10 Most Shocking Places You Get Wrinkles (How to Prevent & Treat from a Dermatologist) | Dr. Idriss

I have one question for all of you. If I tell you wrinkles, what is the first anatomic area that you think of? Is it your forehead? Is it your eyes? Is it even your smile lines? Because I bet you you're not thinking about areas like your earlobes, your chest, your elbows, or even your knees. And yet these are some of the places that patients come in every single day, every single week. I'm a cosmetic derm. I see nearly 100 patients a week, and they ask me, why did this happen? But more importantly, why the hell did no one warn me? So today we are going to talk about it, and we're going to talk about the most surprising places where wrinkles show up. And it's not just on the face, and it's definitely not where people expect it to. Before we start, I have a very important disclaimer. This video is not intended to feed you or give you any insecurity or new insecurities. The reason I'm bringing this up is because I see patients every single day who ask me about these things in clinic, and they usually appear in your 30s, 40s, and 50s. And these patients are so confused because no one has ever talked about them. So we're going to speak up and we're going to talk about them, but we're going to talk about them in a way where we know we can help ourselves. We're going to understand why these wrinkles form, what prevention can realistically do, what in office procedures actually help, and what respectfully does Jack Chateau, AKA Absolutely nothing. And we're going to start from the very, very top and work our way through down. Why do these unexpected wrinkles even happen in the first place? And I think it's really important to a give yourself some grace and also be understand why it happens so you know how best to tackle it. Because wrinkles do not form randomly. They show up where the skin is usually thinner, areas that have really, really high mobility and movement, repetitive repeated folding or even compression, and in some cases, areas that just get completely overlooked and. And forgotten. And yes, I am guilty, too. Add to that the fact that collagen and elastin, you get lost with age. Compounded UV exposure causes more tissue breakdown, especially in areas that we never even protect. Repetitive movement does not help, and dehydration with hormonal shifts, which we spoke about last week, can also come into play. Plus genetics, which is your cosmetic blueprint of how you're going to age and where you're going to age first. So take a look at Your genetics and biological family. But most importantly, it's important for you to understand that these changes are one multifactorial. It's not a moral failure on your end. It's not because you didn't take care of your skin. They're anatomical and they're probably at some point inevitable, or let's at least say predictable. Let's begin and talk about the tiniest, pettiest wrinkle of all. Your earlobe. Yes, your earlobe. Because people do not notice the earlobes until they do. Once they see the wrinkle on their earlobe, they cannot unsee it. And this surprises so many people. But it's simple why this happens because earlobes are irrelev relevant. If you did not wear earrings, why do you need your earlobes? But earlobes are very revealing. And the thing that is happening here is the fact that your earlobe, the skin there, is super thin. You have very little structural support when it comes to your earlobes, and gravity is doing its thing. Not to mention the fact that our ears get bigger as we get older. So if you're someone who wore earrings for most of your life, it's a double whammy. Over time, you get dermal thinning, stretching, elongation of the earlobes, elongation of the piercing, and things start to look really, really off. At home. I'm just going to go out and say there is zero creams out there that is going to give a lift to your earlobe or make your earlobes look better or behave better. I'm so sorry. But behaviorally, you can probably help yourself. One, by changing the types of earrings that you're wearing. Use something that is hollow so it's not putting a lot of weight on your earlobes. Two, if you're going to wear heavier earrings, make sure you have a disc backing it so it can take some of that weight and redistribute it along the earlobe. So it's not just at the piercing. In office things I've done for patients is inject hyaluronic acid filler into the earlobe to help with support and shape. I don't know what's happening upstairs. And in some cases, once the piercing gets really, really elongated, you just cut it all out and surgically repair it so that your lobes are made whole and the hole is not stretched. Number two is the corners of the mouth, AKA the marionette lines. This is the one people usually describe as sudden. They'll say, I woke up and My face looks angry. What is actually happening here is not just on the surface of your skin. It is structural, it is deeper. You have a downward pull because of your dao muscles. In addition, you have volume loss in your mid face. Plus your bone structure is actively thinning out and receding. So things are getting heavier and genetics play a huge role. Thanks, mom, I'm gonna get them. But this is not a skin care problem. At home you can absolutely do have the best skin care. You can be using hydrating creams, you can do barrier repair, you can soften the text, you can use the retinoids for your skin quality. And all of this can be helpful, but it's not going to get rid of. FYI, if you're going to use the retinoids, use an eye cream for sure in this area because it is very, very