This face is like a party balloon. At the height of pleasure, it is plump and firm, the skin is tight and the surface smooth. It appears with good health. But once the games are done and the cake is demolished, there is a noticeable sense of deflation: the firmness disappears, the structure collapses, the surface becomes dull and wrinkles.
The face is the most exposed part of human skin and is prone to wrinkles. It is here that all the factors that drive their formation come together in one place. There are a series of intrinsic changes that cause the skin to become thinner, weaker and less elastic, while supporting muscle, bone and fat decrease. There is the extrinsic aging due to sun damage, smoking, poor diet and pollution that accelerate tissue deterioration. And then there’s the impact of physical demands: when we raise our eyebrows, smile, frown and laugh, the expressions create lines on our faces. When we are young, these disappear as our face settles down, but as the skin ages, these lines become permanent.
The first fine lines can appear on the face in people’s twenties. These are often the horizontal lines that run across the forehead when we raise our eyebrows. As we reach our thirties, more lines, like crow’s feet around the eyes, often appear, not only from smiling and laughing, but also from sun damage and squinting in bright sunlight. “If you ask your friends to frown, some people will get a single line in the center of their forehead, and others will get a double line, because everyone’s anatomy is slightly different,” says Prof. Rachel Watson, executive director of the A* Star Skin Research Labs and Skin Research Institute of Singapore.
Our 40s and 50s bring even more lines under the eyes and around the mouth, which become more visible as they deepen. In your sixties and older, wrinkles may appear all over the face, with the most prominent ones being more than 2mm deep. The folds don’t just come from pulling expressions. If you sleep on your side or stomach and stay in the same position every night, the pressure on the face can cause further lines. Tip: sleep on your back if possible.
On top of the folds caused by physical use are wrinkles that reflect the very fine pattern that is visible on the skin from youth. The skin has a natural ‘micro-relief’ and as the tissue loses thickness and elasticity with age, the patterns become more prominent. “It becomes accentuated with age,” says Michael Sherratt, professor of biochemistry at the University of Manchester. “You get an increase in the depth of the lines you can see on young, healthy skin.”
Understanding the anatomy of a wrinkle is not an easy job. Examine a patch of wrinkled skin under a microscope and there is little to distinguish it from non-wrinkled skin. Removed from the tissues and tensions surrounding it, the wrinkle simply disappears. But there are biological changes behind the patterns. As we age, the supply of new cells to the epidermis decreases, causing the top layer of the skin to become thinner. In the underlying dermis, changes in collagen, elastin and substances such as hyaluronic acid reduce the skin’s strength, elasticity and ability to retain moisture. Meanwhile, the connection between the two layers weakens, making the epidermis even more vulnerable.
Although wrinkles are a hallmark of the aging process, some scientists suspect that they may also cause aging of the entire body. The theory stems from the finding that aged skin contains more defunct, zombie-like or senescent cells. These old cells are more than biological junk: They release chemicals that fuel inflammation linked to a host of conditions — from high blood pressure and diabetes to hardening of the arteries and cancer. Research is now underway to see if wrinkled skin rich in senescent cells is a factor in age-related cognitive decline.
Most wrinkles appear on exposed areas of the skin: the face, neck, hands and arms, because ultraviolet rays in sunlight accelerate the breakdown of skin proteins and cause premature skin aging. Smoking also stimulates the aging process, which reduces collagen in the skin. Studies in twins show large differences in facial wrinkles when one twin smokes and the other does not. Much of the damage is attributed to the toxins found in tobacco smoke, with skin wrinkles being a visible sign of damage done to similar tissues, such as blood vessels, throughout the body. It’s not the only way smoking causes wrinkles. The physical act of sucking on a cigarette causes folds in the skin, and smokers often develop lines around the mouth, including telltale vertical lines across the upper lip.
Remember that party balloon? It’s not just changes to the skin itself that culminate in wrinkles. Just as the air pressure in the balloon keeps it tight, fat, muscle and bone in the face keep it plump and supple. As we age we lose all this underlying tissue: the muscles become weaker, the fat pads shrink, the bone is resorbed. Gravity also plays a role, which reduces the underlying support. “When we think about facial aging, it’s not just about the skin; there are also changes in the subcutaneous fat, muscles and bones. The outer skin is still there, but the elements that keep it sturdy also age.” says Watson. “It’s everything that’s starting to deteriorate.”