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Skin tone, Texture and Wrinkles

The primary causes of uneven skin tone, texture and wrinkles are age, genetics, acne, enlarged pores, photoaging, hormones and improper skin care.

Skin tone

Skin tone is the pigmentation of your skin based on the amount of melanin in your skin. Melanin is the substance that gives the skin its color. It is determined by heredity and is affected by the sun, smoking, medications, skin conditions, hormones and aging. Young healthy skin is even toned, bright and glowing.

Skin texture

Skin texture describes the condition of the surface of the skin. Young healthy skin is well hydrated, and firm with a smooth, soft texture and luminosity. As we age skin cell turnover slows resulting in a buildup up of dead skin cells which contributes to the appearance of dull skin and creates clogged pores. The result is uneven texture, coarse, dry and dull skin, enlarged pores and acne.


Wrinkles result from normal aging and photoaging that degenerate collagen and elastin creating rough skin, enlarged pores, and skin laxity. Lax skin folds against itself to create static wrinkles. Additionally, dynamic wrinkles are created from repeated facial expressions that first become noticeable in the late 20s and deepen with age. Crow’s feet, forehead furrows, and smile lines are all the result of repetitive facial expressions. As we lose skin volume with age hidden indentations and acne scarring can become more apparent.

What is hyperpigmentation?

Hyperpigmentation is the term used to define the over production of melanin due to sun exposure, pollution, hormones, and post-inflammatory discolorations caused by bug bites, pimples, acne and mechanical injuries.

Skin conditions that affect skin tone include Rosacea and melasma. Rosacea is an autoimmune skin disease that causes redness and flushing, burning, and stinging, rough and scaly skin. It is a chronic condition that produces small, red bumps, and broken blood vessels on the nose, cheeks and forehead. There is no cure, but symptoms can be controlled.

Melasma is caused by hormone variations in pregnancy and menopause, and from birth control pills. It is triggered by the sun. Melasma is brown patches of skin on the cheeks, forehead, chin and above the lip in women.

How is hyperpigmentation treated?

Treatment options depend on the cause.

The goal is to even out skin tone. Many treatments for hyperpigmentation can also improve skin texture.

  • Professional-grade chemical peels to exfoliate the top layer of skin called the epidermis; deeper peels penetrate the deeper. They treat age spots, sun damage, melasma and discolorations.
  • Topical Hydroquinone creams to lighten dark spots.
  • Nonablative fractional laser treatments to lighten scars, age and sunspots (Clear + Brilliant, Q-switched lasers) Nonablative lasers do not remove skin layers.
  • Ablative lasers remove layer of skin to rejuvenate the skin and produce new skin cells for a tighter, even toned appearance.
  • Microdermabrasion treats hyperpigmentation and improve superficial scarring.
  • Retinoids – prescription and over the counter strengths will exfoliate the skin and remove discolorations.
  • IPL (Intense Pulsed Laser) treatments can control Rosacea. Treatments improve the appearance of discolorations, wrinkles, spider veins and enlarged pores.

How are skin texture and wrinkles treated?

  • Exfoliation: Exfoliation is the remedy for a buildup of dead skin cells and improve skin texture. Professional chemical peels, microdermabrasion and laser skin resurfacing all exfoliate and reveal healthy, unblemished new skin.
  • Microneedling is a favorite for smoothing and evening out skin texture.
  • Dermaplaning is a professional treatment to smooth rough skin, and remove peach fuzz.
  • Ablative lasers remove layers of skin to rejuvenate the skin and produce new skin cells for a tighter, smoother and more even toned skin.
  • Non-ablative laser skin resurfacing stimulates the production of collagen and elastin to tighten and smooth the skin using ultrasound, or radiofrequency energy.

The skin is the largest organ in the body and despite its accessibility it is a challenge to treat.

Dr. Swetha Kandula is double board-certified in internal medicine and dermatology and is trained in cosmetic dermatology and laser surgery. She is the founder of Dermatology and Skincare Arts in Parsippany, New Jersey. Dr. Kandula has training, skills, and experience to provide state of the art cosmetic and medical dermatological care. Contact her to schedule a consultation today.