and texture. A light chemical peel is done with hydroxy acids, while a deep peel uses phenol, a toxic acid. All peels can be painful and make the skin very sensitive, requiring time to heal. Light ones may require repeated applications. Deep chemical peels require sedation, can take months of healing and may make skin incredibly sun-sensitive for the rest of your life. On the other hand, results can last for decades.
- Laser resurfacing is used to treat age spots as well as wrinkles and acne scars. A laser directed at specific areas on the face destroys the top layer of skin and stimulates collagen growth. It can be mild and localized to just a few areas, or deep and performed over the entire face. Treatments may require anesthesia, depending on their extent. Skin after laser resurfacing is sensitive and can be itchy and irritated. It can also stay pink for months afterwards and develop patches that are lighter or darker in tone. Results tend to improve up to a year after surgery and can last for years.
- Dermabrasion is another technique to remove layers of skin and reduce the appearance of wrinkles, age spots and scars. It essentially involves sanding down the top layer of skin -- imagine a rotating sander with a layer of fine sandpaper. Typically, people are given anesthetics to numb the skin. As with other skin resurfacing treatments, the skin is left pink, irritated and highly sensitive to the sun. Changes in skin tone can also follow, and so can thickened patches of skin. Sometimes repeated treatments are necessary to obtain the desired result, or dermabrasion is used in conjunction with other things.
- An alternative to removing layers of wrinkled skin is to inject substances to fill them in or otherwise temporarily reduce their appearance. Hyaluronic acid, a lubricant that is part of our connective tissue, is injected in wrinkled areas around the eyes, nose, mouth and forehead to "plump up" the wrinkles. Brand names include Restalyne and Juvaderm. Typically, results last for about six months. Dermatologists also inject collagen. Injected fillers cause the skin to swell and bruise, and it typically takes time for the area to look normal as opposed to overfilled. They can cause scars and infections. Botox is another injectable treatment, which temporarily paralyzes the muscles on the forehead where wrinkles form.
So far, we've only talked about dealing with the cosmetic issues associated with aging skin. There are also more serious skin conditions that can impact skin as we age.