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| Fig. 59.1 Large, coarse wrinkles due primarily to photoaging. Some of the fine wrinkles near the eye are glyphic wrinkles and are intrinsic to aging. |
The answer is complicated, because some authorities recognize as many as five different subtypes of wrinkles. The most common type of wrinkles on non– sun-exposed skin are fine wrinkles (glyphic wrinkles) that represent accentuation of normal skin markings. Microscopically, this is due to focal thinning and decreased numbers of keratinocytes. This appears to be intrinsic to aging (Fig. 59-1). The deeper wrinkles in photodamaged skin demonstrate a groove in the epidermis associated with solar elastosis that protrudes on both sides of the groove. These deeper wrinkles are due to extrinsic aging, primarily resulting from ultraviolet light.
