"Fine lines are generally about 20 percent genetic and 80 percent environmental (in other words, brought on by the sun and smoking). They usually occur in the most expressive areas of your face—like around the eyes—but if you were never in the sun, you could smile and squint all day every day and still have very few lines. So if you're not wearing sunscreen: Start now. It won't get rid of the lines you have, but it will prevent new ones from forming. And begin using a prescription retinoid cream nightly; I often prescribe Renova because patients find it less drying than other formulas. You'll notice lines softening in two to three months.
"If you want to be more aggressive, you could try Botox, a botulinum toxin that blocks the nerve impulses that cause muscle activity—and expression lines. I can inject it around the eyes, between the brows, across the forehead; the lines in those areas then fade away over about a week. The shot feels like a quick pinch, and there's rarely bruising or swelling afterward; results should last three months or more. Another botulinum toxin, Dysport, was approved by the FDA just this spring. It works more quickly than Botox, in about three days, and it may last longer."
- A.M.: Sunscreen (like Olay Complete Defense Daily UV Moisturizer SPF 30, $15)
- P.M.: Prescription retinoid, $40+
- Botox or Dysport injections, every three months, $300 to $500 for each area treated