• Mild –Only a few wrinkles that require little or no coverage.
• Moderate –Early wrinkling with a shallow complexion and requires coverage.
• Advanced –Persistent wrinkling with skin discolouration with ruptured blood vessels.
• Severe –Severe wrinkling and furrows along with actinic keratoses and coverage does not hide.

How do Facial Lines form?

Facial lines and wrinkles are also known as rhytides and form because of the following factors:

• Aging
• Sun damage
• Excessive muscle activity
• Skin tension
• Gravitational factors
• Injury
• Surgery
• Acne
• Skin diseases such as discoid lupus erythematosus
• Smoking

The type of facial lines include:

Fine lines

• Fine lines and wrinkles appear due to the irregular thickening of the dermal layer of the skin along with the water-retaining capacity of the epidermis.
• The main factors are sun damage and exposure to environmental toxins, particularly tobacco and such

Frown lines

• These are the vertical lines that appear between the eyebrows.
• They are also called as 11’s or glabellar lines and are categorized as dynamic wrinkles
• These are caused by repeated muscle contraction.
• Dynamic wrinkles may appear prominent when the underlying muscles are in use.
• Brow lift surgery is a good choice to reduce the appearance of frown lines.

Horizontal forehead creases

• Horizontal forehead creases appear from left to right and also caused by muscle activity.
• These lines run across the forehead and can be treated with a brow lift
•  In this procedure, the underlying facial muscles are weakened and the skin is tightened which smoothens out the skin on the forehead

Crow’s feet

• Crow’s feet are wrinkles that are caused by squinting, smiling, and frowning.
• The wrinkles stretch horizontally from the outer corners of the eyes.
• Surgical procedures such as brow lifts and eyelid surgery help to minimize them

Nasolabial folds

• Nasolabial folds are vertical wrinkles that extend from the outer corner of the nose to the outer corner of the mouth.
• They are static wrinkles and develop as the volume loss of collagen, elastin, and hyaluronic acid occurs.
• These lines are present even when the face is at rest, or in a static state.
• Dermal fillers and surgery are usually the treatments of choice

Smoker’s Lines

• Smoker’s lines are the vertical lines that form along the course of the upper lip
• They are challenging to treat, but their prominence may be lessened using fillers

Marionette Lines

• Marionette lines are static wrinkles that run from the outer corner of the mouth to the bottom of the chin in a downward direction
• The lines can be filled in with dermal fillers to improve the skin
• For deeper creases, surgery helps to lift the jowls for a smoother appearance.

Furrows

Deeper lines or furrows are classified as dynamic or static. Dynamic lines appear with movement i.e. the activity of facial muscles. Static lines are unchanged with muscle movement. Eventually, dynamic lines become static.

What treatments are available?

Notable changes in facial appearance can be obtained through cosmetic treatments. Combinations of different cosmetic procedures are recommended by the dermatologist for the best results.

Moisturisers

• Ageing skin is replenished and looks better when moisturisers are used regularly. These improve the water-holding capacity of the skin.
• Choose one that suits your skin with your doctor’s recommendation
• Use warm tap water and a non-soap cleanser to wash your face
• Include UV protection in your morning regime.

Anti-ageing formulas

It is best to use a product recommended by your dermatologist that may include anti-oxidants and/or exfoliants such as:

• Topical retinoids
• Vitamin C
• Alpha hydroxy acids
• Polypeptides
• Biological extracts

Resurfacing

Resurfacing techniques are cosmetic treatments that peel the top layers of the epidermis through chemical or mechanical means. They even out pigmentation and improve the skin texture. The treatments include

• Superficial and medium-depth chemical peels
• Dermabrasion and microdermabrasion
• Neodynium: YAG or carbon dioxide laser resurfacing
• Non-ablative laser such as IPL
• Thermal resurfacing including thermage

Implantation

• Individual lines and furrows can be treated with implants, i.e., temporary or permanent fillers or grafts.

Botulinum toxin

• This treatment targets the muscles and used to treat frown lines, crow’s feet and forehead lines.
• It is effective to alter the shape of the eyebrows and softening the so-called smoker’s lines around the lips, among other uses.

Cosmetic surgery

• A facelift or mid-facelift is a procedure that removes the excessive skin and tightens the muscles of the lower two-thirds of the face
• A forehead or brow lift and mid-temporal lift is effective to reduce static lines and lift up drooping eyebrows.
• Rhinoplasty targets the tip of the nose and reshapes it or thins out as necessary
• Upper and/or lower blepharoplasty or eyelid surgery removes redundancy in the skin and fat of the eyelids.