sensitive and you do not want to get any irritation. You can also do microcurrent with the zip or even a new face to help to strengthen your tissue or even EMS to help to firm the muscles so it picks up the skin. But reality is, no topical will ever lift or structurally correct this area when the area is shifting internally. In office, strategic filler can help with support. You can botox the muscle so it doesn't pull as much the dao muscle so it doesn't pull the corners of the mouth down. And that can actually help in the long term. And then there are collagen stimulating treatments that you can also do to minimize the appearance of this line. But yes, surgery is the ultimate gold standard here. However, beware with surgery. Sometimes people pull too much and their mouths look really long. But number two, people oftentimes think that surgery is your end all, be all answer. But the reality is this area is the first to come back after a facelift and it's usually within the first six months. And that is why I'm going to tell you like I tell my patients, if you're going to go that extreme end and get surgery, make sure you know how to maintain yourself so you can maintain your surgical results even after six months. Number three, we have sleep creases, AKA sleep wrinkles when it comes to our face and the boob value when it comes to our chest. Now, these do not look like normal wrinkles because they have nothing to do with movement. And that is why it is confusing. Sleep wrinkles comes from compression and not expression. And if you are a side sleeper or a stomach sleeper, ding, ding, ding, ding, ding. Your skin is folded for hours, night after night, year after year. And you're gonna get lines on the superficial aspect of your skin. The chest is especially vulnerable because of indirect sun exposure, little skin care attention. Nobody really takes it down to their tits. Even though I've been preaching this for a while. Gravity is doing its thing where your boobs are pulling down. And so botox is not going to help with these lines because again it is not a muscle movement issue. At home you can try to help yourself with behavioral shifts like sleeping on your back. I said I can't do it, but if you can do it, great. Using a silk pillowcases. I haven't made the shift, maybe I should try it. It's going to give you mild benefit and it's definitely not going to prevent everything. But some benefit is better than nothing. Obviously skincare wise things that are hydrating with barrier repair is going to be helpful. And having a humidifier will make your skin look better in the short run. In office you help this superfic texture by micro needling and helping your skin cells to get stimulated. Laser resurfacing to come from the top down. You can even inject PRP to help as a your own bio stimulatory. But really the gold standard I think if you're looking to help your skin from a textural standpoint is going to be bio stimulants like fat stem cells taking fat from your belly, your outer thighs, your flanks and processing it that same day and using that to help regenerate your skin. Skin surgery is not really going to help those sleep wrinkles because they're going to come back. And again it's not because of skin laxity as it is due to repetitive movement. Number four is technic. Now many people have these horizontal lines since childhood and I remember my first vivid memory of them. I was 12 years old and I tried to scrub them off but they never came off. And I had like a rash like a rug burn on my neck. Maybe that was the first indication that I was going to end up doing what I do. But I noticed them since I was 12. These horizontal necklines are due to the fact that the neck skin is much thinner than the rest of your body. We have fewer oil glands, we have repeated movements and yes, our phones and our screens are exaggerating everything at home. You need to bring your phone to your eye level. You don't want to be looking at it like this all the time. You want to extend your skincare down to your neck and your chest. And if you're going to use a retinol on your neck, use again an eye cream strength retinoid after you've moisturized to minimize any irritation. LED red and infrared lights can help to switch support collagen, but you need to use them daily and very, very regularly or else they are useless in office. Botox is not going to help these horizontal lines. Botox is going to help, however these vertical lines. So know what you're getting Botox for. You can however, tighten the skin of your neck with radio frequency tightening. And even using injectable stimulators like PRP or PRF in the horizontal lines or hyper dilute radius can minimize their whole appearance. I have an entire video on this on the neck and chest. I'm going to link it below. Number five are pits. This one catches people off guard because patients will tell me I suddenly feel shy to lift my arms. Now the skin here is thinner. There's constant friction. Hormonal shifts in collagen decline is going to make things worse. And we do not have a lot of oil production. We have sweat production, not oil production in our armpits. At home you can moisturize this area. Probably best to do it at night. You can use a retinoid, but be cautious because the skin there is super, super sen. So if you're going through laser hair removal, wait till you're done to use a retinoid. If you wax your pits, quit the retinoid one week before you actually decide to wax. And if you're shaving, be careful because any inflammation can be even more pronounced over an irritated area. Exfoliating with glycolic acid can also help to promote collagen long