Wrinkles - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Wrinkles are lines or creases on the surface of the skin. They appear as a natural part of aging, most frequently over the sun-exposed areas of the body (i.e., face, neck, dorsum of hands).
Skin texture is mainly determined by genetic factors and skin type. Environmental factors that promote wrinkling over the course of many years include recreational sun exposure and smoking.
Divided into 2 categories, fine and deep lines, and classified as atrophic, elastotic, expressional, and gravitational. Each type develops in specific areas and is characterized by distinct cutaneous alterations.
Treatments include medical treatments (antioxidants, tretinoin), cosmetic procedures (fillers, botulinum toxin injections, chemical peels), and surgical procedures (laser ablation, dermabrasion, rhytidectomy).
Treatments are generally more effective for fine wrinkles. Deep creases require more aggressive techniques, such as plastic surgery procedures.

30-year-old woman with mild wrinkles showing few wrinkles at rest

From the personal collection of Dr Dimitrios Dionyssiou; used with permission

Quick Reference

History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

50-year-old woman with photoaged skin showing advanced wrinkles, discoloration of the skin, actinic keratoses, and dynamic forces affecting the skin
30-year-old woman with mild wrinkles showing few wrinkles at rest
30-year-old woman with mild wrinkles showing moderate wrinkles on major facial activity
80-year-old woman with severe wrinkles, photoaging, and gravitational forces affecting the skin

Citations

Key Articles

Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988 Jun;124(6):869-71.[Abstract]
Bhawan J, Andersen W, Lee J, et al. Photoaging versus intrinsic aging: a morphologic assessment of facial skin. J Cutan Pathol. 1995 Apr;22(2):154-9.[Abstract]
Callaghan TM, Wilhelm KP. A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part 2: clinical perspectives and clinical methods in the evaluation of ageing skin. Int J Cosmet Sci. 2008 Oct;30(5):323-32.[Abstract]
Ogden S, Griffiths TW. A review of minimally invasive cosmetic procedures. Br J Dermatol. 2008 Nov;159(5):1036-50.[Abstract]
Klein AW. Techniques for soft tissue augmentation: an 'A to Z'. Am J Clin Dermatol. 2006;7(2):107-20.[Abstract]
Papadavid E, Katsambas A. Lasers for facial rejuvenation: a review. Int J Dermatol. 2003 Jun;42(6):480-7.[Abstract]

Referenced Articles

1. Ernster VL, Grady D, Miike R, et al. Facial wrinkling in men and women, by smoking status. Am J Public Health. 1995 Jan;85(1):78-82.[Abstract][Full Text]
2. Tsukahara K, Fujimura T, Yoshida Y, et al. Comparison of age-related changes in wrinkling and sagging of the skin in Caucasian females and in Japanese females. J Cosmet Sci. 2004 Jul-Aug;55(4):351-71.[Abstract]
3. Nouveau-Richard S, Yang Z, Mac-Mary S, et al. Skin ageing: a comparison between Chinese and European populations: a pilot study. J Dermatol Sci. 2005 Dec;40(3):187-93.[Abstract]
4. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988 Jun;124(6):869-71.[Abstract]
5. Zimbler MS, Kokoska MS, Thomas JR. Anatomy and pathophysiology of facial aging. Facial Plast Surg Clin North Am. 2001 May;9(2):179-87.[Abstract]
6. Yin L, Morita A, Tsuji T. Skin aging induced by ultraviolet exposure and tobacco smoking: evidence from epidemiological and molecular studies. Photodermatol Photoimmunol Photomed. 2001;17:178-183. [Abstract]
7. Chung JH, Lee SH, Youn CS, et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch Dermatol. 2001;137:1043-1051.[Abstract][Full Text]
8. Browner WS, Kahn AJ, Ziv E, et al. The genetics of human longevity. Am J Med. 2004 Dec 1;117(11):851-60.[Abstract]
9. Lehmann A. Ageing: repair and transcription keep us from premature ageing. Curr Biol. 2002 Aug 20;12(16):R550-1.[Abstract][Full Text]
