Wrinkles are an inevitable part of aging. Forehead wrinkles are especially noticeable and bothersome to people. Luckily, there are several ways to both improve and prevent them. 

When and why do wrinkles form?

As we age, there is loss of hyaluronic acid, collagen, and elastin in the skin, which can start as early as our 30s! These components of the skin are important for the skin’s elasticity, strength, firmness, hydration, and glow. Therefore, loss leads to skin laxity, wrinkle formation and a duller appearance to the skin. In addition, repetitive movement of certain facial muscles with expression, like the forehead muscle, contribute to the formation of wrinkles at rest.

What additional factors contribute to wrinkle formation?

Both intrinsic and extrinsic factors can contribute to the formation of wrinkles. 

Intrinsic factors include genetics, ethnicity, and gender. Some ethnicities age more slowly than others. Women are also more likely to show the signs of aging (i.e. wrinkles) earlier than men due to hormonal changes associated with menopause. 

Extrinsic factors that can accelerate the signs of aging include stress, inadequate sleep, poor nutrition, smoking, excessive alcohol consumption and environmental exposure to UV rays from the sun and pollution. 

What can you do about wrinkles? Prevention and Treatment

“Forehead (and glabellar) wrinkles are one of the first aging concerns we hear from our patients,” said Kerry Heitmiller, MD of Golden State Dermatology in Mountain View and San Mateo. “Luckily, we have multiple treatment options to address every patient’s concerns and goals in his or her rejuvenation journey.”

Lifestyle modifications:

• Nutrition – A well-balanced diet with adequate protein, fats and carbohydrates is key. Include plenty of antioxidants as well (i.e. vegetables, fruits) to help minimize the effects of free radicals. Limiting processed foods and unhealthy sugars is important as these can contribute to decreased collagen production and collagen breakdown. 
• Sleep – This may be the ultimate overlooked health benefit. Your body needs to repair itself daily, and sleep is how that happens.
• Stress – Some amount of stress can be healthy. However, cortisol (a chemical in the body released in times of stress) can lead to collagen damage. There are a variety of activities that can relieve stress such as medication, taking a walk outside, and deep breathing and it is important that you find one that works best for you. 
• Smoking – Try to avoid smoking as much as possible. Smoking offers no health benefit and contributes to the production of free radicals within the body. It is often a common risk factor for many chronic diseases and cancers. 
• Alcohol – Resveratrol (found in wine) is considered an antioxidant when consumed in moderation. However, it is important to limit excessive intake of alcohol as increased intake can cause dehydration and can negatively impact overall health including skin health. 

Topical Treatment 

Sunscreen is the most important thing you can apply to prevent wrinkles as it protects against damage from UV exposure from the sun. It is important to use a broad-spectrum sunscreen that protects against UVA and UVB. Tinted sunscreens or sunscreens containing iron oxide can provide additional protection against visible light.  Applying products containing antioxidants, such as vitamin C, are also important in protecting against the effects of free radicals that would ultimately damage collagen and elastin. Moisturizers and products containing hyaluronic acid, peptides and growth factors are helpful in hydrating the skin and further promoting collagen and elastin formation, leading to the prevention and/or improvement of wrinkle formation when used consistently over time. 

Laser Treatment 

There are many different lasers that can help to improve lines and wrinkles. Oftentimes, these lasers can help improve overlying texture and tone as well! These devices range from non-ablative lasers, which do not remove the top layer of skin, such as the Fraxel laser and Clear + Brilliant, and ablative lasers, which remove the top layer of skin, such as the CO2 laser. Ablative lasers are typically associated with a longer downtime following treatment, although offer more noticeable improvement and are better with treating deeper wrinkles compared to non-ablative lasers. 

Microneedling

Microneedling involves small needles that penetrate the skin, typically delivered in combination with radiofrequency. The mechanical and heat injury stimulates collagen and elastin production, resulting in improvement in skin laxity and softening of fine lines and wrinkles. 

Chemical Peels 

Peels can help to resurface the skin to various degrees based on the strength of the peel (i.e. superficial, medium or deep). Deep chemical peels often lead to greater improvement in fine lines and wrinkles, although, they are associated with longer downtimes. Peels, like lasers, have the added benefit in improving overall skin tone, texture and any associated pigmentation. 

Fillers

Fillers can help to soften wrinkles and restore volume in almost any area of the face. Available fillers include hyaluronic acid fillers and biostimulatory fillers like Radiesse and Sculptra. Hyaluronic acid fillers directly volumize, leading to softening of fine lines and wrinkles and providing natural contour to the face. Biostimulatory fillers stimulate collagen and elastin production where they are injected leading to skin tightening and improvement of wrinkles over time. 

Botulinum toxin

There are many different types of toxins available including Botox, Dysport, Xeomin, Jeuveau, and Daxxify. All work to weak specific facial muscles, which then leads to softening of dynamic wrinkles (or wrinkles that form with movement). Consistent treatment with neuromodulators can prevent wrinkles from becoming deeper and can even soften them over time. If treatment is started early, wrinkles can be proactively prevented from developing!  

If you are interested in prevention or treatment for wrinkles that bother you, make an appointment today at Moy Fincher Chipps! Aging gracefully is different for each of us, and we’re here to talk about your concerns.