Face Ageing – 20s, 30s, 40s

Face changes that occur with aging tend to happen in a fairly predictable order so that it is more-or-less possible to gauge a person’s age from looking at the face shape, skin and lines.

In the 20’s.

The face of youthfulness tends to be full, with glowing tight skin, full cheeks, lips and upper eyelids.

There is minimal loss of volume of the skin and underlying structures and this is the face that we all, unrealistically, hope to retain as we age.

The skin in the 20’s tends to be either normal or slightly oily, particularly the T zone and acne may not have resolved from teenage years.

Skin care during the 20’s really focuses on avoiding sun damage. Sun damage is the main contributor to the lines, wrinkles and colour changes that are seen in the skin with aging.

At this time, preventive skin care yields long term benefits and a broad spectrum sunscreen with good UVA and UVB cover should be used daily, or at least throughout the year from spring to the beginning of winter. Acne that persists beyond teenage years can be managed along the same lines as before, with AHA’s in the form of glycolic acids, face peels, other topical treatments or even oral medications prescribed by a doctor.

During the 20’s may see the development of fine lines around the eyes, the frown area and the forehead due to repeated muscle movements from facial expression. Laser treatments are generally not needed in this age group.

Acne scarring, however, can be improved and various radiofrequency devices, needling and laser resurfacing may be indicated depending on the type of scarring. It really requires a highly skilled professional to be able to select the most appropriate treatment.

In the 30s

Moving into the 30’s, the fine lines on the forehead and around the mouth start becoming a little more noticeable.

Subtle changes of volume loss may become evident, creating less fullness and a longer skinnier appearance. Skin loses its translucent even tone and pigmentation starts to appear, particularly after pregnancy or associated with use of the oral contraceptive pill.

This hormonal pigmentation is known as melasma. Sun spots may pop up and small blood vessels may become visible.

In addition, pores become more noticeable. At this stage, skin care still centres on sun avoidance but other active ingredients can be used to minimize lines, control acne and reduce pigmentation. Botulinum Toxin injections become particularly useful in preventing the development of static lines and dermal fillers can be used judiciously to improve any deflated areas.

Entering the forties, things really start to change. This is when the change in the shape of the face really becomes more noticeable as we lose bone from the skull, fatty tissue holding the skin taut, collagen and elasticity in the skin. The eye sockets seem to enlarge due to the volume loss, creating ‘tear troughs’ causing dark shadowing and hollowness under the eyes.

Because of the ongoing volume loss, the cheeks deflate as the fat pads descend, making the nasolabial folds more full and creating jowls along the jaw line. It is during these years that previous sun damage and smoking really start to affect the quality of the skin.

Pigmentation and redness increase and the skin tends to become a little drier. Acne can persist or develop and is often different from the acne in younger age groups. Painful, cysts can occur, often along the jawline, under the chin and on the neck.

In the 40s

Skin care in the 40’s becomes more proactive. Active ingredients in skin care should be selected to minimize visible signs of aging. AHA’s, special skin lightening preparations and retinols become particularly helpful and consulting a specialist dermatologist or cosmetic physician can assist in tailoring an individualized skin care program. Laser treatments can assist but need to be selected carefully as pigmentation can often rebound and end up worse if the incorrect laser is used.

When Fraxel initially came out, it was thought to be the gold standard for treating all types of pigmentation. However, we now realize that Fraxel is only good for non hormonal pigmentation. Melasma is a challenging condition to treat and should be managed by a doctor experienced in diagnosing and treating it. Care must be taken to avoid irritating the pigment-producing cells to avoid a rebound affect.

Prominent facial blood vessels and redness can be treated with a vascular laser. Peels in this age group range from no-downtime AHA peels, to deeper peels that can cause a week or more to recover. Other treatments to tighten the skin are now available and heavy, loose eyelid skin, crepiness and jowls and be improved with radio frequency and needling devices. Focused high energy ultrasound is now available to perform a non surgical, non injectable face lift.

Other treatments such as LED light treatment can assist in improving complexion and can speed up healing from laser treatments and peels.