By the age of 50s, you can probably tell the difference between the ‘well-maintained’ 50s who have aged well from those who didn’t. And most of that did not happen by chance.
If you are convinced by now that you should probably start some treatments, it’s not too late! Most anti-aging treatments in the 40s are mostly still applicable for the 50s.
In this article, we will discuss more common presenting complaints in the 50s that weren’t the same in the 40s. The average age of menopause is 51 years old. During this phase of your life you will experience a range of menopausal symptoms as the levels of estrogen fluctuates unpredictably. Many of the rapid skin changes that happen in the 50s are directly attributed by these changing levels of hormones.
As you undergo menopause, the intermittent surge of estrogen is related to increased melanin production.
The precise effects of estrogen on melanin production remains controversial as worsening of melama continues after menopause despite lower levels of estrogen.
Estrogen insufficiency decreases defense against oxidative stress, causes accelerated skin ageing with increased collagen loss, decreased elasticity, increased dryness and increased wrinkling in postmenopausal women.
Increased level of estrogen has been linked to hyperpigmentation as seen in the case of pregnancy. This explains the worsening symptoms of melasma with menopause as estrogen levels increases intermittently. Ironically, symptoms of melasma continues to worsen in postmenopausal women, where estrogen is low. This phenomenen remains poorly understood.
Since we know that the lack of estrogen is the culprit to skin ageing, can we take hormones orally so that we do not experience menopause? Studies have concluded that skin ageing can indeed be significantly delayed by the administration of estrogen however this is not usual practice as prolonged use of estrogen has been linked to breast and uterine cancer.
There are definitely safer options available that are proven to work on these signs of ageing.
Sagging Skin Treatments
For most, you would have started to notice the effects of gravity in the 40s. By the time you reach the 50s, the extent of sagginess becomes increasingly concerning. Volume loss from resorption of bone, along with gradual loss of muscle, fat and collagen results in sunken areas of the face. For patients in their 50s dealing with this problem, volume replacement with a combination of the different types of fillers is recommended to fill up the different areas of the face. This procedure can instantly take away a few years!
Although fillers give the most instant improvements, we always recommend Ultherapy prior to fillers. Ultherapy is an FDA approved for skin lifting. Using ultrasound energy, Ultherapy is able to visualise and target the SMAS layer precisely, stimulating collagenesis in the subsequent weeks, resulting in firmer and tighter skin. Compared to Ultraformer 3, I would recommend Ulthera for treating sagging skin in the 50s as the supporting evidence in treating advanced aging skin is more established in Ulthera.
Ulthera has conducted studies to suggest that the longevity and effects of HA fillers are not affected by the ultrasound energy and that Ulthera can be done after fillers. However, when both procedures are planned, we always choose to do the less invasive one first as Ulthera can lift the skin and potentially minimise the amount of fillers used and completely avoid any risk of heat from the ultrasound energy from ‘melting’ away the fillers.
Crepey Skin Treatments
The loss of collagen, skin elasticity and reduced hydration of the skin results in crepey skin. In your 50s, you will need richer moisturisers packed with peptides and antioxidants. Even with regular use of peels and retinoids together with the best moisturisers, the loss of volume under the skin will need more intensive treatments. Although resurfacing lasers are known to be the gold standard resurfacing laser that encourages the growth of new collagen, it is poorly tolerated as skin tends to heal slower in the 50s and the downtime is prolonged and may not always be socially acceptable. In the past, restylane skin boosters were very popular as the injected hyaluronic acid plump up the skin and instantly hydrates the skin. In recent years, collagen stimulating injections such as Rejuran and the most recent Profhilo are getting increasingly popular. Profhilo has a major advantage over other intradermal injections with LESS injection points – which means less pain, less downtime and risk of bruising. The results can be seen in 2 simple sessions. Other treatments that stimulate collagen like Infini and Ulthera can also improve the texture of the skin.
