A Wrinkle in Sleeping Beauty’s Story

When Sleeping Beauty emerged from her long slumber, she appeared to be rested, radiant, and beautiful. She didn’t even have a single sleep line on her face. Had she been a real flesh and blood woman, would she have had cause to worry about sleep wrinkles?

What are Sleep Wrinkles?

Wrinkles are lines that appear in the skin when the skin’s elasticity isn’t as spry as it once was, and the skin doesn’t snap back when it is stretched or compressed. It’s a normal part of aging. Several factors are known to promote wrinkles; chief among them is the accumulation of sun damage that leads to our cells’ declining ability to produce collagen that keeps our skin stretchable. You can look in the mirror as you smile, or frown, or do any of expressions you commonly do in a day, and catch a glimpse of where your wrinkles will appear. By contracting our facial muscles to show our emotions, we repeatedly pull and pull on our skin, and this wear and tear eventually leads to permanent furrows in the skin. The process is similar to the creases that appear in a well-worn pair of leather gloves. Botox works by paralyzing specific facial muscles, thereby removing the stress on the skin, and reducing the appearance of wrinkles.

But not every wrinkle can be explained by the wear and tear of facial expressions. Some wrinkles appear in places that don’t match smiling or frowning. In fact, while many wrinkles caused by facial expressions run horizontally (think of the frowning lines on the forehead and the crow’s feet at the tips of the eyes), these other wrinkles are oriented in a vertical direction. In the late 1980s, researchers proposed that they were caused by the pressure exerted by our pillow on our skin during sleep. That seems plausible enough; after all, the head is heavy and we spend a third of our life with our face buried in a pillow. It makes sense that, over time, the places where pressure folds our skin develop into more permanent wrinkles. If you want to get a sense of where these “sleep wrinkles” are likely to develop on your skin, look in the mirror while you press your flat palms against the sides of your head. In some people, it will create lines running parallel to the nose; in others, vertical lines around the sides of the eyes or the chin; or diagonal lines on the forehead. Botox isn’t helpful in these cases because the lines aren’t caused by the muscle contractions that a drug can reduce. So what can we do about them?

Do Sleep Wrinkles Exist?

Before we tackle that question, we should first tackle whether sleep wrinkles actually exist; that is, whether burying our head in a pillow at night actually leads to the production of wrinkles. Certainly the mechanism proposed to their development is plausible. But what I like about science is that it gives us a means of assessing whether something works the way we think – and that step is important because sometimes we are wildly wrong!

One study (1) asked volunteers to describe their sleep position: did they sleep on their left, or on their right? Pictures of these volunteers were assessed by a dermatologist who determined whether the volunteer had more sleep wrinkles on the left or right side of the face. The rationale was that someone who sleeps with the right side would exert more pressure on the skin on that side of the face, and therefore sleep wrinkles are more likely to develop on the right. The researchers failed to find that people who slept on the right had more sleep wrinkles on the right side of the face, and the same result was found for people who slept on the left side.

We might conclude from this that sleep wrinkles are a myth and don’t exist, but I’m not so inclined to believe this study because people seldom stay in one position during the night. People might think they sleep on the left because that’s where they start the night, but inevitably they will move. In fact, we know from another study (2) that young adults change sleep positions at least four times every hour, whereas older adults shift less regularly, typically settling on only two positions per hour. If anything, this would support the creation of sleep wrinkles, because the older you are, the longer you stay in a position at night, and the more pressure you apply to a specific fold in the skin which eventually becomes a permanent wrinkle. The study provided other interesting tidbits; during a typical night, people tend to shift their head from left to right, on average turning their head right 47% of the time, left 45% of the time, and upward 8% of the time. Irrespective of the position the volunteers adopt when they fall asleep, they spend about the same amount of time sleeping on the right and the left during the night, and I would therefore expect sleep wrinkles, if they do form, to appear symmetrically on the face.

So what’s the take away message about sleep wrinkles? We don’t know that they exist! We have a plausible mechanism to account for the creation of some wrinkles that facial expression and gravity cannot explain, but we are still waiting for confirmation that what we think is causing them really is sleep. For now, it’s the best guess we have. I make this point so that you will take the next section with a grain of salt…

How Can You Prevent Sleep Wrinkles?

Let’s assume for a second that sleeping wrinkles are a real thing. What can we do to slow down their appearance?

The first measure of protection applies to all wrinkles: avoid sun damage. Over time, sun damage destroys your skin’s ability to produce collagen and other chemicals that maintain the skin’s elasticity. Protect your skin from the harmful effects of UV light with a good sunscreen.

