Understanding the distinction between wrinkles in motion (dynamic rhytides) and wrinkles at rest (static rhytides) is fundamental in addressing facial aging effectively. These two types of wrinkles have different underlying causes and often require different treatment approaches.
Wrinkles in motion, or dynamic wrinkles, are those that appear when facial muscles contract during expression. These lines are a direct result of repetitive muscle movements, such as smiling, frowning, or squinting. Common examples of dynamic wrinkles include horizontal forehead lines (caused by raising the eyebrows), glabellar lines (the vertical “eleven” lines between the eyebrows, caused by frowning), and crow’s feet (the lines radiating from the outer corners of the eyes, caused by smiling and squinting). In younger individuals, these lines are only visible during muscle contraction and disappear when the face is relaxed.
Wrinkles at rest, or static wrinkles, are lines and folds that remain visible even when the facial muscles are relaxed. These wrinkles develop over time as a result of several factors, including the cumulative effects of repeated muscle contractions, the natural aging process leading to a loss of collagen and elastin in the skin, sun damage (photoaging), gravity, and volume loss in the underlying fat pads. As dynamic wrinkles are repeatedly formed over the years, the skin gradually loses its elasticity and ability to bounce back, eventually leading to the formation of static wrinkles in the same areas. Examples of static wrinkles include nasolabial folds (the lines running from the nose to the corners of the mouth), marionette lines (the lines extending downwards from the corners of the mouth to the chin), and persistent fine lines and creases all over the face.
The underlying causes of dynamic and static wrinkles are distinct. Dynamic wrinkles are primarily caused by the contraction of facial muscles. These muscles are attached to the skin, and when they contract, they pull on the skin, causing it to fold and wrinkle. The more frequently and forcefully these muscles are used, the more pronounced the dynamic wrinkles become over time. Static wrinkles, on the other hand, are a consequence of the breakdown of the skin’s structural components (collagen and elastin) and volume loss, coupled with the persistent creasing caused by dynamic muscle movements over many years and the effects of environmental factors like sun exposure.
The treatment approaches for dynamic and static wrinkles often differ. The primary treatment for dynamic wrinkles is the use of botulinum toxin (Botox). Botulinum toxin works by temporarily blocking the nerve signals that cause muscle contraction, thereby relaxing the targeted facial muscles and allowing the overlying wrinkles to soften or disappear. It is highly effective for treating forehead lines, glabellar lines, and crow’s feet. By reducing muscle activity, botulinum toxin can also help prevent the dynamic wrinkles from becoming deeper static wrinkles over time.
For static wrinkles, treatments that address volume loss and stimulate collagen production are typically more effective. Soft tissue fillers are a key treatment for static wrinkles, as they can physically fill in lines and folds, restoring volume and smoothing out the skin’s surface. Fillers are commonly used to treat nasolabial folds, marionette lines, and to add volume to areas where it has been lost due to aging. Laser resurfacing, both ablative and nonablative, can also improve static wrinkles by stimulating collagen remodelling and improving skin texture and tone. Ablative lasers are more effective for deeper static wrinkles, while nonablative lasers can improve milder lines and overall skin quality. Fractional laser technology can be used for both dynamic and static wrinkles, offering a balance of effectiveness and downtime. Other treatments like chemical peels and topical retinoids can also contribute to the improvement of static wrinkles by promoting collagen production and skin renewal.
It is important to recognise that dynamic wrinkles can progress to static wrinkles over time if left untreated. The repeated folding of the skin during muscle contraction eventually leads to a breakdown of collagen and elastin in those specific areas, causing the wrinkles to become permanently etched into the skin, even when the muscles are relaxed. Therefore, early intervention with treatments like botulinum toxin to address dynamic wrinkles can play a preventative role in the formation of static wrinkles. A comprehensive assessment of a patient’s wrinkles is essential to determine the most appropriate treatment strategy. Practitioners need to evaluate whether the wrinkles are primarily dynamic, static, or a combination of both, and then tailor the treatment plan accordingly. Often, a combination of different treatments, such as botulinum toxin for dynamic wrinkles and fillers or laser resurfacing for static wrinkles, can provide the most comprehensive and natural-looking rejuvenation . Understanding the difference between wrinkles in motion and wrinkles at rest allows for a more targeted and effective approach to managing the signs of facial aging.