This page is supervised and written by specialist physicians at IC Clinic.

Wrinkle Treatments: A Complete Guide

What Causes Wrinkles and How Can You Address Them? 8 Treatments for Wrinkles and Sagging

“I’m bothered by the smile lines at the corners of my eyes.”
“I’ve started noticing more wrinkles and sagging on my face as I get older.”

Do any of these concerns sound familiar?

Skincare alone—such as creams and serums—may not deliver sufficient results for wrinkles. For this reason, those wishing to address wrinkles are encouraged to consider professional treatment at a clinic.

This page explains the causes of wrinkles, how to address them, and the treatment options available at clinics. We hope it will be a helpful resource for anyone concerned about wrinkles, so please read on.

Why Do Wrinkles Form? Two Main Causes

The causes of wrinkles differ depending on where they form. Wrinkles in the epidermis are caused by skin dryness, while wrinkles in the dermis result from repeated facial movements.

Let’s take a closer look at these two main causes of wrinkles.

Epidermal Wrinkles | Temporary Lines Caused by Dryness

Fine lines around the eyes and mouth—commonly called “fine wrinkles”—are epidermal wrinkles caused primarily by dry skin. The epidermis refers to the outermost layer of the skin.

When the skin becomes dry, the stratum corneum tends to flake away and moisture evaporates through the gaps, making wrinkles more likely to develop.

Fine wrinkles can appear even in younger people, but because youthful skin retains its elasticity, any wrinkles that form tend to be temporary. As the skin ages with time, it loses elasticity, making it harder for fine lines to smooth back out once they appear.

Dermal Wrinkles | Lines Formed by Repeated Facial Expressions

Wrinkles that arise from changes in the dermal cells are known as “dermal wrinkles.”

The dermis refers to the layer beneath the epidermis, deeper within the skin. Dermal wrinkles develop as a result of repeated facial movements over time.

The underlying causes of dermal wrinkles are the degradation and reduction of collagen—which gives skin its firmness—and elastin, which contributes to skin elasticity.

UV damage can reduce the number of fibroblast cells that produce collagen and elastin, or impair their ability to produce these proteins altogether. As a result, collagen and elastin levels decline, leading to a loss of skin firmness.

When lax skin is repeatedly subjected to facial movements, wrinkles that have formed become increasingly difficult to smooth out.

Dermal wrinkles can be divided into fine lines that form perpendicular to the facial muscles, and deeper lines that develop around the mouth and along the facial contour as a result of aging.

How to Address and Prevent Wrinkles and Sagging: The Importance of UV Protection

UV protection is essential for addressing and preventing wrinkles and sagging skin.

Among the various types of wrinkles, the more stubborn dermal wrinkles develop when UV exposure causes a reduction in collagen, elastin, and other components in the skin. UV rays also contribute to the dryness that leads to epidermal wrinkles.

There are several types of UV rays, but UVA in particular—which penetrates deep into the skin—is especially associated with wrinkle formation.

UVA that reaches the deeper layers of skin damages fibroblast cells, which are responsible for producing collagen, elastin, and other structural proteins. Skin that has lost its elasticity due to UVA exposure becomes more susceptible to wrinkles and sagging.

Because UVA also increases melanin—the substance responsible for pigmented spots—UV protection is an important part of maintaining a youthful-looking complexion.

UVA is present in high volumes and penetrates deep into the skin, making its impact on wrinkle formation significant. It also passes through glass and reaches the skin, so protection is necessary year-round regardless of season.

Can Cosmetics Improve Wrinkles? Tips for Choosing the Right Creams and Serums

There is some potential for cosmetics to help improve the appearance of wrinkles. The approach differs depending on whether the wrinkles are epidermal or dermal.

For epidermal wrinkles, thorough moisturisation to support skin texture and promote skin cell turnover may help improve their appearance. Skin cell turnover refers to the ongoing cycle in which the skin renews itself day by day.

Supporting a healthy turnover cycle may make wrinkles relatively less noticeable. Consistent moisturisation helps prevent dryness in the stratum corneum, which can help normalise the turnover cycle.

For dermal wrinkles, it is important to use creams and serums containing ingredients that support collagen and elastin. However, since collagen molecules are large and do not readily absorb into the skin, surface application alone may have limited efficacy.

Increasing the number of fibroblast cells that produce collagen—and the dermal stem cells that generate those fibroblasts—from within the skin is necessary to promote collagen growth from the inside out.

