While aging, skin cells begin to divide slower and the dermis becomes thinner. This causes skin to lose its elasticity, not be able to retain moisture, and produce less oil. This decrease in oil production causes the skin to become drier, also contributing to wrinkle formation. As the skin ages, it becomes more fragile. There are a few causes of wrinkles, including facial expressions, sun exposure, smoking, lack of nutrition, and heredity.
The first wrinkles that appear on the skin are usually caused by facial expressions. Facial muscle contractions like smiling, frowning, and squinting can make fine lines and wrinkles much more prominent. Every time a facial muscle is used, a groove forms beneath the skin’s surface. When the skin ages, it becomes less flexible and can no longer bounce back into place as easily, causing the grooves to become a permanent feature on the face.
Over-exposure to sunlight can also cause wrinkles. Clients with fair skin have a greater chance of developing wrinkles from sun exposure. Ultraviolet radiation speeds up the natural aging process and breaks down the skin’s connective tissue. The skin then loses its flexibility, causing it to begin to sag. The parts of the body that are exposed most to the sun, such as the face, back of the hands, neck, and top of the arms, will have more wrinkles form on them.
Smoking is a major contributor to wrinkles and clients who smoke cause their aging process to accelerate. A smoker’s skin produces less collagen, which is a key part of the skin’s structure.
Another cause of aging is nutrition. Eating unhealthy foods and drinking excessive amounts of coffee and alcohol can cause the skin to dry out and rapidly age. Dehydration can also accelerate wrinkle formation.
Although there are many factors that increase a client’s chance of getting wrinkles, some families just age more. If a client’s mother or father has many wrinkles, there is a greater chance they will.
While almost no client is safe from the formation of wrinkles, there are multiple ways to prevent and treat wrinkles.

Case Study:

A first-time male client comes to the spa for a facial. As the treatment was originally a gift from his wife, the man seems a bit nervous and out of his element. Even though he is reserved, he is upfront and candid when answering questions during the consultation. While examining his skin under the magnifying lamp, you observe development of open comedomes around the nose, as well as age spots on both cheeks. Most prominent though are his wrinkles on the forehead and around the eyes. They do not appear deep and seem superficial. When overviewing his intake form, you notice he listed smoking as a habit quit a year ago, and did not give detail to his daily sun exposure level. He does not use any skin care products and has never seen an aesthetician or dermatologist for any reason.

As a skin care professional, what solution would you propose to treat 
this case study on acne scarring?

Enrique Ramirez, L.E., L.M.T., owner of  face to face nyc

“Most male clients are apprehensive as they enter a spa for the first time. I would approach this client with a nice, firm handshake and the warmest smile to put him at ease. Once comfortable in the treatment room, I would explain the process of the treatment, which always helps men relax as they begin to understand what to expect.
I begin my facials with cleansing, followed by skin-related questions. Once I have the necessary information, from at-home regimens to frequent dermatologist visits, I start the facial. For this client with sun damage and fine lines, I would suggest upgrading to our Micro Peel Groovy Facial, which comes with two quick passes of microdermabrasion, deep pore cleansing, and a light, fruit acid peel. This double exfoliation gives the skin a thorough cleansing while addressing sun damage and fine lines to brighten and smooth the skin.
During extractions I would educate him about the importance of at-home product usage to address sun damage, fine lines, and unruly pores. Easy steps to follow at home would include an anti-aging moisturizer for nighttime repair, daily sunscreen to protect, and weekly five to 10 minute cleansing mask to decongest pores. In addition to his education about benefits of skin care products, I would finalize the facial with a suggestion to see a dermatologist for annual skin cancer screenings. I would provide him with a written referral to a dermatologist with all contact information. If needed, I call the doctor myself to book the appointment since men tend to be less proactive about their skin. Before leaving the spa, I would go over the products and his referral. Showing my male clients that I genuinely care about their skin is just the beginning of a long-lasting relationship. By his next visit, he will not need a gift card from his wife. This newly-converted spa man is here to stay.”