10. Stratigos AJ, Katsambas AD. The role of topical retinoids in the treatment of photoaging. Drugs. 2005;65(8):1061-72.[Abstract]
11. Just M, Ribera M, Monso E, et al. Effect of smoking on skin elastic fibres: morphometric and immunohistochemical analysis. Br J Dermatol. 2007 Jan;156(1):85-91.[Abstract]
12. Helfrich YR, Yu L, Ofori A, et al. Effect of smoking on aging of photoprotected skin: evidence gathered using a new photonumeric scale. Arch Dermatol. 2007 Mar;143(3):397-402.[Abstract][Full Text]
13. Bentley JP. Aging of collagen. J Invest Dermatol. 1979 Jul;73(1):80-3.[Abstract]
14. Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986 Oct;15(4 Pt 1):571-85.[Abstract]
15. Prockop DJ, Kivirikko KI, Tuderman L, et al. The biosynthesis of collagen and its disorders. Part II. N Engl J Med. 1979 Jul 12;301(2):77-85.[Abstract]
16. Bhawan J, Andersen W, Lee J, et al. Photoaging versus intrinsic aging: a morphologic assessment of facial skin. J Cutan Pathol. 1995 Apr;22(2):154-9.[Abstract]
17. Rees TD, Aston SJ, Thorne CH. Blepharoplasty and facialplasty. In: McCarthy J, ed. Plastic surgery. Philadelphia, PA: WB Saunders; 1990:2320-2414.
18. Rabe JH, Mamelak AJ, McElgunn PJ, et al. Photoaging: mechanisms and repair. J Am Acad Dermatol. 2006 Jul;55(1):1-19.[Abstract]
19. Callaghan TM, Wilhelm KP. A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part 1: Cellular and molecular perspectives of skin ageing. Int J Cosmet Sci. 2008 Oct;30(5):313-22.[Abstract]
20. Knuutinen A, Kokkonen N, Risteli J, et al. Smoking affects collagen synthesis and extracellular matrix turnover in human skin. Br J Dermatol. 2002 Apr;146(4):588-94.[Abstract]
21. Raitio A, Tuomas H, Kokkonen N, et al. Levels of matrix metalloproteinase-2, -9 and -8 in the skin, serum and saliva of smokers and non-smokers. Arch Dermatol Res. 2005 Dec;297(6):242-8.[Abstract]
22. Richardson D. Effects of tobacco smoke inhalation on capillary blood flow in human skin. Arch Environ Health. 1987 Jan-Feb;42(1):19-25.[Abstract]
23. Joffe I. Cigarette smoking and facial wrinkling. Ann Intern Med. 1991 Oct 15;115(8):659-60.[Abstract]
24. Demierre MF, Brooks D, Koh HK, et al. Public knowledge, awareness and perceptions of the association between skin aging and smoking. J Am Acad Dermatol. 1999 Jul;41(1):27-30.[Abstract]
25. Landau M. Exogenous factors in skin aging. Curr Probl Dermatol. 2007;35:1-13.[Abstract]
26. Freiman A, Bird G, Metelitsa AI, et al. Cutaneous effects of smoking. J Cutan Med Surg. 2004 Nov-Dec;8(6):415-23.[Abstract]
27. Kadunce DP, Burr R, Gress R. Cigarette smoking: risk factor for premature facial wrinkling. Ann Intern Med. 1991 May 15;114(10):840-4.[Abstract]
28. Koh JS. Cigarette smoking associated with premature facial wrinkling: image analysis of facial skin replicas. Int J Dermatol. 2002 Jan;41(1):21-7.[Abstract]
29. Rexbye H, Petersen I, Johansens M, et al. Influence of environmental factors on facial ageing. Age Ageing. 2006 Mar;35(2):110-5.[Abstract][Full Text]
30. Alexiades-Armenakas M. Rhytides, laxity, and photoaging treated with a combination of radiofrequency, diode laser, and pulsed light and assessed with a comprehensive grading scale. J Drugs Dermatol. 2006 Sep;5(8):731-8.[Abstract]
31. Lemperle G, Holmes RE, Cohen SR, et al. A classification of facial wrinkles. Plast Reconstr Surg. 2001 Nov;108(6):1735-50; discussion 1751-2.[Abstract]
32. Alexiades-Armenakas M. A quantitative and comprehensive grading scale for rhytides, laxity, and photoaging. J Drugs Dermatol. 2006 Sep;5(8):808-9.[Abstract]
33. Green AC. Premature ageing of the skin in a Queensland population. Med J Aust. 1991 Oct 7;155(7):473-4, 477-8.[Abstract]
34. Bukvic Mokos Z, Lipozencic J, Pasic A, et al. Laser therapy for solar lentigines: review of the literature and case report. Acta Dermatovenerol Croat. 2006;14(2):81-5.[Abstract]
35. Lavker RM. Cutaneous aging: chronologic versus photoaging. In: Gilchrest BA, ed. Photodamage. Cambridge, MA: Blackwell Science; 1995:123-135.