Causes and Solutions for Neck Wrinkles

Just like the face, neck wrinkles are a visible sign of aging. The skin on the neck is thinner than facial skin, has fewer sebaceous glands, and is prone to dryness—combined with the frequent daily movements of the neck, this makes it an area particularly susceptible to wrinkle formation. While neck care is often overlooked, caring for the neck alongside the face is key to maintaining a youthful appearance.

Daily Habits to Help Prevent Neck Wrinkles

Everyday habits play a significant role in the development of neck wrinkles. In modern life, increased smartphone use and desk-based work have placed greater strain on the neck.

1. Improving posture:
* Text neck (forward head posture): Using smartphones or tablets for extended periods while looking downward keeps the skin on the neck in a constantly folded position, which is a major contributor to deep wrinkle formation. Make a conscious effort to hold your device up to eye level, and develop the habit of taking breaks to stretch your neck.
* Posture during desk work: When working at a computer for long periods, adjust the screen to eye height and try to sit with your back straight. Slouching or leaning forward places strain on the neck and can cause not only wrinkles but also shoulder stiffness and headaches.
2. Reassessing pillow height:
* Bedding—particularly pillow height—directly affects neck wrinkles. A pillow that is too high can bend the neck at an unnatural angle during sleep, deepening wrinkles. Conversely, a pillow that is too low may also strain the neck.
* Choosing a pillow at an appropriate height that fits the natural S-curve of the neck and allows you to turn over comfortably is important. We recommend consulting a bedding specialist to find the right pillow for you.
3. Sleep position:
* Sleeping on your back is generally considered ideal. Sleeping on your side or face-down can place strain on the neck, cause wrinkles, and make the skin more susceptible to friction-related damage.
* Choosing a pillowcase made of a smooth, low-friction material such as silk can also help reduce stress on the skin.
4. UV protection:
* The neck, like the face, is exposed to UV rays throughout the year. V-neck tops and similar styles can leave the neck area particularly exposed.
* Develop the habit of applying sunscreen to the neck as well as the face every day, year-round. During summer, wearing a UV-protective scarf or stole can also be helpful.

Effective Skincare for Neck Wrinkles

Combining targeted skincare for the neck with the daily habits described above may help enhance the benefits for wrinkle improvement.

1. Thorough moisturisation:
* The skin on the neck has fewer sebaceous glands and is prone to dryness, so it requires even more attentive moisturisation than the face.
* Develop the habit of applying toner, lotion, and cream to the neck in the same way as the face. If you notice significant dryness, it may be worth considering a richer body cream or a neck-specific cream with a higher oil content.
* Applying moisturising products generously while the skin is still warm and soft—such as after a bath or shower—may improve absorption.
2. Using neck-specific creams and serums:
* There is a growing range of creams and serums specifically formulated for the neck, containing ingredients targeting neck wrinkles and sagging—such as firming, hydrating, and tightening components. Incorporating these products can support more focused care for the neck area.
3. Correct massage technique:
* The skin on the neck is delicate, so it is important to avoid strong friction and massage gently.
* Lymphatic massage: Using the pads of your fingers, gently massage from the neck toward the collarbone and décolletage to encourage lymphatic drainage. This may help promote the elimination of waste products, improve circulation, and support the skin’s natural metabolism.
* Upward massage: Using the full palm of your hand, gently lift from the base of the neck toward the chin. Working in cream as you go—following the direction that opens the wrinkle grooves—may enhance the effect.
* Always apply a generous amount of cream or oil before massaging to minimise friction on the skin.
4. Stretching and exercise:
* Stretching to loosen the neck muscles and improve circulation can also be beneficial. Try incorporating gentle neck rolls and side-to-side tilts into your daily routine.
* Stretches targeting the neck and shoulders to support better posture can also be helpful.

Effective Approaches to Wrinkle Improvement

Enhancing the quality of your daily skincare routine is a very important part of addressing wrinkles. Choosing the right products and using them correctly can make a meaningful difference to the skin. In addition, caring for the body from the inside and reviewing everyday lifestyle habits are also essential aspects of wrinkle prevention and improvement.

How to Choose and Use Anti-Wrinkle Creams

There is a wide range of anti-wrinkle creams on the market. To make the most of them, it is important to choose an appropriate product and use it correctly.

