Dry Skin: Hormone levels start to drop long before entering menopause. During perimenopause, as estrogen levels fall, many women first notice their skin is much drier than before. This is a common finding, but if not addressed, can lead to premature fine wrinkling around the eyes and mouth. A good way to add hydration to the skin without excessive greasiness is to use a moisturizer with hyaluronic acid. Hyaluronic acid helps to restore moisture levels to the skin as it actively attracts water.
Dull Skin: Skin cell turnover slows down with age, leading to a dull, lackluster complexion. Using glycolic-acid-containing products, either a cleanser, toner or moisturizer, can help remove some of the dead-skin layer to reveal a healthy glow. Another good option for exfoliation is an at-home personal microdermabrasion device. Used once a week, it can gently remove the dead skin cells to restore radiant skin.
Acne: I have many patients in their forties that say, “Why am I still getting acne when I now have wrinkles, too?” Unfortunately, acne around the mouth and jawline is quite common in our forties and is almost always due to fluctuating hormone levels. Topical spot treatment with salicylic acid can be helpful to dry up the occasional zit. However, if there are many cysts and the skin is otherwise quite dry, a visit to the dermatologist to obtain oral medication may be required. Options include low-dose antibiotics or a medication that works to block the effect of hormones on the skin.
Wrinkles: If she hasn’t seen one already, a woman will likely see her first wrinkles in her forties. Genetics, sun habits, overall body health and skin-care routines all contribute to how the skin ages. During this decade, I advise patients to start paying close attention to their skin because the best time to treat the signs of aging is right at the onset.
Prescription retinoid creams can stimulate collagen to slow the signs of aging; however, people with sensitive skin can use over-the-counter retinol as a less-intense alternative. For evolving wrinkles around the eyes and forehead, botulinum toxin (Botox or Dysport) can be used in small doses to help prevent wrinkles from getting worse while maintaining a natural look.
Not quite ready for Botox? Look for creams containing the ingredient gamma amino butyric acid, which helps to temporarily reduce muscle movement to improve wrinkles. Results are not as long lasting or effective as botulinum toxin, but can be used to temporarily improve fine lines and wrinkles without injections.
For fine lines, discoloration and enlarging pores that often begin in our forties, chemical peels and collagen-stimulating fractionated laser treatments can delay the changes associated with aging skin.