Is it possible to make wrinkles disappear entirely?

Wrinkles are the result of a range of complex biological mechanisms associated with skin ageing. Over time, fibroblasts, the cells responsible for synthesising collagen, elastin and glycosaminoglycans, slow down their activity. The skin then loses density, firmness and elasticity. Added to this are oxidation of the dermis’s structural proteins, collagen glycation and decreased sebum production, which compromise cellular cohesion and the skin’s capacity to regenerate. These intrinsic processes are compounded by extrinsic factors, such as exposure to the sun, which accounts for nearly 80% of visible skin ageing in phototypes fair, but also to tobacco and to pollution, which accelerate wrinkle formation due to oxidative stress and the chronic inflammation they provoke.

Many treatments are now capable of diminishing the appearance of wrinkles, yet none can eradicate them entirely.

Injections of hyaluronic acid, for example, restore volume and firmness to the skin and help to compensate for the loss of dermal support proteins. However, these effects are temporary and require regular top-ups. Similarly, biomimetic peptides, such as argireline, have shown promising results in reducing wrinkle depth and improving skin texture. Their action relies on direct communication with skin cells: they mimic neurotransmitters to limit muscle contractions. These mechanisms offer a visible improvement, but not a total eradication of wrinkles.

For example, a clinical study assessed the efficacy of argireline on periorbital wrinkles in 60 participants. They were randomised to apply a 10% argireline emulsion or a placebo twice daily for four weeks. As shown in the photograph below, the participants’ wrinkles were reduced but not eliminated.

The chemical peels and microneedling techniques stimulate cellular regeneration and collagen production. When used together, their effects are amplified and wrinkles are further diminished. However, these methods do not achieve complete wrinkle removal, as they do not target the deep structure of already compromised dermal tissue. For example, a clinical study evaluated the efficacy of a treatment combining an alpha-hydroxy acid (AHA) and trichloroacetic acid (TCA) peel with microneedling on photo- and chrono-ageing wrinkles in 49 subjects. Participants underwent a single combined session and were reassessed after 30 and 60 days. The results showed a significant improvement in wrinkles across all facial areas, but not their elimination.

Lasers, notably the 755 nm Alexandrite laser, improve skin texture and tone by stimulating neocollagenesis. The results are often impressive on fine to moderate wrinkles, but deeper creases only partially resolve. Studies have assessed the efficacy of the 755 nm Alexandrite laser on photodamage-induced wrinkles in 40 women. These volunteers underwent four sessions spaced one month apart across the entire face. The outcomes demonstrated a significant overall improvement, and 90% of participants reported being satisfied or very satisfied. Nevertheless, it should be emphasised that the laser did not eliminate all the wrinkles.

Surgical interventions, for their part, enable more lasting corrections. Techniques such as facelifts, blepharoplasty or autologous fat micrografting help restore skin volume and reduce the appearance of wrinkles, while maintaining a natural appearance. Nevertheless, beyond being unsuitable for everyone and carrying a significant risk of side effects, these invasive approaches do not guarantee the total and permanent disappearance of wrinkles, as demonstrated by the recent study conducted by XIE and his team.

This study evaluated the efficacy of the subcutaneous face and neck lift in 119 patients with a mean age of 46 years. The results demonstrate a significant improvement in wrinkles and skin laxity. Three-dimensional analysis also revealed an increase in zygomatic volume and a decrease in volumes at the nasolabial folds and lateral cheeks, with outcomes considered satisfactory and natural by the majority of patients. The photographs below of one patient show a marked reduction in wrinkles but, once again, not their complete elimination.

Today, no technique can completely eradicate wrinkles. Current solutions, whether topical, device-based or surgical, aim to reduce their appearance and slow their progression rather than eliminate them.

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