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Last reviewed: 18 Mar 2025
Last updated: 11 Jan 2022

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
Dimitrios Dionyssiou

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
Efterpi Demiri

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
Elisavet Lazaridou

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.

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