Here's What Lasers And Injectables Do That Topical Skin Care Can't

Got wrinkles or sun spots? Dermatologists explain the powers and limitations of creams versus Botox and lasers.

It’s no secret that retinol is considered the gold standard when it comes to truly effective and transformational skin care ingredients. If you’ve ever spoken to a dermatologist, read a handful of skin care articles or flipped through the pages of a magazine, then you know that the vitamin A derivative is the answer to many, many skin care woes. Got acne? Retinol. Starting to see fine lines? Retinol. Dark spots? We don’t need to say it.

Well, we hate to be the bearers of bad news, but when it comes to certain types of wrinkles and skin issues like sun spots, there’s only so much that topical skin care products can do — yes, even omnipotent, beloved retinol. While there are definitely things that can be prevented and treated with topical serums and creams, some skin concerns are best left to professionals and things like Botox or laser treatments.

But how can you possibly determine whether your skin goals are attainable with the use of your favorite fancy serum, or if you’re simply throwing money down the drain by trying to DIY a solution that can only be found inside a dermatologist’s office? We asked the pros to break down the different types of wrinkles and dark spots that can appear on our skin — and how to determine when it’s time to see a dermatologist if you really want them gone.

First things first: Are there different types of wrinkles?

“There are generally two large classifications,” said Sheetal Sapra, dermatologist and co-founder of ICLS Dermatology & Plastic Surgery. First up are static wrinkles. These aren’t dependent upon movement. They’re just kind of there. “They usually occur from the natural aging process, [which causes] loss of collagen and volume. However, they can be accentuated by extrinsic factors, especially smoking and sun exposure.”

On the other end of the spectrum are dynamic wrinkles. “These are lines that occur due to repeated facial movements. These facial movements create creases in the skin that become permanent over time.”

How can you tell if your wrinkles are dynamic?

“The most common place you will see dynamic wrinkles are on your forehead,” Sapra said. “They result from moving your brow upward, squinting or being stressed.” You might have heard of the vertical lines between your brows referred to as “elevens,” while the horizontal lines on your forehead are called “worry lines.” “Another common area is around the eyes — ‘crow’s feet,’” Sapra explained. “When you move your brow up, for example, the lines on your forehead get deeper.” That’s how you know those are dynamic wrinkles.

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How do you reverse dynamic wrinkles?

It’s much easier than reversing static wrinkles, which are caused by genetics or sun exposure, said Howard Murad, dermatologist and founder of Murad Skincare. “You can treat [dynamic wrinkles] with Botox ... paralyzing the muscle that is the cause of that wrinkle.” However, he points out that these types of wrinkles are caused by a repeated habit (like squinting or raising your brows), so you’ll need to “modify your habitual behavior, too,” to really see long-term change.

How do you reverse static wrinkles?

It depends on the location and depth of the wrinkles, but static wrinkles, especially those caused by genetics, are tricky. “Some people have stronger muscles in different parts of their face, and whatever the gene expression is, it’s going to be the same as it was for their parents,” Murad said. So prevention is really key when it comes to these types of wrinkles. “Medical-grade skin care should be introduced as early as possible to assist in preventing wrinkles from forming,” said Sapra, who views topical products as a preventive measure and suggests you “continue fine-tuning your regimen as you age. But skin care [products] would not be best suited as a stand-alone treatment for severely aged, wrinkled skin.”

Since lifestyle and environment play such a major role in the development of these types of wrinkles, “the most important skin care product in anybody’s regimen is a broad-spectrum UVA/UVB sunscreen with minimum SPF of 30,” Sapra said. “Sunscreen is anti-aging — it prevents the photoaging process.”

But that doesn’t mean that topicals won’t do anything for static wrinkles that have already formed. “While it’s not necessarily the best solution, you are going to get benefits regardless from consistent use of topical skin care [products] that address your specific concern,” Murad said.

What type of skin care products work best for static wrinkles?

Look, you already know the answer. “Retinol,” Murad said. “It’s one of those versatile ingredients.” (See, we told you.) So while it won’t freeze any muscles and totally smooth out skin, retinol “visibly minimizes lines and deep wrinkles, evens skin tone, and boosts radiance,” Murad said.

What about skin tone issues caused by sun damage?

While “overexposure to the sun’s rays [can] cause damage to the collagen bundles that live below the surface of the skin” and cause wrinkles, explained Murad, that hot ball of fire in the sky with which we have a major love/hate relationship also contributes to — surprise — dreaded sun spots. Over time and with repeated damage, a collection of pigmentation or melanin, known as a sun spot, may appear, Sapra said.

Do topicals work for sun spots, or are lasers the best solution?

Everything from vitamin C (for brightening) to alpha hydroxy acids (for exfoliating and encouraging skin cell turnover) to, yes, retinol, will likely make a difference — it’s simply a matter of how much of a difference you’re looking for.

“Laser treatments such as ExcelV or PicoSure can actually target single lesions, such as sun spots or broken blood vessels,” Sapra told HuffPost. “IPL (intense pulsed light) treatments can treat overall superficial brown and red pigmentation in the skin. We also use lasers known as Fraxel, Halo or ProFractional to treat pigmented skin. It’s ideal to utilize medical-grade skin care in combination with an individualized treatment plan to get the most optimal results for each and every person.”

If the dark spots you’re looking to get rid of are minor, “I would always just try topical agents first,” Murad said. “Give them a solid chance to work for a couple months, and if that doesn’t help, then go further with laser treatment.”

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