Three board-certified dermatologists discuss the top skin care concerns of women in their twenties, thirties, and forties and provide tips for each age group.
People experience many changes as they age, including changes to their skin. The body’s largest organ evolves over time, so it’s important for a person’s skin care routine to evolve with it.
Although dermatologists’ skin care recommendations for each patient will depend on that patient’s age, there are a few core steps dermatologists advise virtually every woman to take:
- Choose products tailored to your skin type. For example, there are formulations for sensitive skin, moisturizing products for dry skin, and oil-free or noncomedogenic options for oily skin.
- Protect your skin from exposure to ultraviolet (UV) radiation. This can be from the sun and indoor tanning beds, which can lead to skin cancer and early skin aging. The American Academy of Dermatology recommends that you shield yourself from the sun’s harmful UV rays by seeking shade, wearing protective clothing, and using a broad-spectrum, water-resistant sunscreen with a sun protection factor (SPF) of 30 or higher.
- Use a retinoid, unless it dries out or irritates your skin. Retinoids increase cell turnover to exfoliate clogged pores and reduce the appearance of fine lines, which means they can effectively treat both acne and wrinkles.
While these steps form the foundation of most skin care regimens, each individual’s skin care routine should be based on her age and her skin’s specific needs.
In Your Twenties: Get a Head Start on Healthy Skin
Daily Skin Care
“It’s never too early to start taking care of your skin,” says board-certified dermatologist Nada Elbuluk, MD, MSc, FAAD, an assistant professor of dermatology in the Ronald O. Perelman Department of Dermatology at the NYU School of Medicine in New York. “Many of my patients in their twenties are asking me what they can do now to maintain healthy skin throughout their lives, and some women are starting to seek cosmetic treatments at an earlier age.”
According to Dr. Elbuluk, women in this age group are looking for a simple skin care regimen that they can easily incorporate into their daily lives. “If a routine is too complicated or time-consuming, they won’t stick with it,” she says.
Dr. Elbuluk recommends that women in their twenties wash their face twice a day with a gentle cleanser and use a moisturizer with SPF 30 every morning. She also suggests using an anti-aging treatment, such as a topical retinoid or a product containing antioxidants, so long as it doesn’t cause any irritation.
Dr. Elbuluk advises women in their twenties to be vigilant about sun protection every day, year-round, no matter the weather. “Sun damage is cumulative, so UV exposure in your twenties could lead to wrinkles and skin cancer in your forties and fifties,” she says. “Women in this age group may have seen this firsthand if their parents have developed skin cancer.”
Dr. Elbuluk also warns women in their twenties not to get complacent about sun protection just because they’re applying an SPF product in the morning. “If you’re using a moisturizer or foundation with SPF, make sure it’s at least SPF 30—and remember that SPF is not additive, so using two products that each have SPF 15 is not the same as using an SPF 30 product,” she says. “And don’t forget, applying sun protection in the morning won’t cover you for the whole day. During the workweek, remember to reapply if you’re going outside for lunch and before your commute home; if you’re spending the day outside, you should reapply every two hours.”
“There’s no rule that says acne stops after your teens, so many women are still dealing with acne in their twenties,” Dr. Elbuluk says. “In addition to the type of acne they had when they were younger, women in this age group may also experience hormonal acne on their chin and jawline.” She says women in their twenties may be embarrassed by acne, thinking it’s something they should have outgrown, and the skin condition may affect their self-esteem.
Fortunately for patients, there are many treatment options for adult acne, Dr. Elbuluk says, and a dermatologist can determine the best treatment plan for each patient based on the type and severity of their condition. Mild cases can typically be controlled with topical medications, she says, whereas moderate cases may warrant a combination of topical and oral medications. For patients with severe acne that is resistant to other treatments, oral isotretinoin may be the best option.
In addition to a prescription regimen, in-office procedures may be helpful in treating adult acne, Dr. Elbuluk says. Chemical peels can supplement and accelerate the results of other treatments, she says, and laser procedures may be an option for patients who don’t respond to traditional therapies.
In Your Thirties: At the Crossroads of Prevention and Treatment
When women in their thirties come to her Augusta, Georgia, private practice to seek treatment for dark spots, board-certified dermatologist Lauren Eckert Ploch, MD, MEd, FAAD, always provides them with tips for prevention. “If you have dark spots at this point in your life, you’re at risk for getting more as you grow older,” she says.
Because UV exposure causes dark spots, Dr. Ploch reminds her patients in their thirties about the importance of sun protection. When applying SPF 30 sunscreen each morning, she says, it’s vital for women in this age group to make sure they cover their neck and chest in addition to their face, especially if they commute. “Because UVA rays can travel through window glass, you need to make sure you’re protected if you’re spending a lot of time in the car or on a train,” she says.
Women who had unprotected UV exposure when they were younger may start to see dark spots on their temples and cheeks when they reach their thirties, Dr. Ploch says, and these spots may be mistaken for melasma, a condition that causes brown patches to appear on the face. While lightening agents like hydroquinone are a good option for melasma, she says, they usually aren’t effective for treating dark spots.
Instead, Dr. Ploch recommends that patients with dark spots follow a multipronged treatment plan. In addition to sun protection, she says, topical vitamin C and retinoids may be used for both treatment and prevention. Laser surgery and cryosurgery are also options for reducing the appearance of dark spots, she says, but these procedures should be performed only by a dermatologist or other experienced medical professional.
