Once we hit 40, the descriptors used for skin typically have a negative connotation—words we don't necessarily want to associate with our once bouncy, smooth complexions. According to Dendy Engleman, MD, skin becomes "dull-looking," uneven, and wrinkles are more predominant. This is mostly due to something called perimenopause (or the years leading up to menopause), during which your estrogen levels begin to decrease and skin becomes thin and loses its elasticity. Of course, the aging process is natural, beautiful, and a privilege, but many signs of skin degradation can actually be avoided by taking preventative measures and using the right products at the right time.
To find out how to make skin look its best for as long as possible, we spoke with Engelman and Gervaise Gerstner, MD.
What are some treatments you can get in your 20s and 30s for healthy-looking skin in your 40s?
Gerstner says that micro-needling is an excellent preventative measure to take. By rolling the tiny needles along your face, you're creating micro injuries on the skin, which then increases collagen and elastin production to help heal the skin. This then "thickens" the skin a bit to help fill out fine lines and hide dark circles. Engelman notes that by your 30s, you start to lose 10% of your collagen each decade, so introducing a vitamin C serum (which helps boost collagen) is also a wise choice.
Gerstner is also a fan of in-office treatments like platelet-rich plasma injections and Clear + Brilliant. You've probably seen PRP touted as "vampire facials" à la Kim Kardashian West. In this treatment, the patient's own blood is spun in a centrifuge, and the activated platelets are then injected back into the skin, which initiates reparative cells for a fresher, more youthful-looking complexion. Clear + Brilliant is a dermatologist-loved laser treatment that creates millions of "treatment sites" on the upper layers of the skin to help exfoliate away dead cells.
Engelman advocates for regular medical facials that not only clean the skin but also use blue and red light therapy. "This will support collagen production and also target breakouts by killing bacteria deep in the skin," she explains.
How should your skincare routine change in your 40s?
"It's time to switch up your face wash," says Engelman. "Now you need something [gentler], like a cleansing oil. I still use my vitamin C antioxidant but follow with a face cream and eye cream for added hydration. With crow's-feet, you need to target the area to anti-age and reduce wrinkles. To brighten skin, there are great masks that will fade brown spots and hyperpigmentation." Engelman is also keen to administer injectables when necessary. "My rule of thumb for Botox is if you can see the lines when you're not making the expression, it is time."
Lastly, Engelman says you want to target anti-aging with an antioxidant to fight against free radical harm and repair damaged cells. "My favorite, and I believe the gold standard, is SkinCeuticals C E Ferulic," she tells us. "This product will noticeably reduce fine lines and wrinkles while improving overall skin appearance."
What if you have acne?
"Those with acne should avoid dairy, sugar, gluten, and look for ways to decrease cortisol," says Gerstner. These food groups spike insulin levels and throw your hormones out of whack, which then causes breakouts. She continues, "Acne responds well to a great topical routine but often needs orals as well. Topical solutions include glycolic pads, retinol, and masks." If your skin isn't clearing up on a topical regimen, speak with your dermatologist about which prescriptive internal remedies you can try.
Engelman also loves retinol's acne-fighting prowess. "Retinoids are the backbone of any acne treatment," she says. "Previously, all retinoids were prescription-only, but as of two years ago, the FDA approved adapalene (marketed as Differin Gel and Proactiv Adapalene Gel) to be sold over the counter without a prescription. Retinoids help treat two major causes of acne: dead-skin buildup and inflammation."
What are some skincare mistakes women over 40 make?
"Too much stripping," says Engelman. "Overuse of products makes our barrier weak and can actually cause rapid aging since the skin cannot properly defend itself against environmental stressors."
Additionally, while picking your skin is never advised, Gerstner says that women over 40 who pick won't heal as well as they would have in their teens due to a decrease in collagen and elastin, which aid in wound healing. This could lead to scarring and pockmarks, all of which can be avoided by taking a hands-off approach to congested pores and leaving them to the professionals.
What do you wish someone had told you about your own skin 10 or 20 years back?
Both women had the exact same regret: not using enough sun protection. "I wish someone had told me how bad tanning booths were," says Gerstner. "When I was a teen, I went to a tanning booth in Georgia—the horror! Melanoma is the number one cancer killer of women under 40." Engelman, also a southern native, agrees and wishes she'd had a more consistent relationship with sunscreen.