Contrary to popular belief, not all wrinkles are created equal. While they’re often treated as a single concern, they actually develop for different reasons, at different stages, and require a more nuanced approach to treatment. The fine lines that surface from dehydration are not the same as the deeper folds etched in by time, collagen loss, and repeated expression. And treating them as one and the same misses the point entirely.
“Wrinkles differ in their anatomical layer, driving mechanism, and required treatment depth,” explains Dr Manasi Shirolikar, consultant dermatologist and founder, drmanasiskin.com. “For example, a humectant-rich moisturiser will meaningfully address dehydration lines, but will have negligible impact on a deep nasolabial fold driven by volume loss. Botulinum toxin will arrest a dynamic wrinkle brilliantly, but will do nothing for gravitational descent or epidermal atrophy. Retinoids stimulate collagen and accelerate cell turnover, addressing atrophic and static wrinkles at the dermal level, but will not replace lost fat volume.”
Additionally, individual skin biology also varies drastically. According to the expert, the Fitzpatrick skin type impacts how the skin responds to energy-based devices. Hormonal status, particularly oestrogen levels in peri-and post-menopausal women, affects collagen density and hydration. Even genetic predisposition determines collagen quality and the rate of breakdown. To top it off, lifestyle variables including sleep, nutrition, stress, and smoking create entirely different ageing profiles even amongst people of the same age.
“Treating a wrinkle without first identifying what type it is and what is driving it is the clinical equivalent of treating a cough without determining whether it is infectious, allergic, or cardiac in origin,” says Dr Shirolikar. “The mechanism must guide the treatment.”
What: These types of wrinkles form from repetitive facial movements such as smiling, frowning, and squinting, and deepen as collagen declines, eventually settling into the skin. The common areas include crow’s feet, forehead lines, and flabellar ‘11s’. “They are a result of repetitive muscle movements and can progress into static wrinkles,” notes Sarwat Ismail, Medical Aesthetician and Head of Aesthetics, Laser, and Slimming at AIG Clinics, Dubai.
Treatment: While topicals can’t address the muscular root, they can slow progression. Retinoids support collagen, while peptides like argireline may slightly reduce muscle contraction. Of course, daily SPF is essential to prevent these lines from becoming permanent.
In-clinic, botulinum toxin remains the gold standard, temporarily reducing muscle activity and preventing lines from deepening. “This works by blocking acetylcholine at the neuromuscular junction,” adds Dr Shirolikar. “That, alongside resurfacing treatments like peels, RF microneedling, and lasers, can significantly help.”
What: Static wrinkles are those that are visible even at rest, reflecting deeper structural ageing. They often evolve from dynamic lines and commonly appear around the mouth and jawline (nasolabial folds, marionette lines, and perioral lines). “The underlying cause is a combination of thinning dermis, loss of subcutaneous fat, degradation of the extracellular matrix, and reduced hyaluronic acid in the skin's deeper layers,” says Dr Shirolikar.
Treatment: Rebuilding collagen and restoring volume. Retinoids are a key topical ingredient, while other vitamin C, niacinamide, peptides, and growth factors support dermal quality and slow progression.
Ismail notes that in-clinic treatments like dermal fillers aim to restore lost volume, while biostimulators, alongside induction therapies like microneedling and lasers, work over time to remodel the skin.
What: These wrinkles are triggered by chronic UV exposure, where photoageing accelerates collagen breakdown and premature skin ageing, leading to deeper and more stubborn wrinkles.
Treatment: Ismail advises a combination of correction and prevention. Resurfacing treatments like chemical peels and lasers help reverse visible damage, while antioxidants, peptides, and most importantly, daily broad-spectrum sunscreen protect against further breakdown.
What: These are superficial, transient creases caused by low water content in the skin, often linked to a compromised barrier. “They are due to reduced epidermal water content,” says Ismail.
Treatment: Think barrier-first! Ceramides, fatty acids, and cholesterol help repair the skin barrier, while humectants like hyaluronic acid and glycerin draw in hydration. According to Dr Shirolikar, for long-term improvement, stronger ingredients such as peptides and growth factors help support dermal thickness. At the same time, retinoids and AHAs can refine surface texture and improve epidermal turnover.
In-clinic, you can opt for skin boosters that hydrate and stimulate bioremodeling, mesotherapy that nourishes the dermis from within, and microneedling that stimulates collagen and increases dermal thickness.
What: Compression wrinkles form from repeated physical pressure, typically from sleeping positions, leading to vertical, often asymmetrical creases.
Treatment: A combination of both hydration and collagen support — barrier-repair skincare, retinoids, and collagen-stimulating treatments like microneedling can help improve skin resilience. Preventative changes like sleep position and pillow material also play a key role.
“The framing of wrinkle treatment as reversal is, from a dermatological standpoint, the wrong orientation,” says Dr Shirolikar. “Reversal implies a single event or treatment that undoes damage and restores a prior state, which often leads patients toward chasing results with increasingly aggressive interventions, often disrupting the very skin biology they are trying to support.”
The goal is less about reversing damage and more about preserving the skin’s innate rhythm — collagen production, cellular turnover, barrier strength, antioxidant defence, and hydration balance. When these processes are quietly supported, skin ages with intention: slower, stronger, and far less reliant on dramatic intervention.