How to choose:
1. Check for approved active ingredients (quasi-drug):
* Look for products containing active ingredients approved by Japan’s Ministry of Health, Labour and Welfare for wrinkle improvement. Key ingredients include the following.
* Pure retinol: Promotes skin cell turnover and supports the production of collagen and elastin. May help address deeper wrinkles.
* Niacinamide: A multifunctional ingredient that supports collagen production, strengthens the skin barrier, and helps inhibit melanin formation—with potential benefits for wrinkles, skin brightening, and skin condition.
* NEI-L1: (An ingredient developed by Pola) Helps inhibit the enzymes that break down collagen and elastin in the dermis, supporting skin elasticity.
* Products containing these ingredients are classified as “quasi-drugs” (医薬部外品) and will state “Efficacy: improves wrinkles” or similar on the packaging.
2. Prioritise moisturising ingredients:
* Dryness is a concern for all types of wrinkles. Check whether the product contains sufficient moisturising ingredients such as hyaluronic acid, ceramide, collagen, and glycerin. Well-hydrated skin can make fine lines appear less noticeable and may help slow the progression of deeper wrinkles.
3. Choose a texture suited to your skin type and concerns:
* As this is a product you will use daily, choosing a texture that is not overly heavy and that suits your skin is key to maintaining a consistent routine. Opt for a richer formula for dry skin, or a lighter one for combination skin.
4. Choose a price point you can sustain:
* Consistency is more important than immediate results when it comes to wrinkle care. Choose a product within a price range that allows you to continue using it regularly. In some cases, using an affordable product every day may prove more effective than occasionally using a more expensive one.

How to use:
1. Timing: In general, apply after cleansing, toning, and any serums, and before lotion or moisturiser. The recommended order may vary by product, so always follow the instructions provided.
2. Amount: Each product specifies the recommended amount. Using too little may limit effectiveness, while using too much can burden the skin.
3. Application method:
* Apply gently with your fingertips: For delicate areas such as around the eyes and mouth, use the pad of a weaker finger such as the ring finger and apply with a light touch.
* Follow the direction of wrinkles: Gently smooth the product along the wrinkle grooves, as if filling them in, allowing it to absorb into the skin.
* Avoid rubbing: Strong friction places stress on the skin and can in some cases contribute to wrinkle formation, so take care never to rub the product in vigorously.
* Layering for targeted care: For areas of particular concern, applying a small amount in multiple thin layers for focused treatment may also be beneficial.
4. Morning and evening care: Using the product twice daily—morning and evening—generally supports better results. If using in the morning, note that some ingredients can increase sensitivity to UV rays, so always apply sunscreen over the top.

Effects of Retinol and Vitamin C Derivatives

Retinol and vitamin C derivatives are among the most noted ingredients for wrinkle improvement. They each work in different ways to support the skin and may contribute to reducing the appearance of wrinkles.

Retinol (Vitamin A):
* Effects on the skin:
* Promotes cell turnover: Helps normalise the cycle (turnover) in which old skin cells are shed and new ones generated. This may lead to a smoother skin surface and a complexion where fine lines appear less prominent.
* Supports collagen and elastin production: Acts on fibroblasts in the dermis to support the production of collagen and elastin, which maintain skin firmness and elasticity. This may help the skin appear more plump from within and contribute to improvement of deeper wrinkles.
* Supports hyaluronic acid production: Also supports the production of hyaluronic acid, which helps the skin retain moisture, contributing to overall skin hydration.
* Types and characteristics:
* Pure retinol: Tends to deliver stronger effects, but is also more likely to cause skin reactions (known as “retinol reaction”: redness, peeling, dryness, etc.). It is recommended to start with a small amount and gradually acclimatise the skin—a process sometimes called “retinol banking.”
* Retinol derivatives: Includes retinyl palmitate and retinyl acetate. Gentler on the skin and more accessible for those new to retinol. Effects are more gradual than pure retinol, but stability tends to be better.
* Usage precautions:
* Sensitive to light: Retinol is unstable when exposed to light, so nighttime use is recommended.
* Sun protection is essential: During retinol use, the skin can become more sensitive to UV rays, so always apply a sunscreen with a high SPF and PA rating during the day.
* Watch for irritation: When using for the first time, perform a patch test on the inner arm and start with a small amount to monitor how your skin responds. It is generally advisable to avoid use during pregnancy or while breastfeeding.

