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Dx Facial Wrinkles Treatments:

Treatment of Facial Wrinkles

The Merck Manual Home Edition
Cause: Skin Aging
"The skin tends to become thinner, less elastic, drier, and finely wrinkled. However, exposure to sunlight over the years greatly contributes to wrinkling and to making the skin rough and blotchy. People who have avoided exposure to sunlight often look much younger than their age.
  The skin changes partly because the aging body produces less collagen (a tough, fibrous tissue that makes skin strong) and elastin (which makes skin flexible). As a result, the skin tears more easily.
  The fat layer under the skin thins. This layer acts as a cushion for the skin, helping protect and support it. The fat layer also helps conserve body heat. When the layer thins, wrinkles are more likely to develop, and tolerance for cold decreases.
  The number of nerve endings in the skin decreases. As a result, people become less sensitive to pain, temperature, and pressure, and injuries may be more likely.
  The number of pigment-producing cells (melanocytes) decreases. As a result, the skin has less protection against ultraviolet (UV) radiation, such as that from sunlight. Large, brown spots (age spots) develop on skin that has been exposed to sunlight, perhaps because the skin is less able to remove waste products. The skin is less able to form vitamin D when it is exposed to sunlight. Thus, the risk of vitamin D deficiency increases."

Medications Used in Treatment:
1. Retinoids: Refissa® Renova®/tretinoin emollient, Avage®/tazarotene
2. Hylauronic Acid: Restylane® Perlane® Juvaderm®/hyaluronic acid
3. Acetylcholine Release Inhibitors: Botox®/onabotulinumtoxina

*[Editor] The first rule to maintaining good skin, muscle tone, and the underlying supportive fat layer is to maintain youthful levels of bio-identical hormones: testosterone for men and estradiol and testosterone for women.

The second is to restrict sun damage. If sun damage has occurred, there are various treatments that remove the superficial layer of the skin. If there is a supporting repair system, then the choice of peel, Intense Pulsed Light, Laser, Fraxel, etc. is determined by the patient and physician.

The advent of Botox® has been refined to minimize crow's feet, forehead wrinkles, raise the eyebrows and open the upper lip. The use of hyaluronic acid in good hands is able to plump up the upper and lower lip, the cheek area and fill the deep furrows on the forehead and glabella.

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