Wrinkled skin is a fact of life. It occurs naturally as we age, but some people experience it more than others because there are multiple factors that affect how our skin changes as we get on in years.

What causes wrinkles is either intrinsic or extrinsic aging. Intrinsic aging is genetic and, for the most part, out of our control. Extrinsic aging happens because of environmental factors. Here we'll take a look at the processes behind aging as well as some ways to beat the years and keep your skin looking healthy and young.

What Causes Wrinkles: Intrinsic and Extrinsic Factors

Intrinsic Aging Is in Our Genes

As we age, our skin becomes weaker and less elastic. Our bodies cannot maintain the same turgor—a word Derms use to describe the firmness of cells—that they used to, so fine lines and creases form on the face and elsewhere on the body. This is due to a gradual loss of collagen and elastin, the substances which form the skin's "skeleton," or structural support. Skin on the body becomes thinner, finely wrinkled, saggy, and more easily damaged as the years go on. The skin of the lips can become thinner as well.

Extrinsic Aging Happens Because of Us

In contrast to the unavoidable genetic aging described above, extrinsic aging is caused by how you live your life. The more you are exposed to carcinogens—conditions and substances that damage the DNA of cells—the more you'll show signs of extrinsic aging. When the DNA in our skin is damaged, its normal structural support system (collagen and elastin) becomes misshapen and abnormal.

For example, smoke is one of the most common carcinogens and leads to environmental aging. This is why people who smoke cigarettes or are constantly exposed to smoke often have deep wrinkles around their mouths. Those wrinkles can also spread across the rest of the face with prolonged exposure.

The Relationship Between Sun and Wrinkles

Another common environmental carcinogen is ultraviolet (UV) radiation from the sun. UV light also causes mutations in our skin to occur, and if there's prolonged exposure, it breaks down our collagen and elastin. In lighter-skinned individuals, this presents as deep, heavy wrinkling and furrows across the entire face, especially in the corners of the eyes. UV exposure can also cause irregular or mottled brown pigmentation, sagging neck skin and jowls, hollows in the eyes, and drooping brows.

Interestingly, people who have darker skin do not usually experience deep, coarse wrinkles from years of sun exposure. For them, chronic UV radiation leads to deeper under-eye hollows and creases between the nose and lip corners. Jowls often appear more prominently around the chin area.

The bottom line for all skin types is that when we're young, our skin has even tones and symmetric features with no contour irregularities. As we age and are exposed to extrinsic factors, we lose facial symmetry, skin smoothness, and firmness, and we start to have contour and pigment irregularities.

How Can You Prevent Wrinkles?

In some ways, we are destined to have some wrinkles, sagging skin, and asymmetric features as we get older. That's the nature of intrinsic aging. We can, however, make a huge difference in how we age by limiting environmental factors. Sun avoidance and protection is one of the main ways Dermatologists recommend lessening the effects of extrinsic aging. A daily moisturizing sunscreen used 365 days a year on the face and ears is a great, Derm-approved start.

Any time you'll be spending the day outside (even in the winter), you should apply a broad-spectrum sunscreen with an SPF of 30 or higher over any exposed skin. Reapply every two hours, especially if you're active.

Turning Back the Clock With Wrinkle Reduction

There are three basic ways of wrinkle reduction: relaxing, replacing, or removing them. All are helpful in different ways.

Relaxing wrinkles is often done through injections of botulinum toxin, a naturally occurring substance (greatly weakened for safety) that is placed into the muscles that create wrinkles. This method is usually used to relax wrinkles in the corners of the eyes, the frown, and on the forehead.

Wrinkles can be "replaced" with filler injections meant to add volume and support to our degraded collagen and elastin. Such fillers are most commonly made of hyaluronic acid, another natural component of our skin's structural support that is present in many skincare products.

Finally, wrinkles can be removed—to varying degrees—with some exfoliating creams (like retinols), chemical peels, micro-needling, and lasers.

Only your board-certified Dermatologist is qualified to determine the ideal treatments to help you look your best as you age, so refer to them whenever you have questions about your skin. In the meantime, keep up your use of daily sunscreen and avoid carcinogens whenever possible.


  • Lawrence J Green, MD

    Dr. Lawrence Green is an award-winning Dermatologist and clinical professor of dermatology at George Washington University School of Medicine. Based in Rockville, MD, he is the author of over 50 publications in peer-reviewed journals and a member of the Board of Directors of the American Academy of Dermatology.

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