36. Contet-Audonneau JL, Jeanmaire C, Pauly G. A histological study of human wrinkle structures: comparison between sun-exposed areas of the face, with or without wrinkles, and sun-protected areas. Br J Dermatol. 1999 Jun;140(6):1038-47.[Abstract]
37. Sauermann K, Clemann S, Jaspers S, et al. Age related changes of human skin investigated with histometric measurements by confocal laser scanning microscopy in vivo. Skin Res Technol. 2002 Feb;8(1):52-6.[Abstract]
38. Gonzalez S, Swindells K, Rajadhyaksha M, et al. Changing paradigms in dermatology: confocal microscopy in clinical and surgical dermatology. Clin Dermatol. 2003 Sep-Oct;21(5):359-69.[Abstract]
39. English JS, Swerdlow AJ. The risk of malignant melanoma, internal malignancy and mortality in xeroderma pigmentosum patients. Br J Dermatol. 1987 Oct;117(4):457-61.[Abstract]
40. Kligman AM, Zheng P, Lavker RM. The anatomy and pathogenesis of wrinkles. Br J Dermatol. 1985 Jul;113(1):37-42.[Abstract]
41. Glogau RG. Aesthetic and anatomic analysis of the aging skin. Semin Cutan Med Surg. 1996 Sep;15(3):134-8.[Abstract]
42. Fitzpatrick RE, Goldman MP, Satur NM, et al. Pulsed carbon dioxide laser resurfacing of photo-aged facial skin. Arch Dermatol. 1996 Apr;132(4):395-402.[Abstract]
43. Callaghan TM, Wilhelm KP. A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part 2: clinical perspectives and clinical methods in the evaluation of ageing skin. Int J Cosmet Sci. 2008 Oct;30(5):323-32.[Abstract]
44. Kligman AM, Grove GL, Hirose R, et al. Topical tretinoin for photoaged skin. J Am Acad Dermatol. 1986 Oct;15(4 Pt 2):836-59.[Abstract]
45. Kligman AM, Graham CF. Histological changes in facial skin after daily application of tretinoin for 5-6 years. J Dermatol Treat. 1993;4:113-117.
