Wrinkles are a natural by-product of the aging process. With age, skin cells divide more slowly. The inner layer of the skin, called the dermis, begins to thin. The network of elastin and collagen fibers, which support the outer layer, loosens and unravels. This process results in depressions on the skin surface. With aging, skin becomes more fragile. Also, oil-secreting glands are less efficient, making the skin less able to retain moisture and appear more wrinkled. All of these factors contribute to the development of wrinkles.

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A variety of procedures are used to smooth out wrinkles. Some studies indicate that a combination of treatments may yield the most satisfying results. 

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• Laser resurfacing. In ablative (wounding) laser resurfacing, a laser beam destroys the outer layer of skin (epidermis) and heats the underlying skin (dermis). This stimulates the growth of new collagen fibers. As the wound heals, smoother, tighter skin forms. Laser resurfacing can't eliminate excessive or sagging skin.

• Photodynamic rejuvenation. Photodynamic therapy (PDT) can treat fine wrinkles caused by sun exposure. You may need repeat treatments, but recovery for PDT is shorter than it is with laser resurfacing.

• Chemical peel. we apply a chemical solution to the skin to remove the top layers. The skin that grows back after a chemical peel is smother. Depending on the depth of the peel, you may need several treatments before you see a difference in your skin. Redness lasts up to several weeks. Possible side effects include scarring, infection, and lightening or darkening of skin color.

• Dermabrasion. Dermabrasion sands down the surface layer of skin with a rapidly rotating brush. New skin grows in its place. You may need to undergo the procedure more than once.

• Microdermabrasion. Similar to dermabrasion, this technique removes only a fine layer of skin. You'll need a series of treatments over months to produce modest, temporary results. If you have rosacea or tiny red veins on your face, this technique could make the condition worse.

  You may notice a slight redness or stinging sensation on the treated areas.

• Botox. When injected in small doses into specific muscles, Botox keeps the muscles from contracting. When the muscles can't tighten, the skin appears smoother and less wrinkled.

  Botox works well on frown lines between the eyebrows and across the forehead and on crow's-feet at the eye corners. It takes one to three days to see results. The effect typically lasts a few months. Repeat injections are needed to maintain results.

• Soft tissue fillers, which include fat, collagen and hyaluronic acid can be injected into wrinkles on your face. They plump and smooth wrinkles and furrows. You may experience temporary swelling, redness and bruising in the treated area. 

• Face-lift. The face-lift procedure involves tightening the underlying muscle and tissues. It may be done in a hospital or an outpatient surgical facility, with a local anesthetic, sedation or general anesthesia. Healing times can be lengthy after a face-lift. Bruising and swelling are usually evident for several weeks after surgery.

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Keep in mind that results vary depending on the location and depth of your wrinkles. Nothing stops the aging process of skin, so you'll likely need repeated treatments to maintain benefits.

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