From Botox to lasers and beyond: The Evolution of Wrinkle Treatments Over the Past Twenty Years

One day you look in the mirror and you see things you never noticed before. It can start as young at your mid-30s or later. Fine eye wrinkles and crow’s feet seem to have magically appeared overnight, but of course, it took years to develop. Creases and folds in the skin cannot be far behind, and usually, turn up in your 40s and 50s. Some wrinkles appear as the result of facial expressions, like smiling, squinting, frowning and laughing, according to the Cleveland Clinic, sun damage, smoking, drinking a lot of alcohol are also contributing factors to forming wrinkles on your face and neck. Wrinkles tend to show up on the areas exposes to the sun’s UV rays; face, neck, chest, and hands.

Wrinkles are a natural part of the aging process. As we get older, our skin gets thinner, drier, loses elasticity, is less able to protect itself from external damage. This leads to wrinkles, creases, and lines on the skin. Think of it this way; every time you use your facial muscles, a wrinkle is forming beneath your skin. When you are younger, your skin is plump, firm and springs back. Over time, the skin loses these qualities, so the creases and grooves become permanently etched into the skin’s surface.

The two main types of wrinkles are fine lines that are present all the time, and deep lines and furrows that get worse from muscle activity. Minimally invasive procedures that address these wrinkles continue to dominate the market. For deeper creases, more aggressive solutions may be recommended, such as facial cosmetic surgery including face and neck lifts, under-eye wrinkles surgery, and deep laser resurfacing.

So, what can you do to reverse or slow down your skin’s aging process? As it turns out, more than you may think.

Best Wrinkle Treatments

While some of the treatments introduced over the past 20 years have made great claims but delivered mixed results, many other treatments do offer visible improvements for aging skin and their popularity continues to soar.

Retin-A was approved by the US Food and Drug Administration (FDA) in 1995 to treat wrinkles. Fast forward to 2020, and topical Vitamin A in many forms, including the most popular Retinol, is widely considered the gold standard of anti-aging ingredients because of its effects on fine lines and wrinkles, pigmentation and skin roughness. While many over-the-counter wrinkle creams can be effective, most cannot produce dramatic results for wrinkle reduction.

In 2002, BOTOX® Cosmetic (Allergan) received FDA clearance for treating fine lines around the mouth and this was soon followed by nods for other treatment areas, including wrinkles of the forehead, crow’s feet, and glabellar or creases between the brows. BOTOX® Cosmetic is the first treatment FDA-approved to temporarily make moderate to severe frown lines, crow’s feet and forehead lines look better. As of 2020, there are 4 FDA approved toxins for cosmetic uses available in the U.S., including Dysport® (Galderma), Xeomin® (Merz Aesthetics), and Jeuveau® (Evolus). The immense popularity of this wrinkle relaxing treatment cannot be overstated; year after year, it ranks as the No. 1 non-surgical aesthetic treatment in the world.

Often used in conjunction with botulinum toxins like BOTOX, injectable hyaluronic acid fillers are the second most popular treatment for wrinkles. In 2003, Restylane® (Galderma) was the first hyaluronic acid or HA filler approved in the USA. Restylane was quickly followed by a number of other fillers over the subsequent years, including Sculptra® (Galderma) in 2004, Radiesse® (Merz Aesthetics) in 2006. In 2008, the next important milestone in wrinkle treatments was the addition of lidocaine to an HA filler, which made the injections much more comfortable. In fact, hyaluronic acid fillers are frequently considered to be among the best cosmetic procedures for eye wrinkles. In many cases, HA fillers can be an ideal non-invasive alternative to under eye wrinkle surgery.

See the Light

Lasers and light-based devices are in high demand for smoothing facial lines and wrinkles, reducing pigment and redness, and improving skin. The most common technologies include ablative and non-ablative lasers, Intense Pulsed Light (IPL), radiofrequency (RF), and High Intensity Focused Ultrasound (HIFU). Each of these energies works in different ways to rejuvenate the skin, reduce pigmentation, lines and wrinkles, redness and other conditions.

In 2005, the popular Fraxel® (Solta) laser system was launched as an alternative to the very deep ablative lasers that caused a lot of redness, discomfort and long recovery times. Because it treated only a fraction of the skin for tightening, there was less discomfort than the earlier deeper lasers so patients could get back to their lives in a shorter time.

Ultrasonic Energy

Fast forward to 2009, and new technology was introduced to medical aesthetics – ultrasound waves. The treatment, called “Ultherapy” used deep ultrasound to target wrinkles because it delivers energy into deep tissues, patients could feel a heating sensation and tingling below the dermis that can be difficult to tolerate, especially around more sensitive areas like the jawline.

The next-generation ultrasound technology for treating wrinkles and saggy skin is Sofwave® that made its debut in 2020. It’s quickly becoming the top choice of many laser surgeons that really works. The ultrasound energy precisely passes through the skin’s surface to heat the deeper tissues at just the right temperature to remodel collagen fibers and improve the appearance of the face. The beauty of Sofwave is a unique cooling mechanism that protects the uppermost skin layer from burning. The treated zones stimulate a healing response, called ‘neocollagenesis’, which increases and remodels the collagen in the skin, leading to a reduction in fine lines and wrinkles.

Wrinkle treatments have always been in demand and the choices have come a long way in the past two decades from facelifts and deep lasers, to minimally invasive wrinkle treatments.

Find out more about the new Sofwave, a breakthrough ultrasound technology for treating fine lines and wrinkles