46. Weinstein GD, Nigra TP, Pochi PE, et al. Topical tretinoin for treatment of photodamaged skin: a multicenter study. Arch Dermatol. 1991 May;127(5):659-65.[Abstract]
47. Olsen EA, Kats HI, Levine N, et al. Tretinoin emollient cream: a new therapy for photodamaged skin. J Am Acad Dermatol. 1992 Feb;26(2 Pt 1):215-24.[Abstract]
48. Stefanaki C, Stratigos A, Katsambas A. Topical retinoids in the treatment of photoaging. J Cosmet Dermatol. 2005 Jun;4(2):130-4.[Abstract]
49. Maddin S, Lauharanta J, Agache P, et al. Isotretinoin improves the appearance of photoaged skin: results of a 36-week, multicenter, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2000 Jan;42(1 Pt 1):56-63.[Abstract]
50. Creidi P, Vienne MP, Ochonisky S, et al. Profilometric evaluation of photodamage after topical retinaldehyde and retinoic acid treatment. J Am Acad Dermatol. 1998 Dec;39(6):960-5.[Abstract]
51. Phillips TJ, Gottlieb AB, Leyden JJ, et al. Efficacy of 0.1% tazarotene cream for the treatment of photodamage: a 12-month multicenter, randomized trial. Arch Dermatol. 2002 Nov;138(11):1486-93.[Abstract]
52. Kang S, Goldfarb MT, Weiss J, et al. Assessment of adapalene gel for the treatment of actinic keratoses and lentigines: a randomized trial. J Am Acad Dermatol. 2003 Jul;49(1):83-90.[Abstract]
53. Bernstein EF, Lee J, Brown DB, et al. Glycolic acid treatment increases type I collagen mRNA and hyaluronic acid content of human skin. Dermatol Surg. 2001 May;27(5):429-33.[Abstract]
54. Kligman D, Kligman AM. Salicylic acid peels for the treatment of photoaging. Dermatol Surg. 1998 Mar;24(3):325-8.[Abstract]
55. De Boulle KL. Botulinum neurotoxin type A in facial aesthetics. Expert Opin Pharmacother. 2007 Jun;8(8):1059-72.[Abstract]
56. Carruthers JA, Lowe NJ, Menter MA, et al. A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol. 2002 Jun;46(6):840-9.[Abstract]
57. Shetty MK; IADVL Dermatosurgery Task Force. Guidelines on the use of botulinum toxin type A. Indian J Dermatol Venereol Leprol. 2008 Jan;74(suppl):S13-22.[Abstract][Full Text]
58. Gadarowski MB, Ghamrawi RI, Taylor SL, et al. PrabotulinumtoxinA-xvfs for the treatment of moderate-to-severe glabellar lines. Ann Pharmacother. 2021 Mar;55(3):354-61.[Abstract][Full Text]
59. Klein AW, Carruthers A, Fagien S, et al. Comparisons among botulinum toxins: an evidence-based review. Plast Reconstr Surg. 2008 Jun;121(6):413e-22e.[Abstract]
60. Lowe NJ, Yamauchi PS. Cosmetic uses of botulinum toxins for lower aspects of the face and neck. Clin Dermatol. 2004 Jan-Feb;22(1):18-22.[Abstract]
61. Matarasso A, Shafer D. Botulinum neurotoxin type A-ABO (Dysport): clinical indications and practice guide. Aesthet Surg J. 2009 Nov;29(6 suppl):S72-9.[Abstract]
62. Pena MA, Alam M, Yoo SS. Complications with the use of botulinum toxin type A for cosmetic applications and hyperhidrosis. Semin Cutan Med Surg. 2007 Mar;26(1):29-33.[Abstract]
63. Flynn TC. Botulinum toxin: examining duration of effect in facial aesthetic applications. Am J Clin Dermatol. 2010;11(3):183-99.[Abstract]
64. Ogden S, Griffiths TW. A review of minimally invasive cosmetic procedures. Br J Dermatol. 2008 Nov;159(5):1036-50.[Abstract]
65. Zakopoulou N, Kontochristopoulos G. Superficial chemical peels. J Cosmet Dermatol. 2006 Sep;5(3):246-53.[Abstract]
66. Humphreys TR, Werth V, Dzubow L, et al. Treatment of photodamaged skin with trichloroacetic acid and topical tretinoin. J Am Acad Dermatol. 1996 Apr;34(4):638-44.[Abstract]
