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Pathophys and Cause ⬇

Cause:Smoking and sun exposure both cause independently (Ann IM 1991;114:840) by decreasing skin collagen

Treatment ⬆

Rx:Laser (Med Let 1997;37:10); topical tretinoins (Nejm 1997;337:1419) by incr skin cell turnover, collagen thickness, and thickness of stratum corneum; injections of collagen (Zyplast, Zyderm, Cosmoderm, et al.) and hyaluronic acid gel (Hyalaform, Restylane) work for 6+ mos (Med Let 2004;46:19)