What is it?

Collagen is essential to the smoothness of skin texture. As we age the collagen content in the skin is depleted and this leads to wrinkles and folds being set into the skin. Wrinkles tend to develop sooner and deeper in areas of the face where there is repeated muscle movement (such as the mouth, eyes or forehead), or areas that get chronically “squished” or compressed such as sleep lines.

Most lasers or energy based therapies that aim to improve a wrinkle do so by stimulating new collagen to grow in the area.

Lifestyle Factors

UV radiation kills collagen and accelerates ageing effects such as wrinkles.

Skincare Adjuncts

Suncreen that protects daily from UVB and UVA are essential to preserving healthy skin and preventing premature wrinkles. The damaging effects of UVA in particular are underestimated, but even small doses of UVA accumulated over time will result in deep damage to collagen. UVA transmits through cloud cover, window or windshield glass, and is highly reflective off water, sand, snow, asphalt. Basically, if it is daylight hours, assume that skin is being irradiated by UVA. Retinoic acid is evidence based to promoting new collagen growth, which is why it is the most commonly prescribed anti-ageing topical drug/treatment. Vitamin C and other antioxidants also have properties of supporting collagen health and slowing down the ageing process of skin cells.

Treatment Options

Treatment Option	Key Benefit	Average Number of Treatments	Amount of Downtime	Comfort Measures
Botox	Reduces wrinkles and prevents further wrinkling. Common areas are: forehead, frown lines, eyes, mouth area	Treatment typically lasts 3-6 months	None. Return to work same day	None needed
Fillers	Instant results for softening fine lines or wrinkles. Great for “smokers” lines around the mouth	Results may last between 1-2 years depending on area treated and type of filler used	Possible swelling for a few days. Potential for bruise from injections. Some return to work same day	None needed in advance. Ice pack useful during treatment. Anesthetic used if needed
Matrix IR laser	Softening of fine lines, well suited for eyes and mouth area	3 sessions, can be done with Fotofacials	Little to none. Mild swelling for 1 day under eyes. Return to work same day	Topical anesthetic
Venus Viva	Best suited for crepey skin, enlarged pores, fine lines. Very fast healing	3 sessions, can done monthly	Redness for less than 1 day, mild swelling around eyes for 1-2 days. Return to work next day	Topical anesthetic
Dermajet microneedling with PRP (platelet rich plasma)	Well suited for crepey skin, especially around eyes, neck and chest. Healing is boosted by PRP	3 sessions, can be done monthly	Little to none, possibility of some bruising. Return to work next day	Topical anesthetic
Fractora	Improves mild to moderate wrinkles	2-3 sessions, can be done monthly	Redness and swelling for 2-3 days, followed by pixel scabs that exfoliate. Return to work in 5 days	Topical anesthetic, oral sedation optional
Laser resurfacing- Fractional (Erbium or CO2)	Best suited for moderate wrinkles, faster recovery time than full ablative resurfacing	1-2	Oozing for 1-2 days, ointment for 3-4 days. Back to work in 5 days	Topical anesthetic, (nerveblock if needed)
Laser resurfacing- Ablative (Erbium and/or CO2)	For moderate to severe wrinkles. Most dramatic wrinkle reduction possible in a single session procedure	1	Oozing for 2-3 days, redness and severe swelling. Ointment for 1 week. Back to work in 7-10 days	Topical anesthetic, nerve blocks, oral sedation