Just last week, Janine, who is thirty-six years old, walked into myoffice. Aside from having a few small light-brown spots and faintsmile lines, her skin was in great shape for her age. She thought so,too—until she took a good look at her two daughters. Both are underthe age of ten, so it'll be years and years before they see their firstbrown spot or wrinkle. Janine had noticed how much their facesglowed and radiated health, how they lit up every room they walkedinto—and how, somewhere along the way, her own skin had lost itsluster. 'Dr. Dover," she said, "I'd give anything to get back even a frac-tion of that luster."
Most of us can relate to this. If it's not your daughter, maybe it'syour niece, your grandchild, or the high schoolers you see walking toclass every morning. Think for a minute about a child you know.When you look at his or her face, you probably see the following:
For starters, you notice an overall radiance. I have two teenagedaughters. Like Janine's kids, they have this tremendously healthyluster.
One of the qualities that makes children look like children istheir skin's plumpness. I'm not talking about eating too muchcake and ice cream. Youthful skin is filled with goodies like col-lagen, elastin, and a spongy material called hyaluronic acid, whichmakes the skin deliciously plump and full. Think of a baby'sround cheeks and you'll know just what I mean.
Plump skin looks healthy and young. It doesn't matter if yourdaughter has gotten only five hours of sleep or has sunburned herface to a crisp (let's hope not)—her skin is probably still taut andunlined. Of course, all that sun exposure will come back to biteher later on!
No makeup is necessary to improve one's looks here. One of themost prized aspects of young skin is its lovely even color andtone.
Now let's take a look at how the complexion changes over the decades. The section below outlines how the aging process manifestsitself on the skin's surface, as well as below it. Compare your score with the descriptions below. Do yourecognize yourface?
Enjoy your skin now; in many ways, it's at its very best. Since it stillretains its teenage youthfulness and recoil, makeup is probably not necessary to improve the way it looks. All your face requires tolook good is a confident smile. The few creases that appear when you do flash a grin vanish the moment you relax your face. Fortunately,the oil slicks and pimples that were caused mainly by puberty's hor-monal shifts have finally begun to abate—for most women, but not all(read on).
Myth: Using a rich moisturizer now will prevent wrinkles later.
Truth: Moisturizers do just what they say they will do: moisturize theskin. Most formulas that contain ingredients like glycerin, petrolatum, andhyaluronic acid hydrate your complexion by helping cells to attract andhold on to water molecules. More moisture in the skin will temporarilymake it look more plump, minimizing the appearance of fine lines for upto several hours. Regular use of a moisturizer helps to keep the skin wellhydrated over the long term as well. For long-term wrinkle prevention,however, look for a moisturizer that contains anti-aging ingredients, suchas retinol and alpha hydroxy acids.
Here are some of the things you'll notice about your skin if yourSVA is twentysomething:
Persistent pimples. Acne usually begins to subside at this age,but growing numbers of people are still plagued by blemisheswell into their twenties and beyond. Many of my adult patientsfind that the harsh acne products they depended on in adoles-cence are too drying and irritating now. Fortunately, we havemany gentler alternatives.
Sluggish cell turnover.The natural process of cell turnover beginsto slow down very slightly, so dull, dead skin cells stick aroundfor a little longer. This means that your complexion might lose abit of its natural luster as you approach thirty.
Delayed effects of sunburn. Damage from days spent on thebeach starts manifesting itself during this decade. Nevertheless,take heart: any brown spots, fine crinkles, and spidery blood ves-sels that do emerge are usually barely visible, and further injuryis very preventable as long as you get serious about sun protec-tion now.
Your complexion still looks youthful: your skin bounces back whenyou pinch it, and the surface is probably fairly smooth. As you move into your middle and late thirties, however, past sun damage trulybegins to make its mark.
Myth: Drinking lots of water will keep me looking young.
Truth: Water certainly does the body good, but when it comes tostaving off the signs of aging, it's hardly a miracle elixir. Unless you'reseverely dehydrated—and you'll know it if you are—drinking a littlemore or a little less than usual really won't show up on your skin. I can'tsee how drinking eight glasses of water a day would make your skin lookyounger in the long term. If your complexion is genuinely dry or flaky, thebest way to hydrate it is with a good moisturizer, which will help the skinto look smoother and plumper, but only in the short term.
If your SVA is thirtysomething, you'll see the following changes inyour skin:
Luster loss. Your skin's natural glow and radiance continue todecrease as cell turnover slows down more dramatically.
Brown spots. Although the center of your face is still fairly freeof brown spots, the sides show the first signs of pigmentation.The reason for this is that few people ever look directly at the sun,so the sides of the face receive more ultraviolet (UV) exposure.Furthermore, many people neglect the outer part of their cheekswhen they apply sunscreen. You'd also be surprised at how muchsun exposure happens while you're driving: UVA light transmitsright through window glass. Elsewhere on the face, small freck-les become larger and more blotchy.
