I was treating a patient the other day who is in her mid 30's with very healthy skin. She is regular about her skin care treatments and religious about her home care. She is seemingly doing great, but asked me if she should be doing peels. In her case, I advised against it and asked why she felt like it was something she should explore. She said she simply "didn't know what comes next." That sat with me for the remainder of the day and I realized that many of my patients were probably wondering the same thing. So, what comes next? The short answer is that if you are in need of something other than what we are currently doing, I will let you know and we will put a plan together. The long answer comes with some explanation of how skin ages, and since I am rarely at a loss for words on this particular matter...the long answer it is!
No matter what your chronological age, I begin all treatments and consultations by categorizing your individual needs as either corrective or maintenance. Once we figure out what we are doing we can determine which tools we will need to make it happen. The treatments themselves can be either corrective or maintenance depending on how we utilize them. As I run through the basics of the ages and stages of skin aging I encourage you to remember that there are lots of factors we take into consideration when advising you and there is no replacement for personalized consultation with a professional.
In a perfect world, proper preventative skin care would be learned during childhood. I taught my kids at a young age that they need to care for the largest organ they have so that it stays healthy throughout their lifetime. Like dental care, good dermal health requires a combination of in-office and home care. I even wrote a post about it. “Where Are All My Mommas” talks about the importance of teaching kids the basics of good skin care to establish healthy habits early. Unfortunately, we don’t live in a perfect world and skin care typically doesn’t become a concern until it’s a concern. What I mean is that hormonal teen and tween years wreak havoc on skin prompting the maiden voyage into skin care exploration. This means that we are starting with a goal of correction instead of teaching preventative care…not ideal.
Teen skin can be pretty volatile. Acne is one of the biggest teen skin struggles we see, but there is also excessive hair growth and hyperpigmentation issues that sometimes need intervention. I firmly believe that hormones found in meat and dairy products are to blame for the increased number of teens that present with these issues, but I digress. Acne comes in many forms and there are lots of treatment options available. Check out the post “Acne Is a 4-Letter Word” for more detailed treatment information. Other good resources for acne sufferers are “Acne and Your Gut” and “Stop Before You Pop!” Hirsutism, or excessive hair growth, can be devastatingly embarrassing to a young girl. I’ve seen girls as young as 11 years old with full on mustache and beard growth! As a mom of two kids entering this period of awkward changes, I would move mountains to keep my precious babies from being the school bully’s next target. If your child is growing hair in unexpected places or they are growing abnormally thick and dark hair you should start at the pediatrician’s office to rule out any medical issues. If no medical treatment is recommended, come see me (or your own skin and laser professional). Waxing, Laser hair reduction, or electrology could be viable options. For more information about Laser hair reduction, check out “Hair Today…Gone Tomorrow.”
Pigment, while more of an issue later in life, can begin during teen years. We often see it first on the upper lip after introducing oral contraceptives. "The pill" is used during puberty for all sorts of reasons including but not limited to period regulation, acne mitigation, and of course birth control. Starting birth control pills can come with some pretty undesirable side effects. If a person is genetically predisposed, birth control pills can stimulate hormonal pigment called melasma. Melasma is notoriously tough to treat, and it can not be cured, but there are some fantastic treatment options detailed in the post “Unmasking Melasma.” These formative years are replete with emotionally charged moments and even the most confident kid can become vulnerable when faced with hormonal skin changes, so hug ‘em hard and tell them how amazing they are then bring them to a professional to help get them the help they need.
As you grow into adulthood entering your 20’s, expect acne (in most cases) to ease up allowing you to finally focus on learning healthy skin habits. If you escaped teen acne, do not be surprised if you experience some adult acne instead. As humans evolve and are having babies later in life, the systems of our body also evolve and timelines for hormonal changes that prepare the body for childbirth can happen later for some. Adult acne is usually not quite as severe as teen acne and can be treated any number of ways. Whenever possible, try to get acne under control prior to pregnancy because most of the treatment products, medications and devices can not be used when expecting.
If you do become pregnant in your 20’s and you are genetically predisposed, you may experience melasma often referred to as mask of pregnancy. Pregnancy is one of the most common causes of hormonal pigment and like adult acne, most of the treatments for melasma are contraindicated during pregnancy and nursing. That means that you will likely have to wait until after you finish breast feeding to treat. We talk about skin maladies during pregnancy within the 20’s, but they all apply to pregnancy at any age.
Although we begin seeing a depletion in collagen production in the 20’s, structurally, these are the best skin years of your adult life. Maybe start using a low-level retinoid if you are really wanting to get a jump on aging skin. “Magical Mystical Retinoids” explains how they work. As for in-office treatment, don’t worry about those anti-aging interventions just yet; there’ll be plenty of time for that.
Your 30’s and 40’s will bring some architectural changes to the face including laxity and the early signs of jowl formation. You’ll begin noticing more fine lines around the eyes and forehead area, the development of sunspots and increased redness. You may become aware of other new growths as well. Last week’s post “Lumps, Bumps, and Spots…Oh My!” is a quick guide to many of the barnacles that come with age.
This is the time to buckle down and get a solid plan for anti-aging products and treatments. I highly recommend consulting with your aesthetician and writing out a plan for the year. This may seem like a bit much, but your personal plan will keep you on track so you don’t wind up doing aggressive treatments that are unnecessary, It will provide you the opportunity to present a workable budget so costs don’t get out of hand, and it will ensure that you never have to worry about unexpected downtime.
In your 50’s and beyond you may be considering surgical interventions like face lift, neck lift or blepharoplasty (removal of fat pads around the eyes). You should know that if your skin is in good shape prior to your surgery, you will have a better more natural looking outcome. That is your cue to fast track a plan for superior dermal health. In my practice, we offer a package called The Quad that utilizes BBL photofacial to target and eliminate unwanted brown and red in the skin, Scarlet SRF microneedling with radio frequency for global tightening of skin laxity, AGNES RF for correction of individual lines, and erbium resurfacing for improvement of overall tone and texture. BBL, Scarlet and AGNES are performed in-office prior to surgery, and erbium resurfacing takes place in the operating room immediately following your scheduled surgery. If you have decided that you are never ever ever having surgery no matter what, that’s perfectly okay. The Quad can be part of a non-surgical plan too. The only adjustment is that we perform the erbium resurfacing portion of the package in the office with local anesthetic. These tools not only improve appearance, they improve the quality of the skin by redensifying and altering the gene expression to that of chronologically younger skin! Who doesn't want that?
No matter what your age, there’s a skin care plan for you. Your provider should be your first stop before making decisions about what your skin needs. We are here to help identify disorders and deficiencies, and we will help you figure out what should be done about them within your timeline, lifestyle, and budget. Check out “Nobody’s Got Time for That!” to understand the consultation process. Now you can stop wondering and start planning for what comes next.
I am happy to help with a complimentary in-person or virtual consultation if you are ready to plan your skin care journey. Call 480.947.6788 to set up an appointment or visit www.bealsmd.com to learn more about our practice.