What Causes Wrinkles [DermTV.com Epi #200]



There are really two main causes of lines and wrinkles. Most of us are familiar with photo-aging which causes lines and wrinkles from repeated unprotected exposure to the sun and that causes collagen and elastic tissue in the skin to break and that causes lines and wrinkles. But what most people don’t realize is that another cause of loss or breakage of collagen and elastic fibers is repeated motion of the skin, repeated creasing and folding such as frowning, smiling and squinting. All of these things fold the skin back and forth- fold the collagen back and forth and causes it to break. Let me give you some examples, this is a flat piece of paper without any folds and I am going to fold it, and I press on that and now I’m going to fold it again and move my finger back and forth several times. If I open it you can see a fold or a crease. Let me try to rub out that fold or crease. And what happens? You still have a fold, you still have a crease. And the reason is, in folding that repeatedly I’ve actually broken the cellulose fibers that form the structural integrity of the paper. Well, if paper has cellulose fibers to give it integrity our skin has collagen which gives it structural integrity and as a result of repeatedly folding the skin or creasing the skin whether it’s frowning or smiling, anything that does that will ultimately break the collagen fibers and therefore cause the same kind of line or wrinkle. So, think of this paper clip as a collagen fiber. What happens if we fold this paper clip back and forth, back and forth? Well after enough folds back and forth it breaks. And that’s why next to my eye I have a fine line; it’s etched there as a result of the complete destruction of some collagen there. But skin unlike paper, skin also has elastic fibers in it, and the function of elastic fibers is to restore the shape of the skin to its natural shape. So if I take my face and I stretch it out, the elastic fibers are what brings it back. But if you repeatedly stretch elastic fibers back and forth after a while they get stretched out and broken. So now there are folds in this elastic band that just don’t come out because they’ve been broken. Let me give you another example of this. This piece of paper has no folds, it’s in perfect shape. But if you fold back and forth with the elastic, after a while, you can’t get it to stretch out- it’s deformed. And one of main differences between paper and human skin, well human skin we’re accustomed to repairing itself but actually once you’ve broken collagen the skin can make a little more collagen but it doesn’t do it very well. And even worse, once you’ve broken elastic tissue, any time the skin makes new elastic tissue it never works properly. So if you need any more convincing of the value of repetitive folding of the skin in causing lines and wrinkles take a look at the upper lip of somebody who has smoked for ten or twenty years and I can promise you that you’ll see these vertical lines etched into the upper lip as a result of smoking.