Skin Through Your Ages V: The Forties

Skin in the Fifth Decade

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Did you know that you’re never in the same skin twice in any given month? Whether it’s the weather, “that time” of the month, a nasty cold that is challenging your immune system, or the stress you’re under at work, your skin takes a beating and truly reflects what’s going on inside and outside your body. And these constant challenges can cause a myriad of changes like wrinkles, sagging, and dryness, which are never attractive qualities, if you’re trying to look the best you can be. In fact, cell turnover in the skin occurs on the average every 30 days, plus or minus, depending on your age. So literally, you are never in your same skin twice, at least every 30 days. But this rapid turnover of cells is also an opportunity to renew and rejuvenate your skin every month, like having a do-over, which is an incredibly golden opportunity. How often are we able to truly improve the health of an organ in our body every month, especially because it is so very accessible and open to improvement? You can literally change the quality and health of your skin every day of every month, with help of course. So let’s look at how skin changes over time. Let’s look at each decade in the life of your skin.

This installment is the fifth in my series “Skin Through Your Ages,” where we will focus on your forties, the fifth decade of life of your skin. 


The fifth decade or your forties, like the thirties, are quite variable because of all the different life experiences that can influence the state and condition of the skin. Many of us in our forties hope to look much the same as we did in our thirties, especially if we have been able to avoid the sun, maintain a healthier lifestyle, and implement a good skincare and skin rejuvenation regimen. If we are one of the lucky ones, we exhale a sigh of relief because Old Father Time has thankfully been kind to us. If not, don’t lose heart, because it is not too late, especially during the forties, when skin still has enough reserve to repair and improve with a little help.

Although the four key factors of sun damage, smoking, life stressors, and genetics are interplaying continuously to influence the health and stability of the skin, the skin in your forties isn’t able to bounce back as readily and easily as it used to. One’s forty-something skin can still retain some of its glow factor and resilience, but the wrinkles, skin laxity, dyspigmentation, and loss of volume have moved in to stay, much to the chagrin of our stunned middle-aged psyche. Not only is it a shock to our system to gaze in the mirror and see an older self, but quite suddenly, the face gazing back at us looks uncomfortably and uncannily more and more like one’s own mother. Depressing and disheartening, you say? Or maybe you welcome the maturity that has transformed your face to look a little like your mother’s. Either way, just remember that every one goes through it, and we are all in it together. No one enters the forties unscathed, and there’s something rather satisfying and fulfilling about being more mature, more experienced, and wiser despite the insidious arrival of those sags, bags, and wrinkles.

In your forties, like in the thirties, the effects of sun damage, life experiences, and passage of time are affecting the skin more rapidly and more noticeably in the form of wrinkles, textural changes, dyspigmentation, laxity, dryness, rougher texture, and larger pores. Your forties still demonstrate a cell turnover that is maintaining the same, but steady, slower pace of about 30-40 days, allowing damage to be more persistent and less responsive to self-repair. The skin on a functional and physiological level has already started to lose its elastin, collagen and native hyaluronic acid. It can look drier, less supple, less glowing, and more tired. Of course, smoking, sun-worshipping, tanning booths, fatigue, stress, and unhealthy diets have taken their toll to a great extent and have more persistent effects on the skin. Also, the facial bones have started to resorb somewhat, affecting the structural support of the skin, and the subcutaneous fat layer that cushions and plumps the skin is thinning as well.

So you can imagine that the forties are the peak time when women begin their foray into the world of cosmetic treatments. Because the same lovely, youthful face that you remember having in your twenties and thirties is suddenly no longer gazing as youthfully back, the aesthetic procedures like Botox®, Juvederm® and other dermal fillers, IPL or laser photorejuvenation, chemical peels, microdermabrasion, and chemical peels to name a few, start to become very, very popular. Although my patients in their forties often do not want drastic changes, they do desire an impactful and noticeable, but natural change for the better. In fact, most of my forty-something patients will dip their toe in the aesthetic pool with a trial of Botox® as their first step. Not only is it relatively inexpensive on the grand scale of cosmetic procedures, but it is also a treatment that can give beautifully transformative results with minimal commitment and no downtime. And once that first step of Botox® has been taken, the next steps in the cosmetic arena become less nerve racking and more feasible and plausible.

Although Botox® and other aesthetic procedures are great treatments to reverse the appearance of aging skin, they cannot be a stand-alone. Maintenance and prevention through great skincare are essential partners. The healthy and wholesome lifestyle choices of wearing sunscreen, washing the face twice daily, drinking less alcohol, getting more sleep, and moisturizing and caring for the skin are tremendously important, especially during the forties. Also, implementing a therapeutic, “aggressive” skincare regimen, which may include powerhouse ingredients like topical retinoids, vitamin C, peptides, growth factors, exfoliants, and antioxidants, can have hugely rejuvenating effects. One can literally rebuild one’s collagen and repair one’s sun damage by using effective topical products regularly. Because glowing, hydrated, luminous skin is a sure indicator of youth, a skincare regimen powered by these vital ingredients to bring back the glow and luminosity, combined with effective in-office treatments like Botox® and dermal fillers can truly transform the skin and turn back the clock.

A comprehensive anti-aging regimen, at any age, but especially essential to start in your forties, ideally includes a gentle, non-stripping cleanser, a hydrating eye cream, a hydrating day cream with antioxidants, topical vitamin C, sunscreen, a serum that exfoliates and rejuvenates, a serum with peptides and/or growth factors, a moisturizing night cream, and without question, a retinoid. Sometimes there may also be a need for a skin brightener or a skin lightener, if dyspigmentation is an issue. Or at other times, prescription medications that target specific skin conditions may need to be included. The most important element is the customization needed to fit your skin type, your skincare goals and your skin-health needs.

Next month’s installment for “Skin Through Your Ages” will be about the sixth decade of life, the fifties, when the aging of one’s skin can be a graceful journey with some “professional” help. So until then, happy healthy skin!

–Dr. H


Read  more about your skin in each decade:

Skin Through Your Ages I: Childhood 

Skin Through Your Ages II: The Teens

Skin Through Your Ages III: The Twenties

Skin Through Your Ages IV: The Thirties 

Skin Through Your Ages V: The Forties