15 questions to ask a dermatologist after 40!

At 40, our skin is the reflection of our experiences, especially its repeated assaults by the sun, responsible for photo-ageing. Of course, some skin types (darker skin) are less at risk than others, but they are at risk nonetheless.

It is enough to look at an unexposed area our skin (a square inch of the butt, miraculously spared, for example) to get an idea of ​​the treasure we would have possessed had we never put it under the sun. Tobacco and alcohol also exert their harmful influence, as well as certain medications or disease.

When internal hormonal factors are superimposed on this the long history of your skin journey, it becomes urgent to establish “an intermediary”. Otherwise, you risk spending a lot of money in cosmetic or inappropriate and unnecessary aesthetic techniques.

Do not forget either that the skin, protective and beneficial against external aggressions, is also a mirror to what is happening inside. “Dermatology is just as much a form of internal medicine,” says Dr Dutouquet. That is why, to take good care of it, it is important to first consult with a dermatologist.

MY SKIN IS LOSING ITS LUSTRE, HOW CAN I REGAIN IT?

“A sallow complexion occurs mainly due to the action of sunlight and tobacco,” says Dr Dutouquet. “The enormous progress in sunscreens suitable for all skin types allows us to limit the damage, provided they are put on frequently and in sufficient quantity. Moreover, a decrease or quitting of cigarettes can be beneficial.” Otherwise, days off from smoking can be multiplied by thalassotherapy.

MY CHEEKS FLUSH RED FREQUENTLY. SHOULD I TREAT THAT?

Rosacea is an inflammatory disease of vascular origin which particularly affects fair-skinned people between 40 and 50 years. It can manifest as transient redness (flushes) or permanently at the nose and cheekbones, small dilated vessels (of érythrocouperose stage) or inflammatory pimples. The disease is triggered by surges, for some, of too much spicy food or alcohol, a sudden change in temperature, too intense exercise, etc.

Only a dermatologist can diagnose rosacea and propose, at each stage, the most appropriate solution. “The treatment is effective. It is based on the prescription of antibiotic drugs to be applied locally (emulsion, cream or gel) or taken orally,” says Dr. Jean-Luc Schmutz, chief of dermatology at the University Hospital of Nancy in France. “It may be supplemented by a few sessions of vascular laser treatment, very useful for this purpose.”

With this condition, the skin is generally sensitive, so it is better to use cleansers without soap, and instead use moisturizers with fluid creams, getting rid of all products which are too greasy and occlusive. Irritating cosmetics (containing alcohol or fruit acids) are not recommended. Also avoid scrubs that irritate the skin and cause redness.

For sun protection, opt for an SPF30 solution with a fluid texture.

HERE I AM WITH PIMPLES LIKE A TEEN, IS THIS NORMAL?

It may be acne around the mouth occurring in adult women during menstruation; acne rosacea that was mentioned above; or the type that re-emerges when you stop taking the pill. “Diane (brand of pill), for example, limits the acne phenomena,” says gynaecologist Sylvain Mimoun.

So if we cease consumption of the pill, acne reappears because the anti-pimple action no longer exists. On the contrary, it is sometimes just taking a pill or progesterone with too androgenic effects that stimulates the appearance of pimples, oily skin, hair, etc. The gynaecologist prescribes them as they very effectively relieve pain in the breast, but sometimes at the cost of some side effects.”

“There may also be external factors favouring occasional breakouts (dental infections, sinusitis, or infection in the digestive tract),” said Dr Claude Dutouquet. “Causes of the appearance of these pimples are different, thus the treatments prescribed by the doctor will be too. The dermatologist refines them based on skin type and sensitivity of each individual.”

MY BODY IS COVERED WITH BROWN SPOTS, HOW TO REMOVE THEM?

The most common forms, formerly called “cemetery flowers” or “age spots” are due to excessive and repeated sun exposure. They are unsightly, but harmless.

“The most common de-pigmenting creams are little or not at all effective in