What causes fine lines?

SOFTEN AND PREVENT LINES

What causes fine lines?

Fine lines are lines that develop from aging. Aging can be due to:

Intrinsic
extrinsic factors

Intrinsic aged skin can still be smoothes with some expression lines. Underneath the microscope there are changes within the layers of the skin. In particular, the skin has the top layer of the epidermis consisting of keratinocytes which act as a barrier to the skin.

Underlying the epidermis is the dermis which has fibroblasts and extracellular matrix with blood vessels, hair follicles and other cellular components. At the junction of these there are ridges in youthful skin. However as we age, the junction known as the dermal epidermal junction flattens, and the layer of the dermis becomes thinner.

The collagen in the dermis changes in ratio. Usually young skin has about 80% type 1 collagen and 15% type 111 collagen. However with aging the percentage of type 1 collagen reduces and the percentage of type 111 collagen increases.

However, it is proposed that most of the facial aging observed is related to sun exposure. The skin that typically reflects sun exposure is observed on sun exposed areas such as the face, chest and extensor surface of the arms. it occurs as a result of UV radiation, and manifests as:

pigmented lesions such as freckles and solar lentigines
patchy hyperpigmentation
depigmented lesions
elastosis

Skin aged extrinsically causes a thinning of the epidermis, and a change to both collagen and elastin in the dermis. There is fragmentation of collagen and elastic fibres.

Enzymes which typically break down collagen are increased in skin which is sun exposed

The turnover of the upper layer of the skin, ie the epidermis is usually 20 days in youthful skin. However this increases in older skin to 30 or more days.

Additionally the important junction between the epidermis and dermis changes and weakens.

How to improve skin appearance

There are several approaches to improving skin texture. The most obvious of these is to

Fine lines can be static or dynamic. Static lines occur at rest, and dynamic lines occur with facial expressions.

In general more common areas of lines such as the "11" frown lines occur as a result of three muscles between the eyebrows. Lines from facial expressions tend to occur at 90 degrees to the direction of movement of muscles.

As a result of TGA changes from 1 June 2024, we are unfortunately not permitted to provide further education material in any detail.

In general terms we attempt to approach improving skin texture through a number of different treatments aimed at the different layers of the skin including:

epidermis
dermis
hypodermis
muscles

What to expect

Consultation

You will have a thorough medical consultation and facial assessment with Dr Nel to discuss your treatment goals and realistic aesthetic outcomes. We will create a bespoke treatment plan.

The process

We will discuss different types of treatment for each layer, and find the most suitable for your skin type.

Some treatments which give a temporary improvement generally onsets with a few days with maximum effect in 2 weeks, and last for 3-4 months.

Other treatments can be developed into a treatment plan which may include:

skin peels
use of medical devices
daily moisturisers
serums

Risks and side effects

Side effects depend on the nature of treatment in your treatment plan. Our aim is to gradually improve the surface of the skin. Although some treatments are more immediate, we also aim to provide longer term maintenance treatment.

A consent form will be provided for each different type of treatment informing you on the nature of the treatment, how its used and possible side effects.

The most important aspect of assessing skin improvement is a thorough consultation to discuss your main priorities.

Book treatment

Are treatments for fine lines permanent or temporary?

Most treatments are temporary. However combination of treatments to address skin quality in the epidermis and dermis can have an accumulative effect to assist in long term. Please note there are variations in response between individuals.