How Your Face Ages

Learn what to expect during each decade of your life -- and what you can do for younger-looking skin.

From the WebMD Archives

If you've ever seen one of those wrinkle time-lapse videos -- on TV or on line -- then you know how scary it can be to watch a face age.

Even more disconcerting is waking up one morning, taking a glance in the mirror, and seeing what looks like "instant aging" -- lines and wrinkles that seem to appear overnight.

The truth is, no matter how you view it -- quick time or real time -- eventually everyone's face wrinkles and ages.

"How well you cared for your skin from a young age and, more importantly, how much you limited sun exposure before age 20 can make a difference in wrinkle formation. But there are still certain inevitable changes that are going to take place," dermatologist David Goldberg, MD, director of Skin, Laser and Surgery Specialists of New York and New Jersey, says.

But as scary as that sounds, it needn't be. Goldberg and others say by knowing what to expect you can take steps to reduce or delay the impact of facial aging -- including wrinkles -- and take control of how the years unfold.

While you can do many of these treatments on your own -- even on a limited budget -- some require rather costly professional care. When this is the case, remember that the earlier you start, the larger your budget is going to have to be.

Equally important is not trying to cut corners by getting treatments in nonmedical facilities. Instead, always seek out the care and advice of a board-certified dermatologist or plastic surgeon before embarking on any professional anti-aging treatments.

To help you safely get started on your journey to the fountain of youth, several experts prepared a timeline for how the face ages and what you can do, both on your own and with the help of your doctor, every step of the way.

Your Face in Your 20s

Experts say that as you head from your teens into young adulthood, your face shows it with a more "womanly" look.

"You begin to lose the 'baby fat.' And while the change is subtle, overall you begin to look less like a girl and more like a woman," says Ellen Marmur, MD, chief of dermatologic surgery at the Mt. Sinai School of Medicine in New York City.

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But with that new womanly appeal comes, believe it or not, the start of facial aging.

"This is the decade when the very early signs of what we call 'motor wrinkles' -- lines and creases related to movement -- first appear. And the first place they appear is the brow," Marmur says.

In addition, if you spent a lot of time in the sun as a child -- or long hours squinting at a computer screen -- you may also see the beginning of "crow's feet," those tiny expression lines around the eyes.

This is also the decade when many women begin to see facial hair, often on the upper lip, around the perimeter of the face, or on the brows.

Dermatologist Joel Schlessinger, MD, says young women also need to be on the lookout for melasma -- a brown discoloration that appears across the cheeks or forehead. "This condition is typically due to a combination of sun exposure, pregnancy, and hormones [including birth control pills] plus exposure to certain antibiotics such as minocycline or tetracycline," says Schlessinger, director of Skin Specialists P.C. and LovelySkin.com in Omaha, Neb.

Best Self-Care: To keep your youthful glow, Marmur says avoid the sun and be scrupulous about wearing sunscreen when you are outside. "What you do in your 20s will reflect how you look in your 40s, 50s, and beyond -- and wearing sunscreen is key," she says. Sunscreen can also help reduce the risk of melasma or help keep it under better control.

Goldberg says to begin using moisturizers regularly but to choose a "light" product -- one that is gel- based and oil free, particularly if you are still suffering from breakouts you experienced as a teen.

Marmur also suggests this is the decade to begin using retinol-based skin care products. "You should use them twice a week beginning in your 20s," she says.

Best Pro Care: If you find yourself still having to deal with some acne leftover from the teenage years, there are professional treatments that can help skin clear quickly. Goldberg says a combination of lasers and other light devices offers a new kind of one-two punch that clears skin with the speed and thoroughness of the acne medication Accutane but without the health risks, including pregnancy-related problems.

"One type of laser works like an antibiotic to inhibit growth of bacteria linked to acne, and the other type helps to actually shrink the oil glands for that 'Accutane-like' effect," Goldberg says.

If melasma is a problem, Marmur says a chemical peel or Fraxel laser resurfacing may help.

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Your Face in Your 30s

While you'll still retain much of your youthful look, this is the decade when you may notice your skin looks 'tired' and less radiant.

Goldberg says you'll also begin to really notice crow's feet around your eyes, plus previous sun damage may exacerbate the start of small brown spots. You may also begin to see dilated blood vessels, particularly around the sides of your nose.

You should be prepared for the start of the "dreaded 11's" -- that pair of lines that pop up between the brows -- as well as shadows forming in the triangular area between your nose and the corners of your mouth.

"Both the '11' lines and the nasolabial lines around the mouth will appear and deepen during this decade," says Marmur.

Best Self-Care: Increase the use of retinol products to three to four times a week, Marmur says. And if you're still using oil-free moisturizers and foundations, Goldberg says toss them.

"This is the decade you need to get serious about using moisturizers, so choose one that is light but does have some oil because your skin needs that," Goldberg says. And, he says, be sure to keep using sunscreen.

Best Pro Care: If brown spots are your problem, Goldberg says don't waste your time with bleaching agents. Nip them in the bud with a chemical peel or a laser, which, he says, is also the best treatment for visible blood vessels on the face.

Schlessinger says give your face an overall boost of youth with microdermabrasions or a chemical peel, which can also get rid of small imperfections and keep that "youthful glow" a few years longer.

And while it may seem a bit early to consider "serious" anti-aging treatments, some experts say this is the decade to go after those lines and wrinkles with muscle relaxers like Botox and Dysport and line fillers like Restylane, Juvederm, and many more.

