Dermatologist Dr Shyamalar Gunatheesan’s guide to getting rid of wrinkles without Botox


Botox isn’t the be-all and end-all when it comes to minimising fine lines and wrinkles. Dermatologist Dr Shyamalar Gunatheesan explains the topical skincare and the in-clinic treatments to try instead.

As a Beauty Editor, one of the most common questions I get asked by friends, family and my colleagues is; can you actually get rid of wrinkles without Botox or injectables?

Skincare can be so confusing and there’s so many variables at play when it comes to finding stuff that works for your skin – think: collagen supplements, bakuchiol vs retinol – or even the conundrum of JLo and the Botox olive oil debate.

In this case it’s all good news. According to Dermatologist Dr Shyamalar Gunatheesan you can certainly reduce the appearance of fine lines and wrinkles without having to cop needles to the face.

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First things first, let’s quickly recap what wrinkles are and how they form. “Wrinkling of the skin occurs with dynamic movement (AKA expressions, talking, laughing etc),” explains Dr Gunatheesan. “Static wrinkles are seen due to the intrinsic and extrinsic processes of ageing (referring to lines across the neck, cheeks and at the corners of the mouth for example). Wrinkles become visible due to the thinning of collagen and elastin in the skin.”

Let’s talk topicals

Topical skincare to target wrinkles and lines should focus on active ingredients. “Actives such as Vitamin A (retinol), B3 (niacinamide) and Vitamin C, specifically,” says Dr Gunatheesan. “Topical Vitamin A has been proven in numerous clinical studies to increase epidermal thickness, increase collagen and elastin production.”

“Vitamin B3 and Vitamin C are potent anti-oxidants and mop up free radical damage, thereby minimising collagen degradation,” she adds.

Moving on from actives, sunscreen is your best bet at preventing wrinkles altogether (as is sleeping on your back by the way). “Broad-spectrum sunscreen with UVA, UVB and visible light protection to minimise UV damage of DNA and consequent skin ageing,” explains Dr Gunatheesan. We’re talking 50+ here.

Let’s talk treatments

These are your hard-hitters, but they’re nothing without proper, committed at-home care and sun protection. They’ll also work way better when your lifestyle habits like diet, exercise and sleep are optimal.

According to Dr Gunatheesan microfocused ultrasound energy can reduce wrinkles. “The highly targeted ultrasound dermal delivery of heat results in collagenosis (collagen production),” she explains. “A 2mm cartridge work beautifully for crows feet, frown lines, without the need for injectables.”

Next up is dermal needling. “Percutaneous collagen induction involves pricking the skin multiple times using a specially designed device to induce skin regeneration and rejuvenation thereby minimising the depth and appearance of wrinkles.”

Then there are lasers. There are two kinds, non-ablative which focus on the surface of the skin. “Surface sparing lasers fractionate or break up the laser beam delivery on the skin surface in a pixelated pattern resulting heat or vibration and resulting in the production of collagen,” says Dr Gunatheesan.

Laser number two is ablative, which means it works deep down into the skin not the surface. “There is more downtime associated with the loss of the epidermis but these are better at targeting the deeper wrinkles.”

If laser and needling aren’t for you, there’s radiofrequency. “Radiofrequency energy is used to heat up the tissue to stimulate collagen production, it also has a skin tightening effect,” she says.

So, if you’re scared of needles (or of wrinkles) it’s nice to know there’s extra options out there that extend beyond Botox. But it’s important to remember to stick to a holistic skincare routine of a good diet rich in fatty acids, staying out of the sun and remembering everyone ages and wrinkles are normal.

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