November 2, 2016

Keeping your skin healthy as you age

A mother and adult daughter smiling, leaning on each other

There are two types of aging when it comes to our skin. The first is intrinsic aging, which is the product of the genes we are given, and how time and gravity weigh on the skin. The second is extrinsic aging, which includes all the effects of the choices that we make.

Apple A. Bodemer, MD, UW Health dermatologist, says the extrinsic is the more influential and the one we can do something about. Four important things she says you can do to minimize the appearance of aging skin are:

  1. Wear sunscreen regularly

  2. Keep skin well hydrated

  3. Don’t smoke

  4. Don’t tan

Extrinsic aging causes

Sun damage

Notice that two of the four in the above list are related to sun or UV radiation exposure. That's because the most important extrinsic component is sun damage, also known as photodamage. Avoiding sun exposure is the best way to defend against skin aging, but depending on jobs and lifestyle choices that is not always possible. Bodemer recommends covering up if you plan to be outdoors. This can include wearing wide-brimmed hats to protect the head and face, and clothing that covers the entire body.

Sunscreen should be used to protect any skin still exposed to the sun. And sunscreen should be worn regardless if it is sunny or cloudy since the sun’s UV radiation penetrates clouds.

Tanning booths

Tanning booths are another place where skin damage can accelerate the skin aging process. Bodemer is adamantly against tanning booth use.

“You’re not going to see it right away, but in 10 years you’ll start seeing the effects,” said Bodemer. “I see a lot of people who used tanning booths in their teens and by the time they get to their 30s they look older than their counterparts.”


Smoking has significant effects on aging skin as well. “You will see a specific type of wrinkling that happens with smokers,” said Bodemer. “There are hundreds of compounds in cigarette smoke, many of which are carcinogenic. These compounds alter blood vessels and cause breakdown of elastic tissues and collagen, which are what makes our skin appear plump.”


Good skin health practices should start early in life, but it is never too late to start regardless of your age or skin condition, said Bodemer. “You can play catch-up," she said. Wearing sunscreen will help to slow down the aging process. Also making sure your skin is well hydrated is helpful. “If your skin is well hydrated, skin cells will be plump and fine lines and wrinkles will be less noticeable,” Bodemer said.


When we talk about hydration we are talking about moisturizing, said Bodemer. “Most of the moisture in skin comes from the deeper tissues and that’s where the oral hydration plays in," he said. "There are no studies looking at oral hydration for skin health, but I do see a big difference in my patients who are dehydrated versus well hydrated.” Moisturizers, creams and ointments help to lock that moisture in, so a quality unscented moisturizer that will not irritate your skin is a good choice. If you have problems with sensitive skin, Bodemer said to look for something that says hypoallergenic or formulated for babies.

Skin care matters

Soap-less cleansers and pH-balanced cleansers are good options. Avoid traditional soaps, scrubs or anything abrasive that irritates skin making it look older.

Retinol, alpha hydroxyl and beta hydroxyl products can be helpful. They peel away dead skin cells and promote growth of healthy skin cells underneath, said Bodemer. But do your homework when choosing. Since skin creams are not regulated, Bodemer said they do not have to prove that they are effective.

“They don’t have to tell you the percentages of the ingredients in them," she said. "Some can be helpful but be careful and mindful of cost. More expensive isn’t necessarily better.” Finding the right one for you is often trial and error.

There are prescription-strength products that help minimize aging, said Bodemer. If you are really concerned and want the best quality product, she suggests talking to your dermatologist or health care provider. They will be more effective and more cost-effective as well. Even though the initial price tag might be a shock in the long run they tend to be more effective than the over-the-counter options. Another thing to note is that you will not see results right away. It can take months before you see results and you need to keep using them, said Bodemer.

When choosing a mask look at the ingredients. Some masks contain medications or over-the-counter acne medications that are intended to dry out the skin, said Bodemer. “You never want to dry out your skin too much even if you have oily skin,” she said.

Lightening creams that contain Arbutin and Kogic acid can be helpful in evening out skin tones. Arbutin comes from blueberries, cranberries, blackberries, bearberries and other berries. Kogic acid comes from a Japanese mushroom. Vitamin C can also help with evening skin tone. The downside is that it is not photo stable, meaning that if you do have a vitamin C cream it needs to be in a dark container because it will break down with exposure to light.

Procedures can be effective but expensive, so what Bodemer suggests is to set the magnifying mirror aside and take two steps back. “If your concern is still bothering you and it’s bothering you to the point where you are willing to invest money into doing something about it, then go talk to someone,” she said.

Medical/spa treatments such as Botox, wrinkle fillers, laser/light resurfacing, chemical peels and dermabrasions are expensive, and depending on what you go with, some can have significant down time. And you need to keep doing them to keep seeing the results, said Bodemer.

"Botox is great. What it does is paralyzes muscles to minimize wrinkles," Bodemer said. "But you need to do it every three to four months. If you’ve been getting Botox regularly, the effects can last up to six months or more."

Eat fruits and vegetables

What we eat influences every aspect of our health, including skin health. Avoid foods high in simple carbohydrates and sugars, which will accelerate the appearance of aging in the skin. Instead opt for fruits, vegetables and other foods high in antioxidants.

“A big component of aging in the skin is oxidative stress, and antioxidants are helpful for that,” said Bodemer.

Healthy fats like Omega 3 fatty acids are good for the skin, which you can get from fish or supplements. High protein diets can accelerate skin aging through increased dehydration that can compromise the appearance of healthy skin. Bodemer said most Americans already have plenty of protein in their diets, so raising these levels should be avoided.

Sleep on your back

While there is little research on the quality and quantity of sleep and skin aging, Bodemer said that sleep positions can determine if and where wrinkles form. Sleeping on your sides or stomach can result in wrinkling over time.

“That whole thing, ‘If you make that face one more time it’s going to stick,’ is actually kind of true,” said Bodemer. “When you make repeated facial expressions, like squinting or sleeping in one position, that adjusts facial muscles, which over time creates wrinkles.”

Forehead creases can come from side sleeping. Sleeping on your stomach can lead to wrinkles above your nose. So if you are a back sleeper, you'll have less of that.