Summary
Definition
History and exam
Key diagnostic factors
- age >40 years
- chronic sun exposure
- smoking
- lines on face
- horizontal neck folds
- lines on dorsum of hands and wrists
- dynamic lines
- gravitational lines
- deep wrinkles
- fine wrinkles
Other diagnostic factors
- skin laxity
- dyschromia
- dermal elastosis
- erythema
- telangiectasia
- textural changes
- actinic keratoses
Risk factors
- genetic susceptibility
- age >40 years
- white skin
- hyperdynamic muscular activity
- chronic sun exposure
- smoking
- pollution
- low socioeconomic class
- low BMI
Diagnostic investigations
Treatment algorithm
Contributors
Authors
Dimitrios Dionyssiou, MD, PhD

Associate Professor in Plastic Surgery
Department of Plastic Surgery
Aristotle University of Thessaloniki
Thessaloniki
Greece
Disclosures
DD declares that he has no competing interests.
Efterpi Demiri, MD, PhD

Professor in Plastic Surgery
Department of Plastic Surgery
Aristotle University of Thessaloniki
Thessaloniki
Greece
Disclosures
ED declares that she has no competing interests.
Elisavet Lazaridou, MD, PhD

Professor
Second Department of Dermatology
Aristotle University of Thessaloniki
Thessaloniki
Greece
Disclosures
EL declares that she has no competing interests.
Peer reviewers
George Hruza, MD
Clinical Professor of Dermatology and Otolaryngology
St. Louis University
St. Louis
Director
Laser and Dermatologic Surgery Center
Chesterfield
MO
Disclosures
GH has been reimbursed by Allergan, Dermik, and Colbar Life Sciences to attend educational symposia and has also been paid to teach other physicians. GH is a consultant for Ulthera and has received equipment for research from Syneron. GH is an author of a reference cited in this topic.
Stephanos Papanastasiou, FRCSEd, MSc, EBOPRAS, FESSH
Consultant Plastic Surgeon
Lister Hospital
Stevenage
UK
Disclosures
SP declares that he has no competing interests.
References
Key articles
Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988 Jun;124(6):869-71. Abstract
Bhawan J, Andersen W, Lee J, et al. Photoaging versus intrinsic aging: a morphologic assessment of facial skin. J Cutan Pathol. 1995 Apr;22(2):154-9. Abstract
Callaghan TM, Wilhelm KP. A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part 2: clinical perspectives and clinical methods in the evaluation of ageing skin. Int J Cosmet Sci. 2008 Oct;30(5):323-32. Abstract
Ogden S, Griffiths TW. A review of minimally invasive cosmetic procedures. Br J Dermatol. 2008 Nov;159(5):1036-50. Abstract
Klein AW. Techniques for soft tissue augmentation: an 'A to Z'. Am J Clin Dermatol. 2006;7(2):107-20. Abstract
Papadavid E, Katsambas A. Lasers for facial rejuvenation: a review. Int J Dermatol. 2003 Jun;42(6):480-7. Abstract
Reference articles
A full list of sources referenced in this topic is available here.
Use of this content is subject to our disclaimer