What are wrinkles and what causes them?

Wrinkles are natural folds in the skin. These lines usually appear on areas of the face where natural creases form during facial expressions; such as when smiling, frowning or making repeated actions. They are classified into either dynamic or static wrinkles, and treatment differs according to the type of wrinkles present.

Lines over the face can appear over time due to several factors, these include :

  • Repeated muscle movement
  • The natural ageing process
  • Sun-damage
  • Smoking

A person can have a combination of both dynamic and static of wrinkles. Dynamic lines form when you make a particular muscle action (such as frowning or brow furrowing). Over time, like a piece of paper which gets repeatedly folded, the creases become permanent. Static lines are visible even without muscle movement such as frowning. This can give you the appearance of looking angry, sad, tired or troubled even if they are not feeling that way.

Areas on the face where wrinkles & lines commonly occur:

  • Frown lines / Glabella wrinkles (between the eyebrows)
  • Worry lines/ Forehead wrinkles
  • Crows’ Feet (eye area)
  • Bunny Lines (across the nose when you wrinkle your nose)

How can I get rid of wrinkles?


To prevent worsening of fine lines and wrinkles, it is most important to protect the skin from excessive sun-exposure by using sunscreens regularly on exposed areas daily and to avoid smoking and exposure to second-hand smoke or other pollutants. Retinoid creams are also the only proven topical formulations for prevention of fine lines and wrinkles as it helps to encourage a regular cell turnover rate.

Treating Dynamic Wrinkles

For larger dynamic wrinkles, the most effective treatment is BTX (toxin injections). It works by paralyzing the muscles responsible for causing frown lines, worry lines, and crow’s feet. As the toxin takes time to work, most people will only start noticing a reduction in their wrinkles from 4-5 days after treatment. These results will continue to improve until 2 -4 weeks after treatment when results are maximal. Treating early wrinkles helps to slow the development of deeper wrinkles or static wrinkles in the future.

Treating Static Wrinkles

Static wrinkles requires a two-step treatment – you will first need to use BTX (a toxin) to stop the muscle movement so that the lines do not get any deeper, and then require a hyaluronic acid filler to fill out the static crease if it doesn’t go away with just the toxin injection alone.

How long do wrinkle treatments last?

Depending on the area treated and the amount of toxin used, BTX treatments usually last between 3-6 months, while fillers last 9 – 12 months. Lifestyle habits such as drinking and smoking will also affect the metabolism and speed of breakdown of the above mentioned treatments.

Does it hurt?

BTX (toxin injections) treatments are usually done with a very fine needle and most people only experience a mild pinprick sensation. However, you can request numbing cream prior to the procedure if required.

For fillers, numbing cream is applied before the filler injection for maximum comfort.

What are the risks involved for fillers or BTX treatments?

After the injections, you may experience some initial mild redness, swelling, or bruising, which should resolve quickly. Complication from toxin treatments are rare. However, complications can arise when toxins diffuse to other muscles not involved in wrinkle formation. When this occurs, patients may experience eyelid droops or an uneven smile. However, these results are temporary and unintended side effects usually improve with time.

Hence’s it is important that after toxin injections, due care must to taken to avoid the inadvertent spread of toxins. Immediately after treatment, avoid getting facials, facial massages, strenuous exercise, excessive heat exposure (e.g. sauna, jacuzzi) for at least 24 hours.

To reduce bruising risk, it is advisable to abstain from alcohol intake, avoid non-steroidal medications and supplements that contain- vitamins, fish oils, ginseng, traditional Chinese medicine; at least a week before treatment.