Vitamin C derivatives:
* Effects on the skin:
* Antioxidant action: Helps neutralise free radicals generated by UV exposure and stress, protecting skin cells from damage. This may help prevent the breakdown of collagen and elastin, and inhibit the development of wrinkles associated with photoaging.
* Supports collagen production: An essential nutrient for the production of collagen, which maintains skin firmness and elasticity. May help plump the skin from within and contribute to wrinkle improvement.
* Inhibits melanin production: Also has the effect of suppressing melanin production—the cause of pigmented spots—contributing to an overall improvement in skin tone.
* Controls sebum secretion: May help regulate excess sebum production, with potential benefits for enlarged pores and acne.
* Types and characteristics:
* There are various forms including magnesium ascorbyl phosphate, sodium ascorbyl phosphate (water-soluble), ethyl ascorbic acid (both water- and oil-soluble), and APPS (amphiphilic), each differing in penetration, stability, and potential for irritation.
* Usage precautions:
* Many forms are relatively stable and suitable for both morning and evening use, but as some people may experience irritation, monitor your skin’s response as you use it.
* If you find that dryness is a concern, look for a product that combines vitamin C derivatives with moisturising ingredients.

The Role of Hyaluronic Acid and Collagen

Hyaluronic acid and collagen play a very important role in maintaining skin hydration and elasticity. When these components are lacking, the skin becomes dry, loses its elasticity, and wrinkles and sagging become more visible.

Hyaluronic acid:
* Role in the skin:
* Hyaluronic acid is a type of mucopolysaccharide with remarkable water-holding capacity—said to be able to retain up to six litres of water per gram.
* It is found in abundance in the dermis, where it fills the spaces between cells, storing moisture in the skin and providing cushioning elasticity and flexibility.
* Effects on wrinkles:
* It is particularly effective at reducing the appearance of fine, dry surface wrinkles caused by insufficient moisture. When the skin is well hydrated, its texture becomes more refined and wrinkles may appear more plump and less noticeable.
* By increasing the overall moisture content of the skin, it also supports the skin’s barrier function and helps protect against external stressors.
* How to incorporate it:
* Topical application via cosmetics: Applying toners, serums, and creams containing hyaluronic acid delivers hydration to the stratum corneum and helps prevent dryness. Combining hyaluronic acid molecules of different sizes is considered to improve penetration to deeper layers of the skin.
* Oral supplementation: There are reports suggesting that orally ingested hyaluronic acid may be partially absorbed by the body and may contribute to improvements in skin moisture levels.

Collagen:
* Role in the skin:
* Collagen is the primary protein in the dermis, accounting for approximately 70% of its composition, and forms the fibrous structural framework of the skin.
* Arranged in a mesh-like network, it works together with elastin—which provides rubber-like elasticity—to support the firmness and suppleness of the skin.
* Effects on wrinkles:
* When collagen decreases or deteriorates due to aging or UV damage, the skin loses its elasticity, directly contributing to wrinkles and sagging.
* Replenishing collagen may help support skin elasticity and contribute to a plumper-looking complexion from within, potentially making wrinkles less noticeable.
* How to incorporate it:
* Topical application via cosmetics: Hydrolysed collagen and other small-molecule forms of collagen are used in cosmetics to contribute to moisturisation and a firmer skin feel.
* Dietary intake: A balanced diet including animal protein sources (meat, fish, eggs, etc.) and collagen-rich foods (chicken skin, fish skin, shark fin, etc.) is beneficial. Vitamin C is also important to take alongside collagen for efficient synthesis within the body.
* Supplementation: Low-molecular-weight collagen peptide supplements have also been suggested to potentially contribute to improvements in skin elasticity and hydration.

Foods and Nutrients That May Support Wrinkle Improvement

Skin health is closely linked to daily diet. Actively consuming nutrients that support the skin from within is an important part of wrinkle prevention and improvement. Aim for a well-balanced diet to build a strong foundation for your skin.

Astaxanthin (Found in Red-Coloured Foods)

Astaxanthin is a red pigment found in shrimp, crab, and salmon, and is a type of carotenoid with particularly strong antioxidant properties. Said to have antioxidant activity many times that of vitamin E, it may help protect skin cells from free radicals generated by UV exposure and help inhibit the development of wrinkles associated with photoaging.

* Foods high in astaxanthin: Salmon, salmon roe, shrimp, crab, sea bream, and supplements containing astaxanthin.
* Intake tip: Absorption may be enhanced when consumed with fat, so grilled salmon or salmon cooked ajillo-style are good options.

Vitamins A, C, and E

Vitamins A, C, and E each have distinct functions, and together they work to help maintain skin health and support wrinkle improvement.

