The GIST, a YouTube channel created by Allergan (the pharma company behind some popular injectables like Botox and Juvederm) and hosted by five world-renowned board-certified dermatologists—Dr. Doris Day, Dr. Jeanine Downie, Dr. Sabrina Fabi, Dr. Ava Shamban, and Dr. Ruth Tedaldi—works to demystify all of the fluff that surrounds the beauty industry and get down to the facts. One episode, titled “Aging By The Decade,” explores the various skincare concerns that you should be addressing at each decade of your life, and of course, how to treat them. In addition to these five fabulous dermatologists, we also consulted Caroline Robinson, MD, FAAD, a board-certified dermatologist and founder of Tone Dermatology in Chicago, for other skincare solutions you can incorporate into your routine as you get older.
20s
“The biggest skincare concern I hear in [patients] in their 20s is slight dullness and generally looking more tired. This tends to occur in the mid to late 20s,” says Dr. Robinson. These issues can be caused by sun damage that has started to accumulate over time, lack of sleep, stress, or even genetics. She agrees with the doctors from The GIST that the main concern with 20-somethings is to get into a decent skincare routine to prepare your skin for times ahead. Though your skin probably doesn’t show signs of aging yet, laying the foundation (especially with SPF) for years to come will only help your skin in the long run. The doctors couldn’t stress enough the importance of daily sunscreen use—that is, sunscreen that isn’t also in your makeup. Use a separate broad spectrum sunscreen with a minimum of SPF 30 every single day (yes, including the days you don’t go outside) to protect your skin from all light sources, including the one that comes from your laptop or phone screen. Dr. Robinson also recommends starting the use of more potent skincare products in your late 20s that are preventative and habit-forming. “Even if you do not experience acne breakouts, it is still beneficial to add either an AHA/BHA-based serum or a topical retinol to your skincare routine to help address dullness and encourage gentle exfoliation,” she says, adding that both can be irritating so it is best to start with one.
30s
Your 30s are a transitional time, according to the doctors, because your skin is completely post-puberty (which can sometimes go into your late 20s). Thirty-somethings are typically more stable in all aspects of their lives and are able to not only invest in their future (maybe save up to buy a house), but they can also invest in themselves and their skin health. Your 30s is when you start to see some early signs of aging, as well as the first effects of sun damage that most likely happened in your teenage years or in your 20s. Dr. Robinson explains that patients in their 30s start seeing fine lines, loss of volume in cheeks (which can make under eye changes appear more prominent), and heavier pigmentation from sun damage. Your skin’s repair system slows down, which means that skin can appear duller as a result, and decreased collagen production means that your skin will appear less tight, so you might see early wrinkles and thinner skin overall (especially in the under eyes, where we can start to see the blood vessels beneath and then discoloration). In addition to a core skincare routine of cleansing, moisturizing, and sun protection, Dr. Robinson recommends adding a topical retinol (or an alternative like bakuchiol or a peptide-based serum) to help with fine lines and skin firmness. Adding an antioxidant in your 30s is also something she can’t emphasize enough. “Antioxidants will help to repair some of the sun damage that has started to develop over the years—they brighten dull skin, and help to rejuvenate collagen,” she explains. “I like to use them in the morning under my sunscreen.” The most common antioxidant that you’ll find in skincare is vitamin C but there are other great options and formulations that blend many antioxidants together. Look for plant-based products or products with fruits and/or vegetables at the top of the ingredient list, as those foods tend to naturally contain high concentrations of antioxidants. The GIST doctors treat a lot of patients in their 30s with laser therapy, like IPL (Intense Pulsed Light) or Photofacials, which can assist in the removal of discoloration. They also recommend any treatments that encourage cellular turnover, such as chemical peels, microneedling—which is making small punctures in the surface of the skin to stimulate the growth of new collagen—or radio frequency, which incorporates heat via (you guessed it) radio frequency devices to help induce new collagen and elastin production in the deeper layers of the skin. And of course, your 30s is most likely when you’ll start to see more prominent lines and wrinkles, so you can have injectables administered to help reduce their appearance.