Wrinkles in the 50s appear worse when they coexist with thin, crepey skin. As we express ourselves with facial movements, the skin is temporarily wrinkled (dynamic lines) and this should return to its original position. However, when the skin is thin and loses its elasticity, the skin does not bounce back and the form what we call static wrinkles. Unlike dynamic lines, Botox alone will no longer be sufficient to treat these lines. Other collagen-stimulating aesthetic treatments that aims to thicken the dermis and increase elastin production is required for better outcomes. This includes resurfacing CO2 lasers, which vapourises and sheds the superficial layers of the skin and simultaneously heats up the deeper layers of the skin, triggering the collagen remodelling process. In some deeper wrinkles, injection of fillers and collagen stimulating agents like Rejuran and Profhilo directly into the affected area may be more useful in restoring the lost volume on specific areas of the skin.
Neck Lines Treatment
Horizontal neck lines are static lines of the neck. Botox are hardly useful on these lines. The conventional resurfacing CO2 lasers are proven safe and effective for neck rejuvenation, but they have to be done with special caution as the risk of thermal injury causing hypertrophic scars, pigmentary changes are higher compared to the face. Profhilo injection is particularly useful in treating neck lines as they plump up the crepey skin on the neck with collagen production. Energy devices such as Ultherapy is FDA-approved to lift and tighten the skin over the neck and should definitely be considered to holistically rejuvenate the neck.
Platysmal Band Treatment
You may notice vertical bands that runs from the angle of the jaw to the collarbones. These are called platysmal bands. As we age, these bands become more prominent as they are more lax and enlarged. Botox is able to relax the platysma muscles within the bands and diminish its appearance effectively in one session. If you find this particularly useful, you will find yourself returning for more Botox every 4 months!
For some strange reason, skin tags and milia tend to proliferate rapidly in the 50s. This is possibly a combination of slower skin turnover resulting in a build up of sebum, hormonal changes, and increased friction over the area from wrinkled skin. These tiny protrusions can be easily treated by ablating them with a CO2 laser. These unsightly lesions can usually be treated within a session or two.
Warts and Seborrhoeic Keratosis Treatment
These two conditions appear as elevated, brownish growth from the skin. They are both non-cancerous and harmless. However they can be very big in size and affect how you look. As you get older, seborrheic keratosis increases in both numbers and size! Warts increases in size as well as the virus spreads to surrounding area. Unlike deep dermal pigmentations, both warts and pigmentation can too be ablated with a session of CO2 laser. You will be surprised how 1 session of CO2 laser can remove all these disfiguring lesions that have been there for years!
However, cancerous melanomas can look similar to these lesions. It is important to consult an experienced doctor to determine if further investigations are required before you get them removed!
Pigmentation & Melasma Treatment
Worsening and new presentation of melasma in the 50s is a common complain we see day-to-day. Long hours of high UV index all-year-round in Singapore and, as Asians, our darker skin type, predispose our population to developing melasma. Although melasma is known to be a harmless condition to your body, it can affect your confidence and mental health. The most important prevention is to minimise sun exposure with the use of sun screen, sun protective clothings and hats. Minimising UV exposure decreases the activity of pigment-producing melanocytes. However, the exisiting pigmentation do not just go away on their own! Whilst prescription creams containing hydroquinone, cysteamine, retinoids are effective in lightening pigmentations, they usually take months to take effect. Studies have proven that pulsed dye laser and pico lasers can break down stubborn pigmentations and lighten pigmentation further. Oral tranexamic acids should also be considered to treat melasma. In an effort to inhibit melanin production involving multiple pathways, different modalities of treatments should be considered to achieve and sustain best attainable results.
The process of ageing doesn’t only take a toll the body but on the mind as well. Looking younger can change how you feel about yourself. Receiving flattering complements can fuel us emotionally and make us feel more socially acceptable. This can help us regain confidence to achieve what only the ‘younger’ people are capable of. However all these compulsion to look younger is often due to social conditioning. It is important to embrace age and to be satisfied with how you look. Otherwise, no amount of cosmetic procedures and surgeries will be sufficient to make you happy.