* Vitamin A (beta-carotene):
* Function: Promotes skin cell turnover (renewal), helping to shed old skin cells and support the generation of new ones. This may help refine skin texture and lead to a smoother complexion where fine lines are less visible. It also plays a role in maintaining the health of the skin and mucous membranes. Taking it in the form of beta-carotene, which is converted to vitamin A in the body as needed, is considered a safe approach.
* Foods high in vitamin A: Yellow and orange vegetables such as carrots, spinach, pumpkin, and broccoli; also eel and liver.
* Vitamin C:
* Function: Has strong antioxidant properties, helping to neutralise free radicals generated by UV exposure and other factors. It is also an essential nutrient for collagen synthesis, playing an important role in maintaining skin firmness and elasticity. Additionally, it has the effect of inhibiting melanin production, offering benefits for both pigmented spots and wrinkles.
* Foods high in vitamin C: Citrus fruits (lemon, orange), strawberries, kiwi, broccoli, peppers, and potatoes.
* Vitamin E:
* Function: Sometimes referred to as the “anti-aging vitamin,” it combines circulatory benefits with antioxidant properties. By protecting cell membranes from oxidative damage, it may help slow skin aging and support metabolic activity. This can contribute to strengthening the skin’s barrier function and helping to maintain firmness and hydration.
* Foods high in vitamin E: Nuts (almonds, peanuts), avocado, vegetable oils (sunflower oil, rapeseed oil), and eel.

Protein

Collagen and elastin—the key structural components of the skin—are made from protein. Ensuring adequate intake of high-quality protein is therefore essential for building a strong foundation for the skin and helping to prevent wrinkle formation.

* Function: Collagen, elastin, and the enzymes and cells involved in skin cell turnover are all made of protein. When protein intake is insufficient, the skin can lose firmness and elasticity, making it more susceptible to wrinkles.
* Foods high in protein: Meat (chicken breast, tenderloin, lean red meat), fish and seafood (white fish, oily fish), eggs, soy products (tofu, natto, soy milk), and dairy products (milk, yoghurt, cheese).
* Intake tip: Aim to obtain protein from a variety of sources rather than relying on one type, and choose foods with a high amino acid score.

Key Nutrients and Food Sources for Wrinkle Improvement

Nutrient	Key Function	Foods High in This Nutrient
Astaxanthin	Strong antioxidant action; protection against UV damage	Salmon, salmon roe, shrimp, crab
Vitamin A	Promotes cell turnover; maintains skin and mucous membrane health	Carrots, spinach, pumpkin, eel
Vitamin C	Supports collagen production; antioxidant action; inhibits melanin	Citrus fruits, strawberries, kiwi, broccoli, peppers
Vitamin E	Antioxidant action; supports circulation; activates skin metabolism	Nuts, avocado, vegetable oils
Protein	Building block for collagen and elastin; strengthens skin foundation	Meat, fish, eggs, soy products, dairy products
Polyphenols	Antioxidant action; cell protection	Blueberries, green tea, red wine, cacao, coffee
Ceramides	Strengthens skin barrier function; helps retain moisture	Konjac, rice, wheat, milk, yoghurt (small amounts from food)

Wrinkle Prevention Beyond Skincare

Beyond skincare products, small adjustments to daily life can also help prevent wrinkles and limit their progression. However, it is important to avoid misinformation or potentially harmful methods that could place unnecessary stress on the skin.

Garment Steamers: Important Cautions for Skin

Garment steamers are designed to remove wrinkles from clothing, and applying them directly to the skin should be avoided entirely. High-temperature steam poses a significant risk of burns and can dry out and damage the skin.
That said, from an indirect perspective, indoor humidity management does matter, since skin dryness is a major contributor to wrinkles. Rather than directing a garment steamer at the skin, using it on clothing in a clean environment may offer a temporary benefit by adding some moisture to the air—though a dedicated humidifier is the recommended approach for proper humidity management.

Water Mist and Hair Dryers: Risks to the Skin

Spraying water on the face with a mist bottle and then drying it with a hair dryer is a highly inadvisable approach to wrinkle care and should not be attempted.
Even if moisture is temporarily added via a mist spray, when the hair dryer causes that moisture to evaporate rapidly, it draws the skin’s own natural moisture out along with it. This significantly worsens skin dryness, impairs the barrier function, and can ultimately deepen wrinkles.
The foundation of wrinkle care is “moisturisation” and “preventing moisture loss.” When replenishing moisture, use a toner or mist containing moisturising ingredients, then immediately follow with a lotion or cream to provide oil and lock in the skin’s internal moisture.

Using a Warm Towel

When used correctly, a warm towel can potentially offer indirect benefits for wrinkle care. The warmth promotes circulation and may support the skin’s natural metabolic activity. It can also help open pores, potentially improving the absorption of subsequent skincare products.

