Correction of age-related skin changes after 40 years: a special approach

Valentina Zolotareva, Ph.D. Sciences, dermatologist of the highest category, cosmetologist. Chief Physician of the Madeleine Cosmetology Center, Scientific Director of the Cosmetology Department of the Academy of Dermatovenereology.

What challenges do doctors face when working with clients over 40?

There are a lot of difficulties in working with clients over 40 years old. Working with young women is similar to pediatrics, and the correction of age-related skin changes after 40 years is akin to gerontology. Different age, different approach, different results. But, all the difficulties are based on an incorrectly made cosmetic diagnosis.

A correct diagnosis allows developing an adequate treatment strategy for the client. As for the aging of the face and skin, MBC-10 distinguishes two nosologies associated with age-related changes: chronoaging - "senile atrophy" (lethargy) of the skin (code L 57.4) and photoaging - "other skin changes caused by chronic exposure to non-ionizing radiation (code L 57.8) Determination of the dominant mechanism of skin aging is essential, but not sufficient for the development of a program for the treatment and prevention of age-related changes.

What are the principles of correction of this age category based on?

Based on the accumulated clinical experience, we can talk about some features of the prevention and correction of age-related changes in clients over 40 years old. Why was this particular age group selected? For most women, this age is borderline in the transition to menopause (premenopause, menopause and postmenopause).

At first, sharp fluctuations, and then a persistent irreversible decrease in the level of female sex hormones inevitably affects the condition of the skin, which becomes drier, its turgor and elasticity gradually decrease. Changes in muscle tone, volume and even geometry occur at a slower pace, however, in patients older than 55 years, we observe clear signs of this process in the form of gravitational ptosis. Of course, the clinical picture of age-related ptosis is associated primarily with the weakening of the ligamentous apparatus, a pronounced decrease in skin elasticity, redistribution of adipose tissue in the face.

It is very important to assess the type of skin, its sensitivity, pay attention to the rate of aging of different areas of the face, determine the isotype type of facial aging. Such an extension of the cosmetic diagnosis allows to some extent to algorithmize the planned cosmetic correction. When carrying out the prevention and correction of age-related changes in mature clients, it is necessary to take into account all the pathogenetic mechanisms of the formation of the clinical picture of menopausal facial aging.

How do clients perceive the new look at the correction of age-related changes?

To be honest, I myself do not always welcome new trends. I am a cautious person in this situation, I am not in a hurry to jump into the first carriage, I have no right to do so. It is better to wait out the euphoria, wait or not wait for complications, weigh all the pros and cons, and then make a decision. In addition, in the hands of each doctor, the method works in its own way, and what is cool for a developer is not always good for practical use, and therefore, for the end user. I really value each of my clients and have no right to make a mistake.