The shame you describe as feeling, is part of the inner bully or inner critic. It's a way of beating yourself up and this something you have to become aware of and let go of as well. Anxiety can take many forms and right now the distraction about your appearance is a way of coping with anxiety. Just like TMS, it gives your brain something to obsess over. There's nothing wrong with wanting to look presentable or even getting botox....it's the mindset behind it that matters. If the issue is consuming you and terrorizing you that is much different than someone who puts on some makeup or gets a little botox and goes about their life. I think if you take the judgment out of it, and just looks at it for what it is...another form of TMS distracting you....it won't distress you as much. It's just your brain coming up with something new to preoccupy your thoughts. When you start ruminating about wrinkles or anything related to your outer appearance, shift your focus to what you are really feeling....then acknowledge those feelings (for ex. "I'm scared") and look at those feelings (for ex. what am I actually afraid of?). Then tell yourself that it's just a thought ...not reality and no matter what happens in the future you will handle it. Then continue to go about your day and live in the moment rather than the future.