* How to use:
1. Dampen a clean towel with water and wring it out lightly.
2. Warm it in the microwave for approximately 30 seconds to 1 minute (take care to check it is not too hot to avoid burns).
3. Place the warm towel over your face and neck for a few minutes and relax.
4. After removing the warm towel, apply toner, serum, and cream promptly—before moisture has a chance to evaporate—to lock in hydration.
* Caution: If the towel is too hot, it can stress the skin, so always check the temperature carefully. Avoid keeping it in contact with the skin for too long.

Hair Straighteners: Cautions for Skin

Hair straighteners are designed for hair styling, and applying them directly to the skin should be avoided entirely. The high-temperature plates can cause serious burns and damage to the skin, with the potential to leave lasting marks that go well beyond wrinkles.
Care should also be taken during hair styling to ensure that the heat from a straightener does not come into contact with the skin around the face. Hair dryness can sometimes contribute to skin dryness as well. Since maintaining healthy hair can indirectly benefit skin health, when using a hair straightener, it is important to use an appropriate heat setting and a heat protectant product—and to be mindful of the effect on facial skin, not just the hair and scalp.

Conditions That Are Sometimes Confused with Wrinkles

Some skin concerns that are often perceived as “wrinkles” are actually distinct conditions with different underlying causes. Nasolabial folds and sagging skin in particular are frequently confused with wrinkles, but understanding the differences between them can help in identifying the most appropriate approach.

The Difference Between Wrinkles and Nasolabial Folds

Nasolabial folds are the lines that run from the sides of the nose down to the corners of the mouth in an inverted V shape—a common facial concern for many people. While they are often described as “wrinkles,” strictly speaking they are better understood as “grooves” that have elements of both wrinkles and sagging.

* What wrinkles are:
* Fine, shallow lines or creases on the surface of the skin, caused primarily by loss of skin elasticity due to dryness, UV damage, or repeated facial expressions.
* Examples: fine lines at the corners of the eyes, vertical frown lines between the eyebrows, horizontal forehead lines.
* What nasolabial folds are:
* Their primary causes are weakening of the facial muscles, increased or descending subcutaneous fat, and sagging from a reduction in collagen and elastin in the dermis—resulting in the cheek skin drooping downward and forming a “groove.” Bone structure, dental alignment, and habitual facial expressions also play a role.
* As nasolabial folds deepen, they create shadows that make them more prominent and can give the appearance of looking older.

Why understanding the difference matters:
While wrinkles can be addressed primarily through surface-level skincare (moisturisation, application of active ingredients), nasolabial folds are largely caused by sagging and therefore benefit from more fundamental approaches—such as facial muscle exercises, lifting-focused skincare, and aesthetic treatments (hyaluronic acid injections, thread lifts, HIFU, etc.). Correctly identifying the cause rather than conflating the two allows for a more appropriate course of action.

The Relationship Between Wrinkles and Sagging

Sagging refers to the state in which skin loses its firmness and elasticity due to aging, UV exposure, gravity, and lifestyle factors, causing the skin and subcutaneous tissue to descend overall. Wrinkles and sagging are closely related and often appear together, which can make it difficult to distinguish which is the primary cause.

* What sagging is:
* The entire face is pulled downward, resulting in a looser jawline, drooping cheeks, and puffiness beneath the eyes (sagging under-eye bags).
* Primary causes include the reduction and deterioration of collagen and elastin in the dermis, increased or descending subcutaneous fat, and weakening of the facial muscles.
* The relationship with wrinkles:
* Sagging can cause wrinkles: When sagging creates excess skin or causes skin to fold upon itself, deeply etched wrinkles can form—such as nasolabial folds and marionette lines. For example, when the cheeks sag, their weight can contribute to the development of deep lines at the corners of the mouth.
* Wrinkles can accelerate sagging: If fine lines caused by dryness are left unaddressed, the skin’s barrier function may weaken and damage to the dermis can accumulate. This can lead to a loss of skin elasticity, potentially progressing to sagging.
* Shared causes: Factors such as UV exposure and aging affect both wrinkles and sagging.

Recommended approach:
Addressing sagging shares much in common with wrinkle care, but in addition to treatments that support collagen and elastin production (such as retinol and vitamin C derivatives), more fundamental approaches—such as strengthening the facial muscles and aesthetic medical treatments for lifting (HIFU, laser treatments, thread lifts, etc.)—can be effective. Incorporating a comprehensive anti-aging routine that targets both wrinkles and sagging is an important part of maintaining a youthful complexion.

