There is a point in life when you look in the mirror and think, “When did that happen?”
The forehead lines seem deeper. There are little lines around the eyes that weren’t there before. The cheeks don’t look quite as firm, and the skin around the jaw seems to have developed a mind of its own.
Most of us call it ageing. But what is actually happening?
As a pharmacist, I get asked about creams, serums, collagen supplements and all sorts of “anti-ageing” products. Some are useful. Some are expensive moisturisers in very fancy packaging.
The truth is that ageing skin is a combination of several things happening at the same time.
Your skin isn’t just becoming old
When we are young, the skin has a good supply of collagen and elastin.
Think of collagen as part of the scaffolding that gives skin its strength and structure. Elastin helps it stretch and spring back.
There is also hyaluronic acid and other substances within the skin that help it retain water and maintain its plumpness.
As we age, the production of these substances gradually changes.
We produce less collagen, the existing collagen becomes altered and the skin becomes less elastic. The skin also tends to become thinner and drier.
Put all of that together and you begin to see where the wrinkles come from.
Why do we get crow’s feet?
Crow’s feet are those little lines that appear at the outer corners of the eyes.
They are partly caused by something we do thousands of times every day — move our face.
When you smile, laugh or squint, the muscles around the eyes contract and the skin folds.
When you’re young, the skin springs back easily.
As collagen and elastin decrease, those temporary folds are less efficiently smoothed out. Eventually, some of them become visible even when your face is completely relaxed.
So yes, those crow’s feet may partly be evidence of a lifetime of smiling.
I wouldn’t regard that as a particularly bad thing.
And those forehead lines?
Exactly the same principle applies.
Every time you raise your eyebrows, frown or concentrate, the muscles in your forehead move the skin.
Over many years, repeated movement contributes to permanent lines.
But there is another major player here.
Sunlight.
In fact, if you want to understand why some people appear to have aged much faster than others, ultraviolet exposure is one of the biggest clues.
The sun is not your friend when it comes to ageing skin
We all need some sunlight, but excessive ultraviolet exposure damages the skin.
UVA in particular penetrates relatively deeply and contributes to the breakdown and alteration of collagen and elastin.
This is called photoageing.
It can produce wrinkles, uneven pigmentation, rougher skin and loss of elasticity.
That is why someone who has spent decades outdoors without sun protection may have considerably more weathered skin than someone who has had less sun exposure, even if they are the same age.
It is also why sunscreen isn’t just about avoiding sunburn.
A good broad-spectrum sunscreen is one of the more sensible things you can do if your aim is to slow visible skin ageing.
Why does the face sag?
This is where ageing becomes a little more complicated.
It isn’t simply that the skin gets loose.
As we get older, there are changes in several layers of the face.
We lose some of the fat that gives youthful faces their fullness. In other areas, fat can move or become less supportive.
There are also gradual changes to the underlying tissues and bones.
At the same time, the skin loses some of its elasticity.
So the face that once had plenty of structural support gradually loses some of that support.
The cheeks can become less full, the area around the mouth can change and the jawline may become less sharply defined.
Gravity, naturally, isn’t helping.
Why do some people age faster?
Look around a group of people of the same age and you’ll see enormous differences.
Genetics plays a big role.
So does sun exposure.
Smoking is another important factor because it damages collagen and affects blood vessels and the skin’s ability to repair itself.
Alcohol excess, poor nutrition, inadequate sleep and certain illnesses can also affect how healthy the skin looks, although we shouldn’t blame every wrinkle on lifestyle.
And then there is simply time.
You can eat perfectly, exercise regularly and use excellent skincare and you will still age.
That’s not failure. That’s biology.
Can moisturiser get rid of wrinkles?
This is where I become slightly unpopular with the beauty industry.
A moisturiser can make skin look and feel better, particularly if the skin is dry. Hydrated skin can make fine lines appear less obvious.
But a £10 moisturiser isn’t going to rebuild the facial scaffolding that has been lost over 30 years.
That doesn’t mean skincare is pointless.
It means we should have realistic expectations.
What about retinoids?
One ingredient with considerably more evidence behind it is the retinoid family, particularly topical tretinoin, which is a prescription medicine in many countries.
Retinoids can encourage changes in skin-cell turnover and collagen production and can improve some signs of photoageing over time.
But they aren’t instant wrinkle erasers.
They can also cause dryness, irritation and increased sensitivity, particularly when treatment is started.
For people using topical retinoids, sensible sun protection remains important.
There are also cosmetic retinol products available without prescription, depending on where you live. These are generally less potent than prescription tretinoin but may still have a useful role in a skincare routine.
What about collagen supplements?
This is an area where I would keep expectations modest.
There are studies suggesting that some oral collagen products may improve certain measures of skin hydration or elasticity, but the evidence is not strong enough to say that taking collagen will prevent your face from sagging or remove established wrinkles.
And remember, collagen is a protein. When you swallow it, your digestive system breaks it down into smaller components.
It doesn’t simply travel from your stomach to your forehead and repair a wrinkle.
So what actually makes sense?
If someone asks me what they should do to protect their skin as they get older, I would keep it remarkably simple.
Protect yourself from excessive sun.
Use a broad-spectrum sunscreen, particularly when you are going to be outdoors for significant periods.
Don’t smoke.
Keep the skin moisturised if it is dry.
Eat a sensible diet with enough protein, fruit, vegetables and other nutrients.
Sleep properly, exercise and look after your general health.
And if you want to use an evidence-based active ingredient such as a retinoid, speak to a pharmacist or doctor about whether it is suitable for you.
And finally…
There is nothing wrong with wanting to look your best.
But I think we have become slightly obsessed with the idea that ageing is something that must be defeated.
It isn’t.
Wrinkles aren’t a disease. Crow’s feet aren’t a medical problem. A less defined jawline doesn’t mean something is wrong with you.
They are signs that your skin has spent decades doing exactly what skin is supposed to do.
By all means, protect it, moisturise it and use sensible treatments if you want to.
Just don’t let someone convince you that a £200 cream is going to give you back the face you had at 25.
Your skin may be older.
That doesn’t mean it isn’t healthy.
Until next time, look after your skin — but don’t forget to smile. Those crow’s feet have to come from somewhere.
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