Last month, I discussed some of the preventative measures for 20-30 somethings. As we transition into the 40s and 50s, those measures are still important, but it may be time to be more inclusive.
Entering your 40s, your skin begins to mature right along with you. Prevention is still important, as additional damage and pigmentation of the skin can occur with continued sun exposure. Your skincare should include daily sunscreen, retinols, antioxidants, and ideally a growth factor. If your skin feels drier, a hydrator with hyaluronic acid can be very beneficial.
Some of your friends are probably already having regular Botox treatments. Botox is one of the best ways to slow down the progression of deep lines between the brows, on the forehead and crow’s feet. In addition to the volume loss in lips, temples, and undereyes that start in the 20s and 30s, you may see more loss in the nasolabial folds (parentheses) around the mouth. Mid-cheek loss contributes to the heaviness around the nasolabial folds and creates the jowls of the lower cheek. The lips may turn downward, giving the appearance of an unhappy look. Thoughtful placement of fillers in these areas can recreate your youthful volume and lift the cheeks back into place.
Deep lines and pigment respond well to resurfacing treatments. Microneedling, HALO laser, and CO2 laser can all be used to resurface. Most people in their 40s are best suited to the HALO, which I consider the medium option of these three. Downtime is minimal (three to five days) and most patients who have the laser on a Thursday or Friday return to the office by Monday. HALO is a great option to smooth out deeper lines, even skin tone, and generate more collagen. If texture is not the issue but you have developed reds and browns from sun damage, IPL could be a wonderful option. If you just want to maintain your current skin health without downtime, the Forever Young procedure with BBL could be a great starting point.
In our 40s, metabolism of fat can be more difficult than in previous decades. CoolSculpting and Kybella are great options for non-invasive removal of this fat. Ideal locations to treat include the chin and abdomen, and the latest innovations are making it safe and effective to treat the arms, inner thighs, below the glutes (“banana roll”), and more. Tightening devices are great in areas of laxity over fat help lift the skin back into place.
As you move into your 50s, you hopefully are using sunscreen daily and great skincare, including all of the categories mentioned above (retinol, antioxidant, and growth factor). Specialty products, such as eye creams, lighteners, and hydrators with hyaluronic acid can augment a great regimen.
Botox treatments will continue to help the lines between the eyes, forehead, and crow’s feet. If your lines are deeper, fine line fillers can also be added to these areas to help soften the lines faster. The volume loss in the mid-cheek and nasolabial folds continues to occur, and the skin above the upper lip starts to lengthen and flatten, causing the upper lip the turn under and have less “show.” Additional loss in this area causes a disappearance of the cupids bow. Soft fillers into the lips can redefine these areas and give more show to the lip, without adding additional volume than what you previously had.
The deep lines that began in the 40s can be treated with resurfacing as mentioned above, but CO2 may be more effective. It is more aggressive than the HALO laser, which means it has more downtime but fewer treatments. It is typically is a “one and done” procedure, as the results on deeper lines and pigment are dramatic. IPL and the Forever Young procedure with BBL are great for removing the reds and browns of sun damage and maintaining the health of your skin.
-Meg Cherry, MD