Social media is full of advice for better skin, and new trends are keep emerging.
But is there really anything you can do to prevent wrinkles and keep your skin looking youthful and smooth? We asked two dermatologists what kind of skincare has the best scientific evidence.
It's not just the skin that ages
So what actually happens to the skin on your face as you age?
"It's not just the skin that undergoes an ageing process, but also the muscles, fat tissue, and the skeleton," says Miray Al-Mustafa.
She is a dermatologist at Aleris in Drammen and Beth's Medispa in Oslo.
"This leads to wrinkles, folds, and eventually changes in facial shape," says Al-Mustafa, who is also vice president of the European Society of Cosmetic and Aesthetic Dermatology.
We have an internal and external ageing process. There’s not much we can do about the internal one.
Changes in fat tissue begin as early as the late 20s, says Al-Mustafa.
"We have both deep and superficial fat pads. Some shrink, while others may become larger. This can lead to folds and more heaviness in the lower part of the cheeks. You may also develop bags under the eyes," she explains.
"The muscles that pull downwards and make you look angry – muscles between the eyes and at the corners of the mouth – become more contracted over time. This creates a downwards pull that gradually alters the shape of the face," she adds.
Some things we can influence
Changes in the skeleton come last and begin in your 50s.
"The face becomes shorter. The upper jawbone weakens and shifts slightly backwards, causing the middle part of the face to lose support," says Al-Mustafa. "The tip of the nose may droop slightly, and the area around the eyes changes from a more almond shape to a more oval one. The eyes also tend to sink slightly inwards."
However, we can still influence the external ageing process of the skin, which is largely determined by what we do, the researcher says.
"The main culprit is UV radiation. Up to 80 per cent of skin wrinkles are caused by UV exposure," she says.
Sleep and stress can also play a role, she adds.
Protection from the sun
Excessive sun exposure damages the proteins collagen and elastin, which keep the skin smooth, firm, and elastic, according to BMJ.
Annonse
"UV rays break down collagen and prevent the formation of new replacement collagen. It's a double destruction," says Al-Mustafa.
It’s impossible to talk about skin ageing without mentioning the sun, she says. Sunscreen helps, but it’s not the most important measure.
The most effective protection is to avoid direct sunlight when the sun is at its highest and the UV index is at its peak, according to Al-Mustafa. The next best steps are to seek shade and wear clothes, a hat, and sunglasses.
Miray Al-Mustafa is a specialist in skin and venereal diseases.(Photo: Beate Willumsen)
What about during winter?
If you want to prevent wrinkles and pigmentation, you should use sunscreen all year round, according to Al-Mustafa.
She explains that although there is less UVB radiation in winter, the type that causes sunburn, UVA rays are still present. UVA penetrates deeper into the skin and can lead to premature ageing.
"UVA rays pass through clouds, rain, snow, and windows," she says.
She refers to a case study. A photo published in The New England Journal of Medicine shows the face of a man who drove a truck for 28 years. The left side of his face is significantly more wrinkled due to UVA exposure through the window.
Hat, sunglasses, and clothes in addition to sunscreen provide protection in strong sunlight.(Photo: Izabela Magier / Shutterstock / NTB)
Moisturisers containing SPF are not enough
Astrid Haaskjold Lossius also highlights sun protection as the most important factor. She is head of the dermatology department at Oslo University Hospital.
Lossius provides an example:
"Older people often have many wrinkles on their face, which has been heavily exposed to the sun. In contrast, skin that has been covered, such as on the buttocks, is typically smooth and free of wrinkles and pigmentation spots."
"Avoid excessive sun exposure, and especially tanning beds, if you want to keep your skin looking fresh for as long as possible," she advises.
It's true that UVA rays are present during winter as well, says Lossius.
"But I don't think it's necessary to use SPF all year round."
Instead, she recommends adapting to the conditions.
"If you're just cycling five minutes to the office and staying indoors, it's not that important. But if you work outdoors or plan to spend the whole day at the beach, it's important to apply sunscreen."