Visible veins. Tiny red veins appear around the edge of the noseand cheeks. At the same time, leg veins might make their firstappearance, especially if you've had children.
Lines of time. Fine crinkles start to emerge around the eyes. You might also notice two vertical frown lines between your eyebrows—many of my patients call these their 'elevens,"because of their shape—and horizontal lines on the foreheadthat come from raising your eyebrows. All these lines are morenoticeable when you're tired, stressed, or dehydrated.
Not-so-cute dimples. Cellulite might appear or become morenoticeable, particularly on the back of your thighs and buttocks.
As years of cumulative UV exposure keep taking their toll, your skintakes on an increasingly dull cast, especially in sun-exposed areas.
If your SVA is fortysomething, you might notice the following hap-pening to your skin:
More prevalent pigment. Brown spots crop up in larger andlarger numbers—not only on the sides of your face but also in thecentral part.
Additional wrinkles. Fine lines continue to emerge, and the over-all texture of the skin appears less smooth. Crinkles around theeyes become more noticeable; frown lines between the browsand horizontal creases in the forehead become deeper. You mightfind it especially frustrating that people are asking you why youlook angry when you're perfectly happy.
Loss of baby fat.You might notice gradual volume loss, startingin your cheeks, especially during the later part of the decade. Thisis when you first start to notice that your skin is visibly less taut,especially around the mouth and along the jawline.
The skin is noticeably less radiant than it was a decade ago. Althoughyou might feel as young and vibrant as ever, the hormonal changesassociated with menopause, coupled with the ongoing effects of sunexposure from years past, mean that your complexion might lookdrier and more tired.
Having a fiftysomething SVA often means the following for yourskin:
Uneven skin tone. Blotches and redness become even worse asyou sail through your fifties. Even if they weren't a problembefore, individual red blood vessels can pop up around the nose,cheeks, and chin.
More creases. Forehead lines and crow's feet become deeper, andvertical lip lines might begin to form, especially if they run in yourfamily, if you are or were a smoker, or if you're prone to pucker-ing.
Sagging and fat accumulation. As volume loss continues on theface, neck, and other parts of the body, sagging increases. That'sbecause fat redistributes itself as we age, showing up on differentparts of the face and the body. Some of it disappears from thecheeks, causing them to look slightly hollow. At the same time, fatdeposits under the eyes and under the chin cause eyelid puffinessand sagging of the neck. Let's also not forget about the areas thatare notorious for accumulating fat with age: the belly, the sides ofthe hips, and the buttocks.
The skin looks less radiant and more blotchy than it was a decade ago. Along with these changes comes increased sagging at the cornersof the mouth and along the jawline and the neck. All of this is especially disconcerting if you feel as youthful as you did twenty yearsago. If you're considering a face-lift or other skin-tightening proce-dures for the first time, be aware that doctors have a range of less inva-sive alternatives for those who are not ready to take the cosmeticsurgery plunge.
If your SVA is sixtysomething, the following is probably happeningto your skin:
Deeper lines. Creases, wrinkles, and frown lines become progres-sively more etched into your face, especially between the eye-brows, on the forehead, around the eyes and the mouth, andabove the upper lip.
Unsightly sagging. Loose skin continues to be more visible on theface, especially along the jawline, on the neck, and throughoutthe entire body.
More fat accumulation. Even if you're an avid exerciser, youmight not be able to stave off emerging 'saddlebags" (increased fat on the sides of the hips) and belly fat as your skin tonedecreases and areas of unwanted body fat accumulate.
Seventysomething and Beyond
Myth: Topical oxygen treat-ments will make my skin lookyounger and healthier.
Truth: Our cells, includingour skin cells, obviously can'tfunction without oxygen, butthey get plenty of it from ourbloodstream. There's no evi-dence that rubbing or spray-ing your face with oxygen doesa thing, which is why I refuseto let our office aestheticiansoffer any type of oxygenatingtreatments.
This decade just brings more of the same. Nevertheless, just becauseyou might be a grandmother doesn't mean that you want to look like one. I still have vivid memoriesof an older woman who walkedinto my office and confided that herown grandchildren were too scaredto sit on her lap because of the bigbrown blotches and deep wrinkleson her face.
If your SVA is in the seventiesor higher, your skin might exhibitthe following:
Unstoppable spots. Unevenpigmentation usually becomesmore noticeable as you movethrough your seventies, withdarker, raised, and evenblotchier spots.
Red veins. Facial vessels appear or become more noticeablearound the nose and on the cheeks, even if they weren't a prob-lem before.
More wrinkles. Sensing a pattern here? Creases are prominenton the brow, on the forehead, between the nose and the mouth,on the cheeks, and especially above the upper lip. For those whohave expressive faces or who have had lots of sun exposure overthe years, the face becomes more and more wrinkly. Alas, themakeup you once wore to cover the brown spots and to masksmall imperfections now accentuates them.
Sagging skin. The areas around the brows, cheeks, jawline, andneck continue to droop even more.