For Fundamental Wrinkle Improvement, Consider Consulting a Clinic

If you are looking to address wrinkles more fundamentally, receiving professional treatment at a clinic is an option worth considering alongside over-the-counter skincare products. The majority of commercially available cosmetics penetrate only as far as the epidermis, the outermost layer of the skin.

Since many of the cells involved in wrinkle improvement are located in the dermis, relying on cosmetics alone for wrinkle improvement tends to yield only limited results.

At a clinic, treatments and devices that can reach the dermis are available. Those seeking ways to address wrinkles are encouraged to consider professional treatment at a clinic.

8 Representative Wrinkle Treatments

Below is an overview of the wrinkle treatments available at our clinic and their key characteristics.

Treatment	Description	Suitable for
Dermapen Microneedling	Fine needles create micro-channels in the skin	Those concerned about fine lines
ICON	Targeted light energy is applied to the skin	Those without skin inflammation
Agnes	High-frequency current delivered via insulated microneedles	Those who wish to wear make-up the following day
Fractional Laser	Fine laser beams are directed at the skin	Those wishing to improve skin firmness and elasticity
HIFU	Ultrasound energy targets skin sagging	Those who would like to notice results relatively soon after treatment
Botulinum Toxin Injections	Injected agent relaxes muscle contractions	Those wishing to address expression lines on the forehead or between the eyebrows
Hyaluronic Acid Injections	Hyaluronic acid is injected into targeted areas	Those seeking a more supple, elastic complexion
Thread Lift	Threads are inserted under the skin to lift and tighten	Those looking for a higher degree of wrinkle improvement

Below, we explain the features, potential benefits, considerations, and costs of each treatment.

1. Dermapen Microneedling

Dermapen Microneedling is a treatment that uses fine needles to create micro-channels in the skin, promoting the natural renewal of skin tissue. When the needles penetrate the skin, fibroblasts are activated, stimulating the production of collagen and other components that influence wrinkle formation.

Please be aware that results are not typically seen immediately after treatment. Dermapen treatment generally requires around five sessions on average, with intervals of approximately three to four weeks between each session.

For those concerned about cost, our clinic offers a reduced introductory price for the first Dermapen session.

Full details about Dermapen Microneedling are available on the page below. Please take a look if you would like to learn more.

Improve Skin Quality with Dermapen Microneedling! When Do Results Appear? Three Key Features and the Treatment Process Explained

2. ICON

ICON is a treatment device capable of delivering IPL (Intense Pulsed Light) therapy, which uses a specialised form of light energy applied to the skin.

By adjusting the light intensity, ICON can address a range of skin concerns beyond wrinkles. By delivering light energy to the dermis and stimulating fibroblasts, it supports collagen production.

This helps build skin that is more resilient to UV damage and dryness, and may reduce the appearance of shallow wrinkles. However, there are some limitations to be aware of, including that the treatment may not be suitable for those who are pregnant or have skin inflammation.

If you are unsure whether your current skin condition is suitable for this treatment, please feel free to consult our clinic.

It is also worth knowing that approximately five to six sessions are generally needed to achieve a sufficient response. The fee for ICON treatment at our clinic is “6 full-face sessions / ¥110,000 (tax included ¥121,000).”

For full details about ICON, please refer to the page below.

Addressing Pigmented Spots and Acne Scars with Photofacial (ICON)! Effects, Features, and Key Points to Note

3. Agnes

Agnes uses high-frequency insulated microneedles to work directly on the dermis, and can be effective even for skin concerns that are difficult to address through epidermal care alone.

For wrinkle treatment, Agnes is particularly well-suited to fine lines under the eyes. The skin beneath the eyes is thin, which means some treatments—such as botulinum toxin injections—may not be effective in that area. Agnes’s insulated microneedles, however, allow treatment to reach the dermis even here.

Agnes delivers high-frequency current through the needles to stimulate the skin and support the production of collagen and elastin. Because the epidermis is not damaged in the process, downtime is minimal and make-up can typically be worn the following day.

In some cases, side effects such as redness, swelling, or bruising may occur, but these generally resolve within one week. The fee for Agnes treatment at our clinic is “6 full-face sessions / ¥324,000 (tax included ¥356,400).”

For full details about Agnes, please refer to the page below.

Agnes for Acne Removal and Under-Eye Care! Costs, Effects, and Four Case Examples Introduced

4. Fractional Laser

Fractional laser treatment delivers fine laser beams to create thermal damage in the deeper layers of the skin, stimulating skin quality improvement. As the skin damaged by the laser undergoes cell division during the repair process, collagen production increases.

