Fine lines and wrinkles might seem like basically the same thing, or at least closely related, but they’re actually distinctly different challenges – treated with distinctly different approaches.
To better understand fine lines and wrinkles, and the approaches for managing them, we talked with Anthony Nuara, MD, PhD, a board-certified dermatologist, researcher, and founder of Foundation Skincare.
What is the main difference between fine lines and wrinkles?
Dr. Nuara: Fine lines and wrinkles differ in appearance – fine lines on the face are shallow and static, while wrinkles are deeper-set and become more obvious when you move your face.
They come from opposite directions, really. Fine lines are formed on the surface, mostly from sun damage. But wrinkles come up to the surface from deep underneath the surface of the skin – and they’re formed by years of repetitive muscle use – you see this with the set-in furrows, like the ones you see on the forehead or between the brows. A lot of this is what we call intrinsic aging.
And the treatments are different for each, too. For wrinkles, we use Botox and other procedures, fillers, facelift; but for crepey lines and sun damage, that’s where products come in.
How do genetics impact fine lines and wrinkles?
Dr. Nuara: Your genetics determine your baseline skin – your collagen density, the quality of your collagen. Some people will have thicker skin (literally), some people will have oilier skin – and pore size can be inherited, too. And some people will pigment more in response to sun exposure.
Genetics also play a part in determining your facial musculature. If you inherited very strong, prominent facial muscles, you’re more set up to get deep furrows early on. If deep wrinkles run in your family, starting Botox in your 20’s can prevent those wrinkles patterns from forming – and can atrophy those muscles, so that they won’t be nearly as strong over time.
What daily habits contribute to fine lines and wrinkles?
Dr. Nuara: Sun exposure is the biggest factor. Even incidental sun exposure can be damaging. You may start your day thinking, “I'm not going to be outside today. I don't need sunscreen.” Well, you get in your car, you drive, you go walk to the store – you're out getting some cumulative sun damage, and it adds up.
Not drinking enough water can also make fine lines and wrinkles more noticeable. You can't really drink moisture into your skin, but you can dehydrate yourself into bad skin.
What are the surface indicators of aging?
Dr. Nuara: Fine lines and pigmentation are the two big ones. Some of that is inherent, but a lot of it is sun damage. We can also see some redness and flushing as we get older. But there’s a genetic component to that; I tell my patients, you're flushers and blushers.
We can also see some changes to the texture and general appearance of the skin. The hormones that gave us all that oil in our skin as teenagers are on the decline, and the oil glands aren’t working as well as they used to, so we can see kind of a dullness to the skin as a part of intrinsic aging.
How can you improve fine lines?
Dr. Nuara: When we’re talking about fine lines – at the surface levels of the skin – this is when topical skincare products really shine because they can get into those top layers.
Retinols help with fine lines by thickening up the epidermis (the outermost layer of your skin) and removing dead skin – acting like kind of an exfoliant. Our Night Renewal Cream product contains 2% Granactive Retinoid – a high-performance retinol that’s still gentle enough for sensitive skin.
Our Hyaluronic Acid Lotion is a specialized humectant that pulls moisture into the skin to instantly smooth fine lines. To maximize these benefits, it’s essential to follow with a barrier-supporting moisturizer to seal that hydration in and protect against environmental dryness.
Vitamin C is a pillar in skincare. It acts as an essential cofactor in formation of strong collagen helping to reduce visible fine lines.
And if I had to pick one product to put on my own face forever, it'd be niacinamide. Our Niacinamide Lotion enhances DNA repair and boosts production of collagen.
How can you improve wrinkles?
Dr. Nuara: Products are still important because you want to improve the fine lines on the surface of the skin, but there’s really no such thing as a “wrinkle cream” – if you want to address wrinkles, that’s where neurotoxin injections come in – Botox, Dysport, Jeuveau, all of those.
If you’re on a budget, talk to your dermatologist about the best strategy to get the most benefit for your money. Even just minimal Botox, if it’s done strategically, can help. Fillers get expensive so they may be harder to afford. Some of the techniques like microneedling help a little bit, and that's relatively inexpensive compared to lasers.
How can sun protection help?
Dr. Nuara: Protecting yourself from the sun is the most important thing you can do – for fine lines and wrinkles, and to prevent skin cancer.
Sunscreen should be broad-spectrum, with 50-plus SPF. A lot of patients ask about makeup that contains sunscreen, but those really don’t give enough protection. Most face creams with added sunscreen don’t, either. The sunscreen they add is usually a lower SPF – and it’s usually a chemical sunscreen. Chemical sunscreens work by absorbing UV radiation and converting it to heat. Whereas, physical sunscreens, like zinc and titanium that you have in actual sunscreen products, reflect the rays, so the UV rays bounce off your skin.
A lot of my patients like the tinted sunscreens – I’m a big fan of those, as long as they’re 50 SPF. They can work as a makeup primer: It becomes your base layer, and you can build on top of it.
I also really like protective clothing – I wear them all the time. The SPF 50 shirts are really effective. They typically have things like zinc or titanium embedded in the fabric. They don’t last forever – every time you wash them, they decay a little bit, so you want to replace them annually.
What lifestyle changes and products can help treat fine lines?
Dr. Nuara: Lifestyle-wise, if you’re not eating a healthy, balanced diet, that’s the first place to start. Make sure you’re drinking enough water and getting enough sleep. Sleep is our reparative phase, so it can help with collagen production. And also, when you’re not getting enough sleep, you're puffy, you get swollen eyes, and eventually, with chronic sleep deficiency, you’ll get bags under your eyes.
Also, pay attention to stress – it can age us for multiple reasons. Stress generally puts your body in panic mode, and your cortisol goes up. Cortisol will inhibit collagen production and tell your body to actually store fat. Some stress is normal and healthy, but chronic stress will have an aging effect.
And, if you smoke or vape, there are a lot of reasons to quit. It's just a ton of oxidative stress that will show up on your skin.
If we’re talking about products, again, broad-spectrum sunscreen with 50-plus SPF is the most important thing.
I recommend a moisturizer with hyaluronic acid and a retinol product, but save the retinol products for nighttime. Retinol products are sun sensitive, so best to use those before bedtime.
And antioxidants help protect our skin from environmental damage that can show up as fine lines. I’d recommend taking a supplement like Foundation Skincare’s Spectrum Antioxidant Supplement.
When should you start preventing fine lines and wrinkles?
Dr. Nuara: For fine lines, the biggest thing you can do is prevent sun damage, so you should start as young as possible. I tell my patients to put sunscreen on their kids and teach them good habits. We know from research that a lot of the damage from the sun is done early, so you want to start really enforcing it by the teens and 20’s. I find that tinted sunscreen is a pretty easy sell with teens.
To prevent wrinkles, you can start Botox at around the mid to late 20’s, which will help to keep those deep furrows from forming. You may also choose to start fillers as you get older to restore volume.
Some of this is just part of getting older, and you can choose to let the normal aging stuff happen or not.
Anthony Nuara, MD, PhD, is a board-certified dermatologist and the founder of Foundation Skincare. Dr. Nuara conducts clinical trials and educates other physicians on new medications, furthering advancements in dermatological treatments and therapies. His research and clinical work are driven by a commitment to improving patient outcomes through cutting-edge science and personalized care. Dr. Nuara is in private practice in Arizona.