40s
According to the doctors on the show, your 40s is when you really start to see major changes in the firmness of your skin. You’re dealing with loss of volume and elasticity (leading to skin that appears saggy), as well as more pronounced wrinkles and sun damage, which may lead to conditions like melasma. While you may start to invest in more aesthetic treatments, the doctors said that the most successful patients are the ones who mix in-office treatments with their knowledge of skincare. That is, they make lifestyle adjustments to help support the results from the treatments. According to Dr. Robinson, because your skin is going through so many changes in your 40s, you may need to incorporate two different kinds of cleansers—a gentle exfoliating cleanser and a mild lotion-like cleanser—to accommodate your skin’s needs for both cell turnover and hydration. For ultimate moisture retention, she also recommends incorporating hyaluronic acid into your routine (can be used both day and night), as well as a rich night cream that contains glycerin, ceramides, and or fatty lipids to help encourage skin barrier repair. Typically, dermatologists see more patients in their 40s coming in for treatments that help reduce signs of aging. Filler helps replace lost volume. Chemical peels can target melasma, sun damage, and uneven tone or texture. They also recommend treating your skin “from the bottom, up,” or rather, from the lowest layer of the skin to the top. While topical skincare is great for maintaining your skin’s overall health and appearance, if you want to actively work against signs of aging, you have to start to incorporate laser treatments that get underneath the surface of the skin.
50s
“Post menopause, our bodies experience a hormone shift with declining levels of estrogen and increased levels of androgens and this can affect the skin,” says Dr. Robinson. She explains that skin will be thinner and less elastic. Bone resorption occurs and this presents itself as loss of volume—especially in the middle of the face—as we age. Dryness is another major concern, and you may see acne you haven’t seen since your teenage years start to resurface due to these hormonal fluctuations. Excess pigment and signs of sun damage (i.e., brown spots and photo aging) also become more prominent. The biggest skincare solution is to ensure that you’re helping your skin retain moisture. Dr. Robinson says that few skin types can endure the roughness caused by an exfoliating cleanser at this point in their skin, and instead emphasizes the importance of a milder, milky cleanser that doesn’t get too sudsy. “These types of cleansers are effective at removing dirt and debris without removing important oils produced by the skin that the skin needs,” she says. While your 50s can seem like a daunting time—it is a milestone decade, after all—the doctors’ main concern is making sure that patients, especially women, know that life is only just beginning. You should feel empowered to invest in yourself and the treatments that make you happy. In your 50s, you’ll be dealing with even more hormonal changes, as well as overall skin changes that mainly happen because of your genetics. The doctors recommend looking at yourself with kind eyes and to celebrate your best features, rather than attempting to look like a 20-year-old—or someone entirely different, for that matter. The most common treatments they see in their 50-something patients are fillers and Botox, of course, but they also see a lot of patients coming in for body treatments, as this is when you’ll begin to notice the most significant signs of aging on your body. Body contouring with lasers and other machines can help tighten the skin in these areas. They also treat patients with microneedling to help encourage the production of collagen in the face. For the face, Dr. Robinson also recommends in-office treatments like lasers, microneedling, platelet rich plasma (PRP), and chemical peels to encourage skin cell turnover and boost skin repair in a more controlled setting.
60s and beyond
The main thing that the doctors want patients in their 60s to know is that it’s never too late to start anti-aging treatments. Coming in to see your derm frequently will help you look your best over time. Dr. Robinson says that the main concern with patients in their 60s and beyond is lack of hydration and moisture retention. “The emphasis in our 60s shifts from skincare to primarily procedures,” she says. “I recommend keeping skincare very simple, hydrating, and gentle at this age and focusing on procedures such as lasers that can be performed once or twice a year for improvement and maintenance.”
