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Hong Kong-based general practitioner Dr Lisa Chan shares her thoughts on facial lines and tips for treating them

Every face tells a story. It is an intricate patchwork of contours, lines, beautiful features and blemishes that reflect our experiences, our diets and our tastes—and also offers a tantalising glimpse of the life we have led so far.

The longer we live, the richer and more detailed the story our face betrays. That’s why an old face with a tale tucked away in every weathered crack and crevice is infinitely more interesting than a flawlessly youthful face. 

The geography of the ageing face is so absorbing we have names for its distinctive features: Crow’s feet, for instance, for the lines or wrinkles that radiate from the outer corners of our eyes; frown lines for the lines or wrinkles between our eyebrows; and Marionette lines for the lines or wrinkles that run from the corners of the mouth to the chin.

Those names are almost exclusively harsh and negative. Who, after all, would want features that resemble a clawed bird’s foot or a wooden string puppet? They spring from our instinctive reaction to any outward show of ageing: we’d all rather it never happened at all. 

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In reality, of course, lines and wrinkles are an entirely natural part of growing older. The amount of collagen in our skin—the protein that gives it elasticity—diminishes from the age of 18 onwards. So wrinkles and lines in our 20s onwards are an inevitable chapter in life.

We can’t stop the work of Mother Nature, but there are things we can do to make her kinder and gentler. A healthy life with exercise, a good diet, plenty of sleep and minimal stress will keep us looking younger and fresher for longer.  

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Avoiding three key things will help: 
 
1. Smoking: It impairs the skin’s collagen production and breaks down collagen that is already there, creating an ageing effect on the whole face as well as leaving smoker’s lines. 
 
2. Too much sun: While a little sunlight is good for us, too much can lead to photoageing and a loss of collagen in the skin 
 
3. A high sugar diet: This speeds up the ageing of skin by breaking down collagen in a process known as glycation. 
 
Skincare routines can make a difference too. Use mild soaps and cleansers and avoid harsh detergents, and apply cream or moisturiser to your skin after washing or when it feels dry, which makes your face and skin smoother and moister. 

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Beyond that, there are aesthetic treatments that can reduce lines and wrinkles and refresh the skin. Hyaluronic acid injections, for instance, hydrate the skin and make it more elastic and radiant with results lasting up to a year.

Biostimulators, meanwhile, activate the skin’s production of collagen. Botulinum toxin injections—commonly used on crow’s feet and frown lines—temporarily block signals from the nerves to the muscles, making wrinkles relax and soften. 
 
These treatments—which should only ever be taken after consulting your doctor—won’t rewrite your life story. But they can add a sprinkle of magic in storytelling, and make sure it is told in the most compelling and attractive way. 

This is part of a monthly column by Dr Lisa Chan, a Hong Kong-based general practitioner who has an avid interest in medical beauty. Dr Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney), also holds a master's degree in practical dermatology with distinction at Cardiff University.

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