All About Wrinkles

Facial skin tells the world where a woman is in terms of beauty and age. Flawless, wrinkle-free skin is celebrated. "Everyone wants younger, healthy-looking skin, with the goal of looking more beautiful (or at least the best you can)," says author Paula Begoun.

"No one wants wrinkles or drooping skin, and no wants to have blemishes. No one. I can make such a sweeping statement because no cosmetics company in the world is selling products that will make skin look more wrinkled, saggy or broken out," she says. "At least not knowingly."


When the first wrinkle occurs, reactions are mixed. "I was in my early twenties when I saw my first hint of a smile line," says Linda, a California mother of four. "I said to myself, 'This can't be happening.' I didn't bother to do anything about it at first, but then I bought some anti-wrinkle cream. Using it makes me feel better."

Linda is not alone. "I was putting on my make-up one day, says a Virginia woman. I had just bought a magnifying mirror and I was seeing some things I didn't know I had. They seemed very familiar. I thought, 'There's another thing I didn't want to inherit from my mother." She too bought an anti-aging product and applied it to her face.

Few women see any benefit in looking older than they feel. In her book, "Looking Good at Any Age," dermatologist Amy E. Newburger, M.D., gives women a heads-up regarding the skin changes that typically occur during each decade of life.

Facts about Skin

To understand why this happens, first we'll give you a broad overview of the skin's anatomy and physiology.

Skin consists of three basic layers: the epidermis, dermis and adipose (fatty) tissue. New skin cells are born in the epidermis (what is called stratified squamous epithelial tissue consisting of sheets of cells) and rise to the surface where they are sloughed off. This happens all the time, all over your body. Melanocytes or pigment cells that determine skin color and provide some protection against the sun's ultraviolet rays are also found here.

The dermis, or middle layer, nourishes the epidermis. This layer contains three protein related substances: collagen, responsible for skin firmness; elastin, furnishing bounce and resilience; and glycosaminoglycans (GAGs or chains of sugars, sulfur, and amino acids) that help skin retain its moisture. Also resident in this layer are hair follicles, sweat glands, oil glands, blood vessels, muscle cells, lymph ducts, and nerve fibers. These nerve endings send messages of touch, heat, pressure, pain, cold, and sexual arousal to the brain.

The bottom layer, adipose tissue, cushions the skin and keeps it from sagging. These fat cells also insulate your body against extreme temperatures and give shape to your face. Muscle fibers, nerves, blood vessels, and the roots of oil and sweat glands run through this layer.

Your skin protects vital organs, regulates body temperature, provides a barrier against microorganisms, excretes waste products, transforms sunlight into vitamin D, and produces melanin to reduce exposure to the sun's damaging ultraviolet rays.

In general, skin is considered balanced — like Goldilocks' experience, neither too dry nor too oily, oily (often leading to problems with acne, or dry)


The Bad News About Wrinkles

By age 30, Newburger says, inherited patterns for aging generally begin to show. Because cellular regeneration is slowing down, fine lines and wrinkles may begin to appear. Skin blemishes and some loss of hair are not uncommon. By age 40, fat loss may begin, resulting in excess skin that arranges itself in folds and sags.

Initial signs are the horizontal lines seen crossing the forehead and some droopiness of the eyelids. Loss of fat in the cheeks causes the formation of puffy little jowls on either side of the chin, a pattern commonly referred to as "fleur-de-lys." Lips may thin. By age 50, the force of gravity may produce down-turned corners at the edge of the mouth, long ear lobes and a hooked nose, plus a change in the neck from firm to wattled.


In addition, after menopause the outer layer of skin takes longer to renew itself. At the same time, the collagen and elastin in the dermis layer start to break down, resulting in a thinner dermis that allows easy bruising, as well as wrinkles and furrows. The skin becomes more transparent and blood vessels become more prominent.

And there's worse news. Age, also called liver spots may appear because of malfunctioning melanocytes, causing irregular circles of pigmented skin or white spots where pigmentation is lacking. Changes continue to accelerate into the 60s with thinning skin and the breakdown of collagen and elastin in the dermis.

