Frown lines are fine lines and wrinkles that develop on your forehead, between your eyes,
and on your nose as time passes.
Frown lines are an apparent cosmetic problem that not only affects the aesthetics of the
face but also the self-worth and esteem of the person.
The presence of frown lines automatically makes a person appear older than they actually
are.
This alteration in self-perception and perception by others can take a toll on people’s mental
health, making frown lines a significant psychological burden.
Frown lines give the face a constantly annoyed or angry appearance which can limit one’s
social and personal life.
This adds to the psychological burden of frown lines and is often the reason why people choose
to undergo invasive treatments to rid themselves of frown lines.
Also known as the vertical elevens, frown lines are the result of several factors working
together rather than one main etiological factor.
These factors include:
* Aging: As one age, the skin loses elasticity and its collagen content, which is important
for the structural integrity of the skin.
The loss of these components becomes visible in the form of fine lines and wrinkles, which
are especially exaggerated in sun-exposed areas and areas of repetitive muscle contraction.
* Sun exposure: UV rays have the same effect on the skin as the aging process which is
why skin damage from sun exposure is referred to as photodamage.
Constant sun exposure destroys the collagen and elastin content of the skin, resulting
in fine lines, wrinkles, and eventually droopiness of the skin.
* From Flament et al’s paper, sun exposure was responsible for over 80% of the visible
ageing signs in a Caucasian sample.
Mind that in a previous video on skin colour and sun exposure we mentioned that those higher
in melanin will be more tolerant of sun exposure for ageing...
* Smoking: Nicotine and tobacco in cigarettes result in the formation of fine lines and
wrinkles all over the face by constricting blood vessels of the skin.
This decreases the oxygen supply of the skin and makes it susceptible to damage from environmental
toxins.
From Facial Wrinkling in Men and Women, by Smoking Status by Emster et al…
However the results arent as clear cut that smoking is the direct cause of wrinkling.
Those who have never smoked in the male group have almost the same amount of wrinkling as
heavy chain smokers in the 60-69 group, but this is likely an outlier as for all other
groups, heavy smokers have the greatest severity of wrinkling.
With the female group, this correlation is far more linear and easier to see.
If I had to guess what may have caused this outlier, men typically get more sun exposure
with a greater number of men participating in manual labour work than women and so as
sun exposure is the real culprit of skin degradation, smoking just slows down repair, the researchers
did not control for even levels of sun exposure in each group.
* Stress: When we’re stressed, we release a hormone called cortisol.
While this is normal for regular human functioning, chronic exposure, in other words being stressed
all the time is detrimental to skin health.
From Cortisol Control and Beauty by Dr Shawn Talbott, Cortisol is reported to have a destructive
effect on Collagen.
While Dr Talbott has written a plethora of knowledge in his book, let’s keep it straight
to the point with Drielen et al’s study finding an increase in perceived age correlated
with fasted cortisol levels.
While endocrinology is incredibly complex and even the authors of this study acknowledge
that disentangling the effects of different hormones is hard, it should be fairly intuitive
that chronic stress is bad for general health.
Constantly furrowing your eyes in anger is a surefire way to embed frown lines into your
face.
* Facial expressions and repeated muscle use: Squinting and frowning, along with expression
of anger and frustration requires the use of the glabellar complex muscles.
This is supported by Hillebrand et al’s 2010 study which was taken over 8 years, finding
a predictive effect between those who persistently use the same facial expressions and how those
form into defined wrinkles later on in life.They also suggested that having a drier, more alkaline
and drier stratum corneum (in simple terms having dry skin) with a lighter complexion
and being middle aged or menopausal speed up the process
Although all of these factors work together and result in the development of frown lines,
repeated use of the glabellar complex and sun exposure dominate as the major cause over
the other risk factors.
Frown lines appear in several patterns and can be of different types depending on exactly
which facial muscle is under the most strain when forming facial expressions like frowning.
Frown lines appear on the forehead and space between the eyes, known as the glabella.
They can either be horizontal, vertical, or oblique and generally, appear in one of the
following five patterns:
* V-shaped Frown lines: This is the most common pattern of frown lines as it affects approximately
37 percent of the affected individuals.
These frown lines pull the inner edge of eyebrows inward resulting in frown lines that form
a V.
* U-shaped frown lines: This pattern is the second most common pattern and involves elevation
of the outer eyebrow along with the features of V-shaped frown lines.
* Converging arrows-shaped frown lines: This pattern is seen when only the inside of the
brows are affected and come closer to each other with facial expressions.
* Omega frown lines: This pattern includes lowering of the outside of the eyebrows and
elevation of the inner side of the eyebrows.
* Inverted Omega frown lines: This pattern is rarely seen and is commonly associated
with the flattened nasal shape.
The best way I can explain it is through this meme
The diagnosis process is quite straightforward as a simple examination of the frown lines
by a doctor is more than enough for the diagnosis to be made.
When performing the physical examination, the doctor will pay special attention to facial
anatomy and anatomy of facial expression, as in which muscle is being contracted the
most with each expression.
This helps the doctor have a better understanding of the frown lines and provides significant
clues about possible treatment methods.
Generally, frown lines can be treated using topical agents or injectables, depending on
the depth of the facial lines and patient preference.
There are also several homemade remedies in the form of avocado masks, coconut oil massages
and so on that can be done in the early phases of frown line development, however, there
is no scientific evidence backing up their alleged benefits.
The topical agents that can treat frown lines are available in lotion, gel, and creme form.
To ensure maximum results, it is recommended to use topical agents with at least one of
the following ingredients:
* Hyaluronic Acid: It is a natural component of the skin that decreases as time passes
and one age.
Topical use of this ingredient helps rejuvenate the skin as hyaluronic acid is responsible
for the stimulation of collagen and elastin synthesis along with hydration of the skin.
… but the effect isn’t as great as you would expect, but it is better than nothing.
From Nobile Et al’s study on hyaluronic efficacy…
Jegasothy’s study saw smaller molecule hyaluronic acid being more effective with reported rates
of upto 40%
* Retinol: It is a form of Vitamin A with significant anti-aging properties.
Using topical retinol has been associated with increased collagen content and it does
so by promoting collagen synthesis at a genetic level.
Retinol upregulates the genes responsible for collagen production which reduces facial
lines and wrinkles significantly.
Unlike Tretinoin which is used in heavy duty acne medication, and we did talk all about
this in this video, retinols have a lower risk of skin redness and irritation which
makes them perfect for over the counter cosmetics.
From Fisher Et al 1996, Retinol was found to inhibit UV intake, i.e. reducing photodamage,
while also stimulating collagen synthesis through genetic stimulation.
* Niacinamide: Niacinamide or Vitamin B3 also has anti-aging properties, along with anti-pruritic
and anti-inflammatory properties.
This ingredient is especially helpful in treating frown lines that have developed as the result
of UV exposure and photodamage.
Niacinamide reverses the damage done by sunlight, namely hyperpigmentation and wrinkles.
Niacinimide has been shown to improve fine lines, but nothing substantial in the way
of heavy wrinkles like you would expect from frown lines.
The injectable treatment of frown lines includes the use of botulinum toxin type A or BOTOX
and dermal fillers containing hyaluronic acid, collagen, hydroxylapatite, and Poly-L-lactic
acid.
BOTOX injections smoothen the skin by preventing the overactive facial muscles from contracting
and straining the overlying skin.
Dermal fillers, on the other hand, reduce frown lines by injecting components that promote
wound healing and repair the skin from
the inside.
It
is important to note
that
dermal
fillers only last
for approximately six months.