Dr Stefanie Williams is a leading dermatologist and Medical Director of Eudelo Dermatology & Skin Wellbeing, a central London based clinic which offers both medical and cosmetic dermatology. Her philosophy is holistic, in the sense of looking at all the factors affecting ageing, but doing so using high-tech ingredients and advanced techniques. Here she talks to us about skincare through the ages.
What makes our skin change with the years?
Of course, there are internal influences – your genetics, cell metabolism, hormones and so on, but environmental influences are responsible for up to 80-90% of visible skin ageing. The role of UV and infrared irradiation from the sun is well known, but blue light which not only comes from the sun, but also from digital devices with screens like laptops and mobiles, as well as pollution, stress, lack of sleep, diets that are high in sugar and processed carbohydrates, all play a role in premature skin ageing.
What might you see in terms of skin ageing in your 20s?
It’s when you see mostly what nature gave you, as in most people there are very few visible signs of ageing in your 20s. In your 20s, it’s all about prevention and good skincare plays a key role in this. However, if you have an over-expressive face, you might already see some mimic lines (ones that mirror the movement of underlying muscles), such as frown or forehead lines or crow’s feet appearing in your 20s. These will gradually turn into static lines as the years pass (i.e. they won’t disappear when you relax your facial muscles) and once this is the case, they become much more difficult to treat, so it’s important to tackle them early enough, rather than thinking 20s is too young for treatment. And what about skincare for this age group? Skincare is very important with the key message being 'prevent and protect'. Sun protection with a broad-spectrum product with an SPF of 30 - 50 is essential for women in their 20s. I'm a fan of mineral sunscreens such as SkinCeuticals' Sheer Mineral UV Defense SPF 50. For most people this will double as a moisturiser. They should however all be using a daily antioxidant underneath the sun protection and moisturiser. SkinCeuticals’ Serum 10, which contains 10% l-ascorbic acid (vitamin C), and ferulic acid would be a good choice for this age group. As far as evening moisturisers are concerned, unless your skin is very dry, I recommend something lightweight. Exfoliation should be done two to three times a week.
How about your 30s?
The first few lines, which may have started as mimic lines, are now becoming visible, also as the collagen metabolism of the skin starts to decline. The message here is continuing to prevent and protect, but also start thinking about correcting. This is the age when I would suggest people consider introducing retinol containing skincare.
In addition to daily sun protection with SPF 30-50, I’d also advise a high-grade antioxidant serum each morning. Your 30s are a good time to upgrade your antioxidant serum to, for example C E Ferulic (a synergistic antioxidant combination of 15% vitamin C, 1% vitamin E and 0.5% ferulic acid); or if you have oily skin or are breakout-prone, go for Phloretin CF [an oil-free antioxidant containing 10% vitamin C as well as 2% phloretin and 0.5% ferulic acid]. In the evening, start introducing retinol such as Skinceuticals’ Retinol 0.3. As with any vitamin A derivative, it’s important to taper this in slowly and use it as tolerated, which may just be 2-3 times a week. Don’t worry if your skin can’t tolerate it every day – every drop helps and you are doing your skin a world of good even with intermittent use!
Once you’re in your 40s, what will you see?
Skin may become thinner and you will start to notice a loss of elasticity as well as deepening of lines and wrinkles, as the skin is losing about 1% of its collagen content every year. You may also start to see a flattening of your cheeks with less youthful plumpness. There may also be more pigmentation such as sun spots (‘lentigines’). Now the message is ‘correct’, in addition to continuing to protect the skin.
As before, continue with sun protection and topical antioxidants (for example either C E Ferulic or Phloretin CF). If you prefer a gel texture, you may find Phloretin CF Gel more comfortable (in this age group, some women will develop rosacea with redness and breakouts. If this is the case, see a dermatologist). Retinol is now highly recommended for this age group, at least twice a week.
By the end of the 40s, the skin may become a little dryer and you could add in a hydrating serum, for example Skinceuticals Retexturing Activator, which replenishes moisture in the skin but also gently supports healthy exfoliation and cell turnover (in your 40s, the skin’s turnover cycle naturally slows down and benefits from support).
When you are 50, is it all over?!
No, absolutely not! But we are now into damage limitation mode. The average age of menopause is 51 and after menopause levels of collagen and elastin in the skin plummet. Lines will become deeper still, as it has been reported that in the first 5 years post menopause, about 30% of our skin’s collagen is lost, leaving the skin noticeably thinner, more fragile and less firm and elastic. This, plus the accelerating loss of volume in our mid face that comes with age, will lead to more sagging and jowls. The face which was heart shaped in youth may now look more triangular with less plump apple cheeks and more heaviness in the lower face.
Less oxygen and nutrients are being delivered to the skin as the density of dermal blood vessels declines. The skin also often becomes noticeably dryer after menopause and adjusting your moisturiser may be necessary.
Continue with topical antioxidants, sun protection and retinol, as tolerated, but if you were using Retexturing Activator as a hydrating serum before, perhaps move up to H.A. Intensifier which supports the skin’s own hyaluronic acid production. Add an anti-pigmentation product such as Advanced Pigment Corrector, if pigmentation is an issue.
In addition to making a commitment to good skincare, what else should we be doing?
Skincare can only do so much if you are still smoking or using sun beds! What’s good for your skin is a diet rich in antioxidant vegetables, low in sugar and processed carbohydrates, but with complete protein and with plenty of good fats such as olive oil, macadamia nut oil, avocado oil or coconut oil. Moderate stress levels and make sure to sleep 8 hours each night. Pollution is also ageing our skin. Most people can’t avoid pollution but an electronic cleaning brush can be helpful for removing pollution left-overs from the skin more effectively.
For further information on Dr Williams’ approach visit www.eudelo.com or read her book ‘Look Great, Not Done’, available on Amazon: https://www.amazon.co.uk/great-science-ageing-aesthetic-treatments/dp/099263623X
Clinic: Eudelo Dermatology & Skin Wellbeing, 63 Bondway, London, SW8 1SJ
Instagram: @Eudelo & @DrStefanieW
Twitter: @EudeloClinic & @DrStefanieW
This article reflects the opinions of dermatologist Dr Stefanie Williams and is intended as general information only.