The next bit of advice is to try to sleep on your back. Adopting this position means that your face will not be buried in a pillow and therefore that the skin will not be compressed. That might be difficult to do, given that we have control of where we start out in the night, but once we are asleep, the body acquires a mind of its own. And this approach may not be ideal given that people who sleep on their back have a greater tendency to snore. (So you’ll look great, but no one will want to sleep next to you!)

Some manufacturers sell pillows covered in a slippery fabric like silk and they claim that their product reduces the appearance of wrinkles. I couldn’t find any evidence for or against this in the scientific literature, but I am very skeptical. When you rest your face sideways on a pillow, there are two forces that conspire to exert stress on your skin. There is the weight of the head, which causes compression of the skin, as we have been discussing, and there is also friction between your skin and the fabric of the pillow. That second type is a considerably smaller contributor to the stress on your skin; how often do you rub your face up and down the pillow?

Another type of “anti-wrinkle pillow” that you might encounter online is one that is designed to remove the pressure on the face when your head is resting on it. All of the scientific papers on this tested a doughnut-shaped pillow where the chin and forehead rest on the pillow but the cheek and eye areas are suspended above the “doughnut hole” and therefore do not exert pressure on the skin. The papers report moderate improvement in the appearance of wrinkles after using the pillow for a month (3). I’m cautiously optimistic about this study, in part because it did show that there was less pressure exerted on the cheek area. However, I remain skeptical, because at least one of the researchers had ties to a company that manufactures and sells these pillows, so there is a possibility for conflict of interest.

In fact, most research done on marketable products suffer from this type of conflict of interest. The next one is another such example, and the company fabricates copper oxide-containing pillowcases. Here’s the idea behind it. Copper is an element that is absorbed through the skin and that can stimulate skin regeneration, possibly by stimulating the production of collagen. Previous work had shown that copper oxide-impregnated socks could treat athlete’s foot (copper is known to kill bacteria and fungus). The researchers of that study noted that in addition to curing the infection, the volunteers reported that the skin on their feet felt and looked great. So another study was performed with copper oxide socks, but this time the researchers investigated the elasticity of the skin on the feet. Lo and behold, copper oxide worked in this capacity as well. Researchers interested in cosmetology took these results to the next level and investigated whether a pillowcase containing fabric impregnated with copper oxide could improve the appearance of wrinkles (4). They randomly assigned 30 volunteers to sleep on a normal pillowcase and 30 others to sleep on the copper-containing one. After two months, the volunteers’ “before and after” pictures were compared by skin experts who did not know which pillowcase the volunteers had slept on. They evaluated the appearance of wrinkles and determined that sleeping on a copper-containing pillowcase resulted in better skin. In case you are wondering, the volunteers were told to wash their pillowcase as they normally would wash one, so I have to presume that copper doesn’t leach out of the fibres during the wash cycle.

I have some reservations about this study because the researchers are working for the company that markets this product, but the results are thought-provoking and I look forward to other researchers confirming these results.

So after all that research, we can guess that Sleeping Beauty was resting her head on a specially shaped pillow, or perhaps one infused with copper oxide, or perhaps she was sleeping with her head facing up. Or, you know, maybe she didn’t wake up from her prolonged slumber with any sleeping wrinkle because there is no such thing. The fairy tale doesn’t say. And only more research will tell….

Cited Research

(1) Kotlus BC (2013). Effect of sleep position on perceived facial aging. Dermatol Surg. 39(9):1360-2. doi: 10.1111/dsu.12266. PMID: 23865987

(2) De Koninck J, Lorrain D, Gagnon D (1992).Sleep positions and position shifts in five age groups: an ontogenetic picture. Sleep 15(2): 143-9. PMID: 1579788

(3) Poljsak B, Godic A, Fink R, Oder M, Lampe T, Dahmane R, (2015). Sleeping on an anti-wrinkle pillow reduces facial wrinkles: Results from an anatomical study. Forensic Medicine and Anatomy Research, 3, 48-56.  doi: 10.4236/fmar.2015.32010.

(4) Baek JH, Yoo MA, Kohn JS, Borkow G (2012). Reduction of facial wrinkles depth by sleeping on copper oxide-containing pillowcases: a double blind, placebo controlled, parallel, randomized clinical study. J Cosmet Dermatol. 11(3):193-200. doi: 10.1111/j.1473-2165.2012.00624.x.  PMID: 22938003

  

Images

Baby Sleeping

License image obtained from Jim Champion (Love 2 Sleep) on Flickr.

Woman who earned her wrinkles

License image obtained from Mario Popova (Age of Sad) on Flickr.

Thanksgiving Feast Can Make You More Attractive

Thanksgiving dinner is just around the corner and with it comes extra portions of carrots, sweet potato casserole, and pumpkin pie. This feast might fill your heart with dread about the potential effects on your waistline, but believe it or not, this may be an opportunity for you to become more attractive.