67. Berardesca E, Cameli N, Primavera G, et al. Clinical and instrumental evaluation of skin improvement after treatment with a new 50% pyruvic acid peel. Dermatol Surg. 2006 Apr;32(4):526-31.[Abstract]
68. Hetter GP. An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg. 2000 Mar;105(3):1061-83.[Abstract]
69. Matarasso SL, Brody HJ. Deep chemical peeling. Semin Cutan Med Surg. 1996 Sep;15(3):155-61.[Abstract]
70. Vedamurthy M; IADVL Dematosurgery Task Force. Standard guidelines for the use of dermal fillers. Indian J Dermatol Venereol Leprol. 2008 Jan;74(suppl):S23-7.[Abstract][Full Text]
71. Lowe NJ, Maxwell CA, Lowe P, et al. Hyaluronic acid skin fillers: adverse reactions and skin testing. J Am Acad Dermatol. 2001 Dec;45(6):930-3.[Abstract]
72. Monheit GD, Coleman KM. Hyaluronic acid fillers. Dermatol Ther. 2006 May-Jun;19(3):141-50.[Abstract]
73. Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging. 2007;2(3):369-76.[Abstract][Full Text]
74. Brown SA, Rohrich RJ, Baumann L, et al. Subject global evaluation and subject satisfaction using injectable poly-L-lactic acid versus human collagen for the correction of nasolabial fold wrinkles. Plast Reconstr Surg. 2011 Apr;127(4):1684-92.[Abstract]
75. Brandt FS, Cazzaniga A, Baumann L, et al. Investigator global evaluations of efficacy of injectable poly-L-lactic acid versus human collagen in the correction of nasolabial fold wrinkles. Aesthet Surg J. 2011 Jul;31(5):521-8.[Abstract]
76. Woerle B, Hanke CW, Sattler G. Poly-L-lactic acid: a temporary filler for soft tissue augmentation. J Drugs Dermatol. 2004 Jul-Aug;3(4):385-9.[Abstract]
77. Narins RS, Baumann L, Brandt FS, et al. A randomized study of the efficacy and safety of injectable poly-L-lactic acid versus human-based collagen implant in the treatment of nasolabial fold wrinkles. J Am Acad Dermatol. 2010 Mar;62(3):448-62.[Abstract]
78. Klein AW. Techniques for soft tissue augmentation: an 'A to Z'. Am J Clin Dermatol. 2006;7(2):107-20.[Abstract]
79. Klein AW. Soft tissue augmentation 2006: filler fantasy. Dermatol Ther. 2006 May-Jun;19(3):129-33.[Abstract]
80. Kanchwala SK, Holloway L, Bucky LP. Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation. Ann Plast Surg. 2005 Jul;55(1):30-5.[Abstract]
81. Jansen DA, Graivier MH. Evaluation of a calcium hydroxylapatite-based implant (Radiesse) for facial soft-tissue augmentation. Plast Reconstr Surg. 2006 Sep;118(3 suppl):22S-30S.[Abstract]
82. Tzikas TL. A 52-month summary of results using calcium hydroxylapatite for facial soft tissue augmentation. Dermatol Surg. 2008 Jun;34(suppl 1):S9-15.[Abstract]
83. Fakhre GP, Perdikis G, Shaddix KK, et al. An evaluation of calcium hydroxylapatite (Radiesse) for cosmetic nasolabial fold correction: a meta-analysis and patient centric outcomes study. Ann Plast Surg. 2009 Nov;63(5):486-9.[Abstract]
84. Goldie K, Peeters W, Alghoul M, et al. Global consensus guidelines for the injection of diluted and hyperdiluted calcium hydroxylapatite for skin tightening. Dermatol Surg. 2018 Nov;44 Suppl 1:S32-S41.[Abstract][Full Text]
85. Baker TJ, Gordon HL. Chemical face peeling and dermabrasion. Surg Clin North Am. 1971 Apr;51(2):387-401.[Abstract]
86. Perotti JA. Cutaneous resurfacing: chemical peeling, dermabrasion, and laser resurfacing. In: Grabb and Smith's plastic surgery. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:459-467.