Several years may pass between a woman's penetrating assessments of her facial skin. But a recent photograph or comments on how tired she looks when she feels quite vital may trigger a new assessment. She realizes that her public and private images are out of synch. "I saw them and I just wanted the wrinkles to go away," says Debbie, originally from Canada. "At the same time, I want the steps I take to be not too hard, too painful or too expensive. I would like to enhance what I have for as long as I have it. I would like to grow old gracefully."

But aging continues, and many women turn to facelifts, dermabrasion, chemical peels, or Retin-A to restore the skin's surface and tone. Women also take a variety of supplements and spend billions of dollars annually on products to protect their skin. But most health experts agree that the first line of defense is to use sunscreen SPF15, or higher, every day and avoid sunbathing.

Ultraviolet light wrinkles, dries, and burns the skin, as well as increasing the odds you'll develop skin cancer. But the sun is not your only enemy. Cigarette smoke and alcohol greatly accelerate the skin aging process.

A 1997 editorial in the New England Journal of Medicine reported that more than 80 percent of facial aging may be caused by exposure to ultraviolet radiation from the sun. Experts also maintain that cigarette usage damages the skin, saying that if you smoke, stop.

A report in the Journal of the Society of Cosmetic Chemistry states that cigarette smoke, whether you are a smoker yourself or someone who is regularly exposed to "side-stream" smoke, is bad for your skin. Other factors over which women have some control are diet, exercise, sleep, stress, and drug use. Simple things, such as drinking eight glasses of water each day and eating sufficient servings of fruits and vegetables throughout your life can help to keep your skin healthy.


New Hope for Aging Skin

One of the newest bodies of information regarding skin care that addresses all of these factors has been produced by Nicholas Perricone, M.D., assistant clinical professor of dermatology at Yale University School of Medicine. After 20 years of research, he does not agree that skin must deteriorate due to age. He maintains that aging skin is a disease that we can do something about. He recommends a wide range of strategies from an insulin-balancing diet to oral supplements and topical antioxidants. His research, which utilizes all-natural formulas, is endorsed by a variety of experts including Christiane Northrup, M.D., author of "Women's Bodies, Women's Wisdom."

Dr. Perricone's Wrinkle Cure

Using nutrient antioxidants topically to impede and even repair cellular damage to skin cells, Dr. Nicholas Perricone's program is based on healthy living habits, especially a diet high in nutrition-packed, antioxidant-rich foods, and includes the use of the following products for smooth, healthy skin.


  • Vitamin C esters: According to Dr. Perricone, when Vitamin C is combined with palm oil it forms an ester that can penetrate the skin (something other cosmeceuticals have had difficulty in doing) and the thin membrane of cells that help to produce collagen and elastin. This action helps to reduce fine lines and to firm mildly sagging skin, says Dr. Perricone.
  • Alpha lipoic acid: Called a universal antioxidant by many doctors, this acid boosts the ability of other antioxidants. It can increase cell metabolism that slows with age. It can even activate a process to remove damaged collagen. This activity reduces inflammation, and fades wrinkles and scars.
  • DMAE: an acronym for the nutrient dimethylaminoethanol — This antioxidant is found in abundance in fish. When it is mixed with nutrients and other antioxidants, then applied to the skin, it improves skin tone. Initially effective for approximately 24 hours, continued use is said to result in firmer skin due to improved facial musculature.
  • Tocotrienols: a high-potency form of Vitamin E — protect and moisturize the skin.
  • Alpha hydroxy and beta hydroxy acids: reduce skin roughness, diminish fine lines, and exfoliate the skin. Ralph Waldo Emerson said, "For well the soul, if stout within, can arm impregnably the skin," reminding us that our face — wrinkled or smooth — broadcasts a message. Frowns are old. Smiles are young. And a smile, which costs nothing, is the most affordable facelift in the universe. (For additional information see, "The Wrinkle Cure" by Nicholas Perricone, M.D., Rodale Books.