Wrinkles: Do Any Medicines Help?

Here’s a fun topic; what can we do to prevent wrinkles? It may be a “fluffy” doctor topic but it certainly is relevant to people. So, let’s review what actually works; maybe you’ll save yourself a lot of money after reading this.

There’s a nice review of the best treatments for aging skin from the Natural Medicines Database. It’s a great and readable evidence-based review of what works and doesn’t work. They have a nice chart of the most effective natural treatments:

Aging Skin Treatments

Here’s my take on what works best:

1. Sunscreen, sunscreen, sunscreen. This is treatment #1 — and number 2, and 3, and so on. It’s by far the most important product you should use, since the best treatment for wrinkles is to avoid them in the first place. There is overwhelming evidence that most wrinkles are caused by sun-related damage, and all methods to avoid sun will help protect your skin. That means avoiding mid-day or summer sun if you can, and wearing hats with with brims. But of course the underlying method would be always using sunscreen on your face, even in the winter. Many moisturizers now have SPF15 or higher protection. Everyone should get themselves a basic sunscreen and just use it every morning. And no, you absolutely do not need to spend a lot of money on skin products; I like the Neutrogena or Loreal Mens brands, which are available at Watsons and very reasonably priced.

2. Don’t Smoke. Plenty of people will spend a small fortune on skin care products and yet still smoke. As with #1 above, there is clear evidence that smoking damages your skin both from toxic effects of the smoke directly on your skin as well as the internal cell damage from the inhaled carcinogens and free radicals.

3. Vitamin A Creams. The prescription versions of this (Retin-A and others) are probably the #1 doctor-prescribed treatment to help with wrinkles and keep your skin healthier looking. It definitely works well for some people — but only if you continue to take it, and there are some side effects as well.

4. Some OTC Creams May Work A Little. There was a very intriguing study last year, notable because it was well designed to prevent bias, which did show a statistically and clinically significant improvement in photoaging. The product is quite cheap, from Boots pharmacy, called No7 Protect & Perfect Intense Beauty Serum. Here’s part of their abstract:

Results: In the 12-day patch test assay, we observed significant immunohistological deposition of fibrillin-1 in skin treated with the test product and RA compared with the untreated baseline (P = 0·005 and 0·015, respectively). In the clinical RCT, at 6 months, the test product produced statistically significant improvement in facial wrinkles as compared to baseline assessment (P = 0·013), whereas vehicle-treated skin was not significantly improved (P = 0·11). After 12 months, there was a significant benefit of the test product over that projected for the vehicle (70% vs. 33% of subjects improving; combined Wilcoxon rank tests, P = 0·026). There was significant deposition of fibrillin-1 in skin treated for 6 months with the test product [(mean ± SE) vehicle 1·84 ± 0·23; test product 2·57 ± 0·19; ANCOVA P = 0·019).
Conclusions: In a double-blind RCT, an over-the-counter cosmetic ‘anti-ageing’ product resulted in significant clinical improvement in facial wrinkles, which was associated with fibrillin-1 deposition in treated skin. This study demonstrates that a cosmetic product can produce significant improvement in the appearance of wrinkles and further supports the use of fibrillin-1 as a robust biomarker for the repair of photoaged dermis.

The Bottom Line

The best defense is a good offense; avoid wrinkles and photo-aging in the first place by avoiding strong sunlight and always using facial sunscreen. The next best level is to not smoke. As for “cosmeceuticals”, a few may work a little bit but you do not need to spend a fortune on them. And doctors can give you the prescription vitamin A (retinoid) creams, but you need to keep taking them, and you need to review the risks and benefits with your doctor.

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