"The argument for having these treatments this soon is that, first, you need very little to get a very good result, and, second, there is increasing evidence that, if you start at this age, you can actually stop things from getting worse. In the long run, you'll need much, much less to maintain a youthful appearance," Goldberg says. In fact, Goldberg and others report that some women are now beginning to have Botox or Dysport injections in their brow starting as early as their late 20s in an effort to stem the tide of aging.

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Remember, though, these options don't come cheap, with costs averaging about $2,000 per treatment, depending on the extent of what you have done.

Also, if you are considering these treatments in your 20s or 30s and anticipate continuing them for some time, note that there are few studies on the safety of decades-long continued use of facial rejuvenation injections. While doctors don't anticipate any problems, there are no guarantees. Since 2009, the FDA has required all of the botulinum toxin products -- including Botox, Dysport and Myoblock -- to include a special warning on their labels. It states that the toxin may spread from the area of injection and cause problems with breathing or swallowing or even death. Most of these problems occurred in children with cerebral palsy, however, and not when used for approved cosmetic purposes.

Again, the best way to optimize results and ensure safety -- at any age -- is to seek treatment with a board-certified dermatologist or plastic surgeon.

Your Face in Your 40s

As you enter your 40s, lines begin to appear around your upper lip -- and if you smoke, they'll come faster and go deeper.

"This is called the 'purse string' muscle," Marmur says. "And because this area is prominent, it's more at risk for sun damage. So if you skipped out on sunscreen in earlier years, you'll see the results here first."

Goldberg says be prepared to see more wrinkles in your forehead and crow's feet around your eyes plus a deepening of the smile lines.

Best Self-Care: Moisturizers need to be richer and thicker, say experts, and if you haven't already started, this is the decade to use a night cream.

"You do need stronger moisturizers and you definitely need to use a night cream after 40," Goldberg says.

The reason, he says, is that when you sleep, your body goes through a natural rejuvenation process. You're also not exposed to all the dirt and pollution that assaults skin during the day. So, Goldberg says, products used at night tend to get into the skin a little better and may offer better results.

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This is also the decade when you may benefit most from using an antioxidant skin care product. Marmur says keep using those retinol-based creams, upping the frequency to between four and five times a week.

Best Pro Care: To treat lines on the upper lip, experts say the synergistic effects of Botox and line filling injections can work miracles, leaving at least a decade of aging skin behind. So can chemical peels and Fraxel laser treatments, which can literally take years off your appearance around the lips and eyes.

"The Fraxel is great because you get all the benefits of traditional laser treatments without the scarring or downtime," Goldberg says.

Your Face in Your 50s and Beyond

If you've minimized sun exposure and used sunscreen, you can expect to glide into your 50s and 60s with your skin looking pretty darn good. If not, you'll likely be facing the cumulative effects of sun damage and age, which include not only a deepening of lines and wrinkles but also a massive breakdown of collagen and elastin fibers, the support structures that hold up skin.

"This usually results in a drooping of the face, and skin gets loose," Marmur says.

Moreover, she says, as we age, we lose some of the fat beneath our skin, which also contributes to a loss of structure as well as making skin thinner and more translucent. This can cause blood vessels just below the surface to look more prominent and your skin to look discolored.

In addition, Goldberg says brown spots that went untreated in the past will become more prominent now as new ones continue to appear. Moreover, a drop in estrogen that occurs during the 50s will cause skin to look and feel drier, making lines and wrinkles look deeper and more prominent.

"The 50s and 60s is also when the effects of gravity really kick in. So in addition to treating lines and wrinkles, you also need to focus on treatments that tighten the skin," Goldberg says.

Best Self-Care: Increase the use of rich moisturizers, such as shea butter, and if you've been a soap-and-water girl, Marmur says stop immediately and start using a gentle nondrying cleanser on your face and neck. And, she says, continue using retinol products five to six times per week.

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Best Pro Care: If you haven't tried Botox wrinkle filling injections or Fraxel laser treatments in the past, experts say this is the decade to jump into the fountain of youth. It's also the best time to consider skin-tightening treatments like Thermage or Titan -- nonsurgical ways of lifting the skin. Thermage uses radiofrequency and Titan uses infrared light to promote skin tightening.

In fact, some experts say if this is something you've been considering, once you hit 50, sooner is better than later.

"If you haven't done a skin-tightening treatment by the time you are 60, then most of the time it's too late," Goldberg says. "You won't get the desired effect, and the only other option will be a facelift." Other experts caution that procedures such as thermage and titan are expensive and have had disappointing results.

But while facelifts are an option, they do require major surgery, including the use of anesthesia, plus they are costly procedures that come with weeks of downtime. Goldberg also reminds you that you can only have one or two lifts in a lifetime. So it's best to hold off as long as you can, using other, nonsurgical options to buy more time.

Says Goldberg: "We're all living longer, so the earlier you start professional care, the younger you'll look as the years advance."

WebMD Feature Reviewed by Melinda Ratini, DO, MS on December 02, 2012

Sources

SOURCES:

David Goldberg, MD, director, Skin Laser and Surgery Specialists, New York and New Jersey.

Ellen Marmur, MD, director of cosmetic surgery, Mt. Sinai Medical Center, New York City.

Joel Schlessinger, MD, director, Skin Specialists PC, Omaha, Nebraska.

WebMD Medical News: "FDA Checks Reports of Botox Risks."

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