WrinklesWrinkles

Wrinkles are creases, folds and ridges that develop in the skin over time. Fine wrinkles measure less than 1 millimeter in width and depth, while coarse wrinkles measure 1 millimeter or more. Collagen and elastin production falls by roughly 1% each year, thinning the dermis and weakening the fiber network that holds skin taut. Slower skin cell division, repeated facial expressions, gravity, ultraviolet exposure and lifestyle factors contribute to permanent lines and folds. For treatment purposes, the useful distinction is between dynamic and static wrinkles. Dynamic lines appear when a muscle contracts and disappear when the face is at rest; static lines remain visible when the face is still. Botulinum toxin addresses dynamic lines. Static lines require volume restoration, collagen stimulation, a change in the skin's surface quality, or a combination of these approaches. Dr. Julia Tzu works across all three routes at the practice's Financial District office and plans treatment around which category a given line falls into.

5 min read · Last updated: 2026-02-08 · Reviewed by Dr. Julia Tzu , MD, FAAD, FACMS

• Photoaging from UV exposure is responsible for approximately 90% of visible changes to the skin [3]
• Collagen and elastin synthesis decreases by approximately 1% each year as skin ages [7]
• Fine wrinkles are less than 1 mm in width and depth, while coarse wrinkles are 1 mm or more [7]
• Botulinum toxin injection has been shown to be more effective than placebo at improving wrinkles for up to 120 days [5]
• Visible signs of skin aging may begin to appear after age 25 [3]

• Fine lines appearing around the eyes (crow's feet)
• Horizontal lines across the forehead
• Vertical lines between the eyebrows ("eleven" lines, frown lines or glabellar lines)
• Lines extending from the corners of the mouth (marionette lines)
• Creases running from the nose to mouth corners (nasolabial folds)
• Thin, less resilient skin texture
• Loss of skin elasticity and firmness
• Skin appearing looser or more saggy

• Lines that remain visible when your face is completely at rest
• Interest in professional evaluation of cosmetic treatment options across injectables, lasers and topicals
• Sudden or unusual changes in skin texture or appearance
• New growths or lesions that have appeared alongside the lines
• Interest in prescription-strength treatment such as retinoids, which work on fine lines over months
• Facial hollowing or flattening, which is volume loss and is treated differently from a crease
• A wish to start treating dynamic lines while they are still forming, when softening a line is more straightforward than erasing one

Have questions about wrinkles? Our team is here to help.

• Decreased collagen and elastin production with age
• Slower skin cell division causing dermis thinning
• Repeated facial muscle contractions from expressions
• Loss of collagen and elastin from photoaging due to cumulative UV radiation exposure
• Reduced skin moisture retention capacity
• Decreased oil gland secretion

We offer a service to help manage this condition: Botox .

• Wrinkles are a natural part of aging and cannot be completely prevented
• Consistent sun protection, lifestyle modifications, and appropriate skincare may slow the development of new wrinkles
• Treatment results vary based on wrinkle severity and type
• Many treatments require ongoing maintenance for sustained results
• Combination approaches often yield the most noticeable improvements

Triple board-certified cosmetic and surgical dermatologist · Manhattan's Financial District

Trained at Stanford, Johns Hopkins, Penn & NYU

✓ Results that preserve natural facial movement

With over 15 years of cosmetic dermatology experience, Dr. Julia Tzu has become known for botulinum toxin results that look natural – softening wrinkles while keeping your expression intact. She builds each injection plan around your natural facial movement, so the effect is a refreshed look rather than a frozen one.

More About Dr. Tzu →

1. What are the symptoms of Wrinkles?
2. When should you seek care for Wrinkles?
3. What causes Wrinkles?
4. How are Wrinkles treated?
5. Prognosis
6. FAQs
7. Sources

This article draws from 7 peer-reviewed sources.

• [6] NIA – Skin Care and Aging
• [7] PMC – Wrinkles (Review Article)

• [1] Mayo Clinic – Wrinkles Symptoms and Causes
• [2] Mayo Clinic – Wrinkles Diagnosis and Treatment
• [3] Cleveland Clinic – Wrinkles & Fine Lines: Types, Causes & Prevention
• [4] Cleveland Clinic – Treatments to Reduce Wrinkles

• [5] AAD – 11 Ways to Reduce Premature Skin Aging

Medically reviewed by Dr. Julia Tzu , MD, FAAD, FACMS · Last reviewed: 2026-08-31