Nick Berner, vice president of sales and marketing for Dude Skin Care

“Since the client is male with no previous skin care experience, it is best to address his multiple skin challenges with as few products as possible if he is to maintain a regimen after this initial treatment. With men, simplicity rules!
Assuming no aspirin allergy was confirmed, I would start with a two percent salicylic acid cleanser to dissolve the oil and debris causing his comedones. If he confirmed little or no prior sensitivity, I would carefully apply a rejuvenating peel with lactic acid, resorcinol, and copper tri-peptides. This combination addresses the client’s mild wrinkles and fine lines, age spots, and any previous sun or smoking damage.
Once the peel was complete, I would apply a serum around his eyes that has a high concentration of antioxidant vitamins C and E, green tea extract, botanical stem cells, and marine algae extracts. These actives combine to reverse sun damage, reduce inflammation, and keep his collagen and elastin production at ideal levels.
Lastly, I would top off the treatment with a replenishing, non-comedogenic sunscreen with SPF 30, protecting against both UVA and UVB rays. The client would be sent home with no more than three products to actively use.”

Erin M. Holder, B.S.N., R.N., co-owner of Mod Skin Nutrition

“My usual go-to for superficial wrinkles is chemical peels. However, men typically want a no down-time option. In this case, I would choose a medium-depth microdermabrasion and add a layer of 10 percent retinol post treatment as a boost to repair photo-damaged skin while minimizing the fine lines. The microdermabrasion-retinol combination will not only target the wrinkles but also the comedomes and hyperpigmentation.
The wrinkles on the forehead and around the eyes are considered expression lines that are secondary to repetitive of facial muscle movement. Under the care of a physician, a neurotoxin may be injected into these expressive muscles to temporarily improve the appearance of both frown lines and crow’s feet.
While these muscles are relaxed for three to four months, now is an ideal time to focus on daily care to improve the collagen production for overall health and appearance of this client’s skin. Choose a multi-beneficial, simplified skin care system formulated specifically for men. Morning care should include an antioxidant serum or corrective shave product completed with a lightweight, moisturizing lotion that hydrates the skin while providing ultraviolet protection. The evening regimen should include a cleanser that removes environmental impurities followed by an all-in-one (retinol, peptide, hydrator) regenerating night cream.”

Aliesh D. Pierce, national education director at DMK Skin Revision

“The client’s candid response signifies that he is ready to take action. After conducting a thorough skin diagnosis, I would ascertain his primary cosmetic goals. Then, before initiating treatment, I would start to explain my findings. Assuming his biggest concern is wrinkles, I would explain my course of action. Since wrinkles are more than just ripples on the surface of the skin, I would recommend a series of enzyme treatments designed to rebuild the dermis. Upon determining that the structure was rebuilt and the skin function – specifically the skin’s immune response – was restored, I would begin resurfacing treatments. He would need to commit to a four to six treatment program that would completely refine the skin and revert it back to the texture of his youth.
To truly achieve lasting results the client would need to commit to a home prescriptive regimen. Following a daily and nightly ritual of self-care with a few select products would allow him to maintain the results achieved in our bi-monthly treatments. The key product I would prescribe is a low, molecular weight beta-glucan serum to stimulate collagen and activate his immune system.
If this course of action seems too overwhelming, he could opt for a simple, hydrating facial. He would definitely feel more relaxed from a facial, which would show on his skin. However, true results can only be achieved through skin revision treatments.”

Tasha D. Manigo-Bizzell, M.S., M.B.A., L.E., owner of Muse Wellness Company

“This client is already nervous so the last thing I want to do is overwhelm him! However, I think it is necessary to assess how he feels about his skin and what he is willing to do to achieve the best results. With that said, addressing the primary concern of wrinkles requires looking at root causes. Dehydration, dead skin build up, lack of sleep, excess sun exposure, and inadequate nutrition can all lead to superficial wrinkles (and ultimately deeper wrinkling) if the skin is not taken care of. It appears this client's skin condition is the result of several lifestyle factors that are easily remedied. Since he is not currently using any skin care products, I would propose a simple routine that supports his skin, both internally and externally, with hydration, weekly exfoliation, and daily sun protection. This client was a smoker – smoking can rob the skin of vital nutrients, including vitamin C, which is necessary for collagen synthesis; so it is equally important to encourage him to adopt an eating plan that includes antioxidant-rich foods, healthy fats (especially essential fatty acids), adequate water, and limiting refined sugars to support his skin's substructure.”