Treatment is divided into two types: the ablative type, which operates at higher output, and the non-ablative type, which uses lower output and involves shorter downtime.

In addition to improving wrinkles through skin regeneration, a firmer, more elastic complexion may also be supported through collagen remodelling.

There is a possibility of side effects such as discomfort, redness, or post-inflammatory pigmentation following treatment, but these generally improve over time. The fee for fractional laser treatment at our clinic is “6 full-face sessions / ¥110,000 (tax included ¥121,000).”

For full details about fractional laser treatment, please refer to the page below.

What Is Fractional Laser Treatment? Three Skin Benefits Including Scar and Pore Improvement

5. HIFU

HIFU (High-Intensity Focused Ultrasound) is a treatment that uses ultrasound energy to address skin sagging. Because it can target the superficial musculoaponeurotic system (SMAS)—the structural layer that forms the foundation of the skin—it can provide a noticeable tightening effect.

In particular, the “Ultraformer III” device used at our clinic is designed to deliver a perceptible tightening effect with consideration given to patient comfort during the procedure.

While individual results vary, some patients notice an improvement in wrinkles relatively soon after the procedure.

Redness or a sensation of warmth may occur after the procedure, but these effects are temporary and typically subside within approximately one week. The fee for HIFU at our clinic is “5 full-face sessions / ¥135,000 (tax included ¥148,500).”

For full details about HIFU, please refer to the page below.

What Is HIFU? “Ultraformer III” for Facial Sagging Improvement

6. Botulinum Toxin Injections

Botulinum toxin injections work by relaxing the muscles at the injection site, helping to create a smoother appearance and may also be effective for wrinkles on the forehead and between the eyebrows.

Muscle contractions are often a contributing factor to wrinkle formation. Botulinum toxin injections help suppress muscle contractions, which may lead to a reduction in wrinkle appearance.

Potential considerations include the risk of swelling, discomfort, or bruising, as well as the possibility of an unnatural facial appearance.

Since the treatment works by suppressing the facial muscles involved in expression, excessive treatment may limit the natural movement of the face.

Fees for botulinum toxin injections at our clinic vary depending on the treatment area. For full details about botulinum toxin treatment, please refer to the page below.

What Are Botulinum Toxin Injections? Five Potential Aesthetic Benefits and Possible Side Effects

7. Hyaluronic Acid Injections

This treatment involves injecting hyaluronic acid—which has excellent moisturising and water-retention properties as well as elasticity—into targeted areas of the face.

When hyaluronic acid is injected into the grooves of wrinkles, the dermis lifts the overlying epidermis, adding overall volume to the skin. This may make wrinkles and nasolabial folds less noticeable and provide a visible improvement in appearance.

Hyaluronic acid is a substance naturally present in the body, so the risk of complications from injections is generally low. However, in some cases discomfort or swelling may occur.

The effects and costs of hyaluronic acid injections vary depending on the treatment area. For full details, please refer to the page below.

What Are Hyaluronic Acid Injections? Nine Treatment Areas and Their Potential Aesthetic Benefits

8. Thread Lift

Thread lift is a treatment in which threads are inserted under the skin to achieve a lifting effect. As the skin is tightened, wrinkles may become less noticeable.
As thread lift is close to a surgical procedure, it places greater demands on the body and involves a longer recovery period.

On the other hand, it has the advantage of delivering results that tend to last longer. This may be a suitable option for those who feel, “I’d prefer not to have surgery with a scalpel, but I’d like a treatment that delivers a higher level of improvement.”

Treatment costs tend to be higher compared to other options, typically in the range of approximately ¥200,000 to ¥500,000.

For full details about thread lift, please refer to the page below.

What Is Non-Surgical Sagging and Lifting Treatment? Medical HIFU Explained

For Wrinkle Treatment, Visit IC Clinic

Since the effects of skincare on wrinkles are limited, visiting a clinic is worth considering for those wishing to work toward a smoother complexion more effectively. Over-the-counter cosmetics are generally unable to penetrate beyond the epidermis, the outermost layer of the skin.

At our clinic, we can recommend a treatment approach suited to your individual wrinkle concerns from a selection of six options.

1. Dermapen Microneedling
2. ICON
3. Agnes
4. Fractional Laser
5. HIFU
6. Botulinum Toxin Injections

If self-care alone has not been delivering the improvements you are hoping for, please do not hesitate to come in for a consultation.