Dr. Ploch estimates that about half of her patients in their thirties are dealing with both wrinkles and acne. As a result, she says, many patients in this age group may not be able tolerate wrinkle treatments designed for more mature skin because these heavier formulas can aggravate acne or cause milia, small cysts that occur when dead skin cells become trapped at the surface of the skin.
Dr. Ploch recommends that women in their thirties use a retinoid to address both wrinkles and acne. “Retinoids are my go-to wrinkle treatment for women in this age group,” she says. “In addition to improving your skin’s current appearance, they also help build collagen, which can lead to more voluminous skin in your forties and fifties.”
Dr. Ploch also suggests that women in their thirties use a light antioxidant serum to protect their skin from the elements and improve signs of early skin aging. She says that those who are concerned about wrinkles may also want to consider botulinum toxin and hyaluronic acid fillers. A low dose of botulinum toxin can minimize muscle movements that lead to future wrinkles, she says, and hyaluronic acid fillers can restore volume loss, reducing the appearance of lines around the mouth.
While spider veins are one of the most common problems for women in their thirties, Dr. Ploch says, they are also one of the least addressed problems in this age group. Many women believe that treatment would be too invasive or expensive, she says, so they leave the condition unaddressed, allowing it to worsen as they get older.
According to Dr. Ploch, however, laser surgery and sclerotherapy are two accessible and noninvasive treatment options that women in their thirties may want to consider if they have spider veins. She also suggests that women in this age group take preventive measures against the emergence and progression of this condition.
Pregnancy and frequent standing are two risk factors for spider veins, Dr. Ploch says, and the condition takes several years to develop, which is why it often appears in women when they reach their thirties. To help relieve the pressure that causes spider veins, she recommends that women wear compression stockings, elevate their legs when possible, and exercise, especially if they work in a field that requires prolonged standing, such as health care or education.
In Your Forties: Improvement through Noninvasive Interventions
As people age, their skin begins to lose collagen and elastin, making it thinner and looser, without the resilient, springy quality of youthful skin, says board-certified dermatologist Anne M. Chapas, MD, FAAD, a clinical instructor of dermatology at Mount Sinai Medical Center in New York. Skin laxity is most prevalent on the face and neck, she says, but it can occur anywhere on the body, including the arms, abdomen, and thighs.
Everyone will experience some amount of skin laxity as they age, Dr. Chapas says, but the degree of laxity depends on many factors, including sun damage, exposure to pollution, diet, weight fluctuations, and lifestyle factors such as smoking. “Women likely will start to notice skin laxity in their forties, but they may not want to undergo an invasive procedure to correct it,” she says. “Fortunately, there are noninvasive options ideally suited for women in this situation.”
According to Dr. Chapas, energy-based treatments such as microfocused ultrasound and radiofrequency microneedling can help improve skin laxity by promoting the production of collagen and elastin for firmer skin. “Imagine wrapping your loose skin in shrink wrap to pull everything tighter—that’s the kind of effect these energy devices can have,” she says.
Dr. Chapas says filler injections also can improve skin laxity by replacing lost collagen and elastin. “If you picture your skin as a tablecloth, then you can think of fillers as a sturdier table for it to rest on,” she says.
In addition to losing collagen and elastin as they age, Dr. Chapas says, women also lose fat in areas like the face and hands, resulting in a loss of skin volume. As a result, she says, women in their forties may experience sagging skin, as well as prominent bones and veins.
According to Dr. Chapas, noninvasive treatments with dermal fillers and energy devices can help restore lost volume in addition to improving skin laxity. These treatments also may be combined to provide the best possible results.
In addition to seeking treatment for lost collagen, Dr. Chapas recommends that women in their forties take steps to preserve the collagen they still have: “It’s important to continue protecting your skin from the sun and the elements as you age, and you also should consider incorporating topical growth factors and peptides into your skin care routine.”
Women in their forties may have unwanted body bulges as the result of pregnancy, slowing metabolism, or other lifestyle changes, Dr. Chapas says. Even if women exercise regularly and are otherwise fit, it may be difficult for them to eliminate fat in areas where the body is designed to store it, including the torso and legs.
According to Dr. Chapas, women in their forties who have isolated pockets of fat are ideal candidates for noninvasive body-sculpting procedures like focused ultrasound, thermal energy treatment, and cryolipolysis—all of which cause areas of damaged fat that the body gradually removes. Although these treatments can be performed anywhere on the body, the waistline and thighs are the most commonly treated areas, Dr. Chapas says, while the neck and bra spillover area are currently gaining popularity.
Dr. Chapas says interest in these body-sculpting treatments has surged in recent years because the procedures are noninvasive, quick, and effective, with little downtime for patients. Although liposuction remains the gold standard for fat removal, she says, other body-sculpting procedures can provide subtle results for women who want to address problem areas without undergoing an invasive procedure.
No matter your age or skin concern, a board-certified dermatologist can answer your questions about skin health and help you develop a skin care plan that’s right for you.
Reprinted with permission from the American Academy of Dermatology.
About the AAD
Headquartered in Schaumburg, Illinois, the American Academy of Dermatology (AAD), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 18,000 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair, and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair, and nails. For more information contact the AAD at 888-462-DERM  or aad.org. Follow the AAD on Facebook (American Academy of Dermatology), Twitter (@AADskin), and YouTube (AcademyofDermatology).