Research has shown that eating certain fruits and vegetables changes your skin tone and makes you look healthier and more attractive. In fact, the effect is more reliable than a tan. Becoming more attractive in this way is surprisingly achievable; it only takes an increase of about 2 portions of fruits or vegetables each day and the results are noticeable after six weeks. Men and women of all skin types (Caucasians, Asians, Blacks) can improve their sex appeal in this way.

How Do We Know This?
We have known for some time that eating foods high in carotenoids - found in certain fruits and vegetables - gives the skin a yellowish tinge. That gave a group of researchers at the University of St Andrews in Scotland the idea to investigate whether this colour change is a good thing. They took pictures of people and used a software to make their skin more yellow or less yellow – in effect matching the skin tone to that of people who consume more or less fruits and veggies. They then asked a group of volunteers to compare the pictures and identify the skin tone for each person that made them look healthiest and most attractive. The results showed that people were deemed healthiest and sexiest when the skin tone was more yellow, by an amount that corresponds to the consumption of about 2-3 additional portions of fruits and vegetables each day.  

Why is Yellow Skin More Attractive?

It might seem bizarre that yellower skin is perceived as more attractive, but it actually makes sense in the context of animal studies. In some bird and fish species, carotenoids are important for health. They must be obtained in the diet but they can be hard to come by. When animals are infested by parasites or infections, they use their scarce carotenoid resources to combat infection and have little left-over to spare. Those that are healthy tend to have more carotenoids and they display them in richly colored ornamentations – bright beaks and feathers and scales (for example, the red feathers of cardinals and the bright beak of bald eagles). In effect, they are telling potential mates “I am rich with food resources and I am healthy.” Males who are brightly coloured attract more females, who prefer them to the less coloured males. Inspired by wildlife, some researchers believe that this is happening in humans as well. Humans need carotenoids in order to fight-off infections. Carotenoids are also important to ensure good health. Deficiencies have been linked to cardiovascular disease, diabetes, and even some cancers. Carotenoids have even been proposed to protect the skin from the damages of UV light. Men and women who have good levels of carotenoids have yellower skin, and the hypothesis proposes that we have evolved to prefer people who advertise their good health in this way. We find people with “tanned” skin sexier.  

Where to Get Carotenoids
So what can you do to get more attractive-looking skin? Humans and other animals cannot make their own carotenoids; they must consume them in their foods. Carotenoids can only be found in plants – fruits and vegetables – but not all plants contain them in abundant amounts. A good rule of thumb is that orange, yellow, or red fruits or veggies contain lots of them, though some dark green ones do so as well. Excellent sources include sweet potato, carrot, pumpkin, spinach, collards, kale, apricots, cantaloupe, and tomatoes. The foods can be eaten raw, boiled, baked, or fried, but contact with air should be minimized (cutting the fruit prior to eating or eating it from a recently opened can or frozen container). Supplements can cause the skin to yellow but don’t bring the same beneficial health effects as whole foods. Once ingested, the carotenoids are absorbed in the blood and make their way to the skin and fats. It takes about six weeks for carotenoids to accumulate and infuse all of the skin layers.

Despite recommendations to eat 5-7 servings of fruits and veggies every day, more than half of us do not get enough. Adding portions of these food groups to your diet is beneficial for health, will likely decrease the consumption of less healthy foods, and will cause the skin to take on a healthier glow. All it takes is an increase of two servings each day to make a difference in the skin tone, and people who currently eat the least amount of carotenoid-containing foods should see the greatest effect. If Thanksgiving marks the start of this new diet, you should have more attractive skin by the New Year.

Who knew that the start of the holiday season this week could mark the start of a new beauty regime, one that can cause noticeable improvement in your attractiveness in a matter of weeks! So go ahead, eat that extra serving of pumpkin pie!  

Additional Readings

Whitehead RD, Ozakinci G, Perrett DI (2012). Attractive skin coloration: Harnessing sexual selection to improve diet and health. Evol Psychol 10(5): 842-854. PMID: 23253790

Whitehead RD,Re D, Xiao D, Ozakinci G, Perrett DI (2012). You are what you eat: within-subject increases in fruit and vegetable consumption confer beneficial skin-color changes. PLOS One 7(3): e32988. doi: 10.1371/journal.pone.0032988. PMID: 22412966

Photo Credits

Pumpkin Pie

License image obtained from Flick User: browniesfordinner (Pimpkin Piefrom a *real* pumpkin).

Eagle with yellow beak

License image obtained from Flick User: Pen Waggener (Eagle Closeup).