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Dermatology on Bloor has been recognized by Consumer's Choice as a top cosmetic dermatology clinic in 2011, 2012, 2013 and 2014.
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Deep Wrinkles

Lines, wrinkles and other skin conditions are a fact of life, or more specifically, aging.

As we get older, the fatty, subcutaneous tissue that provides “scaffolding” for superficial layers of skin thins out. Surface layers loosen and sag, promoting deep-seated lines and wrinkles.

A lifetime’s worth of quirks, from how you laugh to how often you squint, shows up on your face. Each time we use a facial muscle to frown or smile, a groove forms under the skin. As we get older, the mid-layer of skin containing collagen (for firmness) and elastin (for flexibility) thins. Dynamic lines that appear with movement become static creases that remain unchanged, regardless of how the face moves.

We can control our exposure to ultraviolet light from the sun or tanning beds, which affects the smoothness of our skin by breaking down the collagen and elastin that thins from age alone.

We can also control habits, like smoking. Several studies since the 1970s have blamed smoke more than sunlight for premature aging. Telltale signs of a smoker include severe vertical lines between the tip of the nose and the upper lip -- engrained after years of puffing. The New Zealand Dermatological Society reports a 70-year-old daily smoker would have the “skin age” of an 84-year-old. It’s believed smoking narrows the blood vessels, reducing the supply of blood to the skin, which changes the fibers responsible for its spring and firmness.

A wrinkle isn’t a wrinkle

Glogau’s classification is used to objectively describe the severity of age-related changes, starting with:
  • Mild aging, characterized by few wrinkles requiring little to no makeup coverage
  • Moderate damage includes early wrinkling, accompanied by dull complexion
  • Advanced aging’s persistent wrinkles coexist with discoloration, broken blood vessels and precancerous growths
  • Severe damage includes wrinkling so extensive makeup may seep into folds instead of covering up lines
Fine lines and wrinkles are mainly caused by sun exposure and smoking. Deeper lines and furrows are associated with repeated movement of face muscles.

Treatments vary depending on the severity of the damage, as well as where the wrinkles are located.

Cures through history

It’s said Cleopatra bathed in sour milk and the ancient Chinese used ginseng and other herbs to resurface the skin.

The 1990s saw the first use of laser resurfacing, and the millennium brought with it commercial fillers to smooth the skin.

On one end of the spectrum, we have moisturizers and OTC or medicated face creams with anti-aging benefits. On the other end of the spectrum, we have facelifts to reposition our wrinkly, sagging skin.

Somewhere in the middle we have the following:


The top layers of the epidermis are removed using chemical peels, rotating brushes, lasers, intense pulsed light or radiofrequency energy. Generally, they improve fine lines and static furrows like crow’s feet.


Fat, collagen or hyaluronic acid may be injected into deeper wrinkles to plump up problem areas, smoothing skin. These injectables treat static creases seen at rest and add volume to shallow areas.

A complementary procedure involves applying proteins to block the action of nerves responsible for the dynamic muscles we see at the corners of our eyes when we laugh or on our cheeks as we smile.

There is no single best answer for each patient, and certainly a one-size-fits-all solution for our deep wrinkle needs eludes us.

Contact Dermatology on Bloor in Toronto at 416-922-6869 so we can develop a treatment plan that addresses your concerns and fits into your lifestyle.

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