term. And can you use a face LED on your armpits? Sure, but I don't have the time for that. If you do, God bless you. Do you in office. I have injected PRF in this area to help the to create a denser under padding which has made patients very, very happy because they responded to it. So that is an option for you. Number six is the inner upper arms. This whole crepey area. Even very fit people get it and it's very frustrating because the dermis is thinner here and we also have fewer oil glands. Plus our arms lose collagen faster than many body areas. So early collagen loss is very, very visible on our upper arms. Plus constant pulling and downward pull, AKA gravity and yo yo. Dieting Mounjaro Ozempic does not help. Firming creams are not going to do much brushing is not going to tighten your skin. It might Help with lymphatic drainage, sure, but it's not going to tighten you. Supplements. Why, if you have a healthy diet, is not going to be the answer. So what can you do to help yourself? It's basic things that sound basic that are often overlooked. Rich moisturizers with ceramides, butter and squalene, shea butter and squalene can help. Thick ointments like Vaseline or Aquaphor body spray can make the appearance of that creepiness better. Minimizing hot showers, because hot water, think of a greasy pan, gets rid of that superficial oil. So minimizing hot showers minimizes how much of any oily residue is left behind on your skin, which can help with the look of that creepiness. Now, our arms are usually covered, especially in the northern hemisphere in winter. You can use tretinoin once or twice a day on your arms, as long as it's not out in the sun. Urea also helps to improve crepiness. And then don't forget about muscle strengthening. Triceps strengthening. It can play a big role and really help you in the long run. In office, I have done ultrasound therapy to tighten the skin with nice results. Micro needling without any sort of radio frequency or heat can also help to help with the quality of your skin. Doing it once every, I don't know, season or every other month, it can be helpful. And you can inject biostimulatory fillers like Super Dilute Sculptra or even fat stem cells to help with that superficial quality of your skin. Now, the most extreme option is a brachioplasty where they literally cut you from here to here. I don't love it, but of course I have seen patients who have needed it and they've been very happy with those results. Number seven is our elbows, because our elbows age super aggressively. Why? Constant friction, pressure bending and very low oil production. So our skin here is much thicker. We can think of exfoliating them, but we do not want to physically scrub it because it's going to make the thickening worse. So exfoliating creams with lactic acid can help that superficial, very fine line texture. And it can also help a little bit with hydration, but the best is a keratolytic with urea at 10 to 20% to really help to dissolve thick skin and hydrate your skin. It's the foundation mission of the skin care. You can also use a retinoid if you want, but you don't want to get it too irritated because it might be counterproductive in office Light to medium chemical peels can be helpful. So can resurfacing with a frax axle laser. You have to be a little bit careful with micro needling because you don't want to over stimulate. Number eight is our hands that are the giveaway to everything else. The eyes are the giveaway to your soul. The hands is everything else. From sun exposure, washing, volume loss, visible veins, tendons and crepey texture become very, very visible very, very fast. At home, always put the SPF on the back of your hands, especially if you drive a lot. Barrier repair with thick creams also helps. Using a retinoid on the back of your hands is also a great idea. And if you're someone who runs dry, buy yourself some plastic gloves, cut off the fingertips, be Michael Jackson at night in the best possible way and go to sleep just with the gloves and the moisturizer underneath. In office you can help yourself by evening out the skin tone with either IPL or Fraxel. But this is where filler actually makes a big difference. Number nine, the knees, especially above the kneecap, people will notice this very suddenly because this area has a huge range of motion. There's a lot of stretching and a lot of compression. And weight changes also contribute to your knees changing. In office transfers are interesting both in the knees and I didn't mention in the hands is that with fat stem cells you also have the opportunity to recreate newness longer term. If you can't afford or don't want to go under that sort of extreme end of the spectrum in terms of treatment, you can also use bio stimulatories like Sculptra help thicken and create more density within your dermis. This so wrinkles, they're not showing up just randomly. They show up where biology and behavior intersect. And it is something that we can unfortunately more or less predict. It's not like those areas were meant to stay smooth forever. Prevention is great because at least you are aware. But it's not about trying to be perfect. And some changes are really structural and that's not something that skincare can undo. So as long as we understand these, we have better expectations and we're going to be happier overall. But I'm just curious, what area are you most surprised by? Feel free to leave a comment if you have more questions. If you want me to do a deep dive on any one of these areas, let me know in the comments below. But otherwise I will see you next week. I hope you guys have a beautiful Saturday.