(FORTUNE Magazine) – What, if anything, makes you wince when you look in the mirror? Frown lines, puffy eyes, crow's-feet, laugh lines? What about turkey neck, which is skin-expert talk for those wattles that may impel you to stock up on turtleneck sweaters? Okay, so this is about vanity, pure and simple--but hold on. According to one school of dermatological thought, wrinkles aren't an inevitable consequence of time's passing. They're a medical disorder brought on by exposure to sun, stress, and quick-and-unhealthy foods--by life as many of us know it. Change your life, and your skin will change too. But how much change, and what kind, are you willing to consider?

Wrinkles, in case you're wondering, are actually tiny scars in the collagen layer just under the tissue-paper-thin surface layer of the skin. They appear as lines (rather than, say, dimples) because collagen, at the cellular level, is stringy in consistency.

Treatments vary wildly, from simple application of sun-blocking and antioxidant lotions--"Some patients really just need a good skin-care regimen to look significantly younger," says Patricia Wexler, a prominent Manhattan dermatologist--to the direst extreme, i.e., face-lift surgery that hoists your skin up around your ears and leaves you looking for weeks afterward as if you'd been thrashed with a knotted plowline. In between are treatments that impose so little trauma that you can have your face "done" on your lunch hour and go straight back to work. One popular method: laser resurfacing, which zaps away laugh lines and crow's-feet, typically in two or three treatments at $500 to $750 apiece.

Then there are injections of "plumpers," which, for anywhere from $700 to $4,000, depending on the size of the area you want plumped, will ease away lines and creases. These aren't for the squeamish. Most people know that Botox, which unpuckers the skin by paralyzing underlying muscles, contains the same potentially deadly bacterium that causes botulism; but were you aware that a popular plumping material called Alloderm is made from sterilized collagen harvested from cadavers? You can also have fat from elsewhere on your own body injected into your face. You can have all these procedures done at regular intervals--lasers at 35, collagen at 40, and so on. But every incursion into your face carries risks beyond simple ickiness. One is that in some states "aestheticians" with no medical training at all are allowed to wield lasers. So, please: Go to a bona fide dermatologic or cosmetic surgeon.

Meanwhile, there's no shortage of over-the-counter products that promise to slow the wrinkling process without professional intervention, and some actually work. Elixirs containing retinol (or Retin A, its prescription-only counterpart), vitamin C, and alpha-hydroxy acids have been proven--in clinical tests by researchers who don't work for cosmetics companies--to smooth fine lines and wrinkles. Unfortunately, they can also make your skin look and feel as if you had scoured it with a Brillo pad. So lately the cosmetics industry has begun pushing potions that promise to unwrinkle without irritating. A sensible course: Give an over-the-counter contender a few weeks' trial, and if you don't like the results, see a dermatologist. Prescription stuff--often with many of the same ingredients but in higher concentrations and customized for you--is usually better.

Watch much public TV? You may already have seen Dr. Nicholas Perricone, the main proponent of the medically controversial idea that wrinkles are not a melancholy inevitability but a curable disorder. An assistant clinical professor of dermatology at Yale School of Medicine, Perricone has been plugging his bestseller, The Wrinkle Cure (Warner Books; $13.95 in paperback), on PBS fundraisers. The cure involves a diet heavy on fresh fruits and vegetables; cold-water fish like salmon and tuna; and water (the same eight glasses a day nutritionists have recommended for years). The regimen is extremely low in starches and sugars--farewell, fusilli! Twinkies, adieu!--which allegedly foster wrinkles by triggering inflammation in skin cells. (Perricone also suggests you use his pricey lotions, available through his Website, www.nvperriconemd.com.)

No independent studies have been conducted to prove that this regimen works, though legions of celebrity fans swear by it. But whether or not it smooths your skin, Perricone's plan may help you lose weight--Peter Marchese, the Wallingford, Conn., marketing executive pictured above, says he dropped 27 pounds in six months. It may also help prevent high cholesterol and other ills discussed in these pages. "It's a funny thing," Perricone says. "For years I advised my patients to eat this way, drink lots of water, and so on, for their general health. They never listened until I started emphasizing how much better it would make them look." Hey, what's wrong with that? If vanity ends up making you healthier, maybe it's not in vain.

--ANNE FISHER