"To achieve the level of protection stated on the sunscreen, you need to apply a thick layer. A moisturiser with added SPF is not enough," says Lossius.
Smoking breaks down the skin
Lossius adds that another cause of premature skin ageing is smoking.
"Smoking affects the skin in several ways, but most importantly it leads to the formation of free radicals that break down the skin's structure."
"Collagen and elastin are degraded, making the skin less firm and elastic. Blood circulation in the skin is also reduced, meaning less oxygen and nutrients reach it, which accelerates ageing," she says.
Astrid Haaskjold Lossius is a dermatologist and head of the dermatology department at Oslo University Hospital.(Photo: Øystein Horgmo)
What about creams?
Should you use a moisturiser?
"You can use moisturisers, especially if you have dry skin," says Lossius. "If your skin isn't dry, it's less important, as the skin is able to produce what it needs on its own."
She recommends choosing a fragrance-free moisturiser that is gentle on the skin.
Are there creams with ingredients that can prevent or smooth out wrinkles?
"Creams containing retinoids have the best documented effect – vitamin A creams," says Lossius.
Can irritate the skin
Retinoids stimulates renewal and repair of the top layer of the skin, according to BMJ.
One such product, tretinoin, is only available by prescription, though milder versions can be bought over the counter.
"They help reverse many of the effects of UV damage," says Miray Al-Mustafa. "They promote skin renewal and make the dermis thicker, which improves firmness and elasticity."
Retinoids can irritate the skin and cause redness and peeling. They also increase sensitivity to sun damage, so proper sun protection is essential when using them. These products are not recommended during pregnancy, although retinoids used for acne do not appear to increase the risk of birth defects, according to the Norwegian Institute of Public Health.
Start gently
When using vitamin A products, it’s important to begin with a low concentration, says Al-Mustafa.
The current over-the-counter limit is 0.3 per cent; previously, it was 1 per cent.
The limit was reduced after studies showed a risk of excessive vitamin A levels in the body.
Al-Mustafa recommends buying these products from pharmacies or medical clinics.
"You can start by using it two evenings a week, then after about a month increase to three evening. You don't need more than that," she says.
Start gently if you plan to try vitamin A or C products, recommends Miray Al-Mustafa.(Stock photo: Shutterstock / NTB)
Vitamin C serum
Al-Mustafa also highlights vitamin C serum, although the evidence supporting its effectiveness is not as strong.
"Vitamin C comes in a good second place, typically as a cream or serum. It should be used during the day, ast it helps protect against UV rays and plays a role in collagen production," she says.
Many vitamin C serums are unstable and should be stored in the fridge, she notes.
"The most well- documented type, ascorbic acid, requires a low pH level. These products are so acidic that they irritate sensitive skin," she says.
For that reason, she does not recommend them for people with sensitive skin.
There are many other ingredients used in skincare products.
"Other ingredients like peptides, growth factors, exosomes, or salmon sperm are not well documented. That doesn't mean they don't work, but we don't have enough data," she says.
What is a good skincare routine?
Miray Al-Mustafa says you can start by washing your face with water in the morning.
If you have normal skin, it may be enough to use a vitamin C serum along with a good sunscreen that also provides some hydration. You can skip a moisturiser if the sunscreen gives sufficient hydration.
"In the evening, you should of course wash your face with a cleanser. Then you can apply either a moisturiser or first a vitamin A cream followed by a moisturiser," she says.
You don't need a ten-step routine, according to Al-Mustafa.
"But if you have other skin concerns, you can add more products," she says.
If you want to improve skin texture or pores, different acids can be used, says Al-Mustafa.
She mentions alpha hydroxy acids for dry or ageing skin, beta hydroxy acids for oily skin, and polyhydroxy acids for sensitive skin.
As with vitamin A, these acids shouldn’t be used daily. Start with two times a week and gradually increase to three, says Al-Mustafa.