87. Spencer JM. Microdermabrasion. Am J Clin Dermatol. 2005;6(2):89-92.[Abstract]
88. Tan MH, Spencer JM, Pires LM, et al. The evaluation of aluminum oxide crystal microdermabrasion for photodamage. Dermatol Surg. 2001 Nov;27(11):943-9.[Abstract]
89. Groff WF, Fitzpatrick RE, Uebelhoer NS. Fractional carbon dioxide and plasmakinetic skin resurfacing. Semin Cutan Med Surg. 2008 Dec;27(4):239-51.[Abstract]
90. Rinaldi F. Laser: a review. Clin Dermatol. 2008 Nov-Dec;26(6):590-601.[Abstract]
91. Metelitsa AI, Alster TS. Fractionated laser skin resurfacing treatment complications: a review. Dermatol Surg. 2010 Mar;36(3):299-306.[Abstract]
92. Airan LE, Hruza G. Current lasers in skin resurfacing. Facial Plast Surg Clin North Am. 2005 Feb;13(1):127-39.[Abstract]
93. Alster TS. Cutaneous resurfacing with CO2 and erbium:YAG lasers: preoperative, intraoperative and postoperative considerations. Plast Reconstr Surg. 1999 Feb;103(2):619-32.[Abstract]
94. Alster TS, Lupton JR. Erbium:YAG laser resurfacing. Dermatol Clin. 2001 Jul;19(3):453-66.[Abstract]
95. Papadavid E, Katsambas A. Lasers for facial rejuvenation: a review. Int J Dermatol. 2003 Jun;42(6):480-7.[Abstract]
96. Pessa JE. An algorithm of facial aging: verification of Lambros's theory by three-dimensional stereolithography, with reference to the pathogenesis of midfacial aging, scleral show, and the lateral suborbital trough deformity. Plast Reconstr Surg. 2000 Aug;106(2):479-88.[Abstract]
97. Coleman S. Structural fat grafting. St Louis, MO: Quality Medical Publishing; 2004.
98. Coleman SR. Hand rejuvenation with structural fat grafting. Plast Reconstr Surg. 2002 Dec;110(7):1731-44.[Abstract]
99. Coleman SR. Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg. 1995 Sep-Oct;19(5):421-5.[Abstract]
100. Bucky LP, Kanchwala SK. The role of autologous fat and alternative fillers in the aging face. Plast Reconstr Surg. 2007 Nov;120(6 suppl):89S-97S.[Abstract]
101. Glasgold RA, Lam SM, Glasgold MJ. Facial fat grafting: the new paradigm. Arch Facial Plast Surg. 2008 Nov-Dec;10(6):417-8.[Abstract]
102. Thorne CH. Facelift. In: Grabb and Smith's plastic surgery. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007:498-508.
103. Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990 Jul;86(1):53-61.[Abstract]
104. Matarasso A, Hutchinson OH. Evaluating rejuvenation of the forehead and brow: an algorithm for selecting the appropriate technique. Plast Reconstr Surg. 2000 Sep;106(3):687-94.[Abstract]
105. Shin MK, Lee JH, Lee SJ, et al. Platelet-rich plasma combined with fractional laser therapy for skin rejuvenation. Dermatol Surg. 2012 Apr;38(4):623-30.[Abstract]
106. Hui Q, Chang P, Guo B, et al. The clinical efficacy of autologous platelet-rich plasma combined with ultra-pulsed fractional CO2 laser therapy for facial rejuvenation. Rejuvenation Res. 2017 Feb;20(1):25-31.[Abstract][Full Text]
107. Smith SR, Munavalli G, Weiss R, et al. A multicenter, double-blind, placebo-controlled trial of autologous fibroblast therapy for the treatment of nasolabial fold wrinkles. Dermatol Surg. 2012 Jul;38(7 Pt 2):1234-43.[Abstract]
108. Stirling RJ, Haslam JD. A self-reported clinical trial investigates the efficacy of 1072 nm light as an anti-ageing agent. J Cosmet Laser Ther. 2007 Dec;9(4):226-30.[Abstract]
109. Matarasso SL, Carruthers JD, Jewell ML; Restylane Consensus Group. Consensus recommendations for soft-tissue augmentation with nonanimal stabilized hyaluronic acid (Restylane). Plast Reconstr Surg. 2006 Mar;117(3 suppl):3S-34S.[Abstract]
110. Morton CA, McKenna KE, Rhodes LE, et al. Guidelines for topical photodynamic therapy: update. Br J Dermatol. 2008 Dec;159(6):1245-66.[Abstract][Full Text]
111. Khunger N, IADVL Task Force. Standard guidelines of care for chemical peels. Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S5-12.[Abstract][Full Text]
112. Krupashankar DS, IADVL Dermatosurgery Task Force. Standard guidelines of care: CO2 laser for removal of benign skin lesions and resurfacing. Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S61-7.[Abstract][Full Text]