Wrinkle Reduction

Wrinkles arise from intrinsic ageing plus photoageing, with UV exposure responsible for the large majority of visible facial ageing. Topical retinoids have the strongest evidence of any intervention, increasing dermal collagen and reducing fine lines over months of consistent use. Daily broad-spectrum sunscreen prevents further photoageing and has randomised evidence for reducing skin ageing over four years. Oral collagen peptides show small but reproducible improvements in wrinkle depth and elasticity in meta-analyses, though many trials are industry-funded. Smoking accelerates wrinkling independently through matrix metalloproteinase activation.

1) Use broad-spectrum SPF 30+ daily, the only intervention with randomised evidence for preventing skin ageing. 2) Use a topical retinoid nightly, starting low and building tolerance — the best-evidenced treatment for existing wrinkles. 3) Stop smoking, an independent accelerator of dermal collagen breakdown. 4) Consider oral collagen peptides at 2.5-10g daily for small additional improvements in elasticity and wrinkle depth. 5) Moisturise to support barrier function, which improves the appearance of fine lines immediately. 6) Sleep adequately and manage stress, both associated with skin barrier recovery. 7) Eat adequate protein and vitamin C, the substrate and cofactor for collagen synthesis. 8) Set realistic expectations — topical and oral interventions soften wrinkles, they do not erase deep folds.

• •Daily broad-spectrum SPF 30+
• •Nightly topical retinoid
• •Smoking cessation
• •Oral collagen peptides
• •Consistent moisturising
• •Adequate sleep
• •Protein and vitamin C sufficiency