Wrinkle creams: Your guide to younger looking skin

Do over-the-counter wrinkle creams really reduce the appearance of fine lines and wrinkles? The answer depends on many factors.

Many wrinkle creams and lotions sold in department stores, in drugstores and on the Internet promise to reduce wrinkles and prevent or reverse damage caused by the sun.

Do they work? Research suggests that some wrinkle creams contain ingredients that may improve the appearance of wrinkles. But many of these ingredients haven't undergone scientific research to prove this benefit.

If you're looking for a face-lift in a bottle, you probably won't find it in over-the-counter (nonprescription) wrinkle creams. But they may slightly improve the appearance of your skin, depending on how long you use the product and the amount and type of the active ingredient in the wrinkle cream.

Common ingredients in anti-wrinkle creams

The effectiveness of anti-wrinkle creams depends in part on the active ingredient or ingredients. Here are some common ingredients that may result in slight to modest improvement in the appearance of wrinkles.

• Retinol. Retinol is a vitamin A compound, the first antioxidant to be widely used in nonprescription wrinkle creams. Antioxidants are substances that neutralize free radicals — unstable oxygen molecules that break down skin cells and cause wrinkles. Retinol is less potent than the vitamin A derivative tretinoin, a topical treatment approved by the Food and Drug Administration (FDA) for treating wrinkles. Tretinoin is available only by prescription. Avoid vitamin A derivatives if you are pregnant or may become pregnant, because they may increase the risk of birth defects.
• Hydroxy acids. Alpha hydroxy acids, beta hydroxy acids and poly hydroxy acids are synthetic versions of acids derived from sugar-containing fruits. These acids are exfoliants — substances that remove the upper layer of old, dead skin and stimulate the growth of smooth, evenly pigmented new skin. Because hydroxy acids increase your susceptibility to sun damage, always wear sunscreen during use and for at least one week afterward.
• Coenzyme Q10. Coenzyme Q10 is a nutrient that helps regulate energy production in cells. Some studies have shown reduction in fine wrinkles around the eyes with no side effects. Other studies show that application before sun exposure protects against sun damage.
• Copper peptides. Copper is a trace element found in every cell. In products applied to the skin, it's combined with small protein fragments called peptides. Copper peptides enhance wound healing. They also stimulate production of collagen and may enhance the action of antioxidants.
• Kinetin. As a plant growth factor, kinetin may improve the appearance of wrinkles and uneven pigmentation with minimal irritation. It's unclear how it works, but it may help reduce wrinkles by helping skin retain moisture and by stimulating the production of collagen. It may also be a potent antioxidant.
• Tea extracts. Green, black and oolong tea contain compounds with antioxidant and anti-inflammatory properties. Green tea extracts are the ones most commonly found in wrinkle creams.

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Why does skin wrinkle with age?

What is the best way to slow or prevent this process?

Suzan Obagi, assistant professor in dermatology at the University of Pittsburgh and director of the Cosmetic Surgery and Skin Health Center, explains.

Normal healthy skin has a nice epidermis with a smooth cornified, or outer, layer that acts as a good barrier to water and environmental injury. Skin color and tone is even and unblemished. Components such as collagen (which provides skin firmness), elastin (which supplies skin elasticity and rebound) and glycosaminoglycans or GAGs (which keep the skin hydrated) are all abundant. It is interesting to note that under a microscope a biopsy of a wrinkle exhibits no telltale signs that reveal it to be a wrinkle. So what causes the skin to look wrinkled? It is probably a multi-factorial process of intrinsic aging and extrinsic aging.

Intrinsic aging is the natural aging process that takes place over the years regardless of outside influences. After the age of 20, a person produces about 1 percent less collagen in the skin each year. As a result, the skin becomes thinner and more fragile with age. There is also diminished functioning of the sweat and oil glands, less elastin production, and less GAG formation. Wrinkle formation as a result of intrinsic aging is inevitable, but it will always be slight.

Extrinsic aging occurs in addition to intrinsic aging as a result of sun and environmental damage (tobacco use and exposure to pollution, for example). Extrinsic aging shows up as thickening of the cornified layer, precancerous changes such as lesions called actinic keratosis, skin cancer (including basal cell carcinoma, squamous cell carcinoma, lentigo maligna melanoma), freckle and sun spot formation, and exaggerated loss of collagen, elastin, and GAGs. Alone or in concert, these processes give the skin the appearance of roughness, uneven tone, brown patches, thin skin and deep wrinkles.

Prevention is key to minimizing wrinkles. The most important thing is to take care of your skin before all these changes start to take place. Sun protection against both UVA and UVB rays is critical 365 days a year using an SPF of at least 35: I prefer zinc- or titanium-based products. After the age of 25 I recommend using Retin-A (a vitamin A derivative that uses the generic name tretinoin) as an antiaging cream. It is a prescription agent that has been used for more than 30 years with a safe track record and excellent results. In the first two or three months patients may experience redness, peeling and flaking, but should then noticed a marked improvement. Over time tretinoin improves fine lines, the appearance of pores, precancerous changes, and brown spots. If tretinoin treatment is not enough, then medium depth chemical peels and some non-invasive lasers can help build collagen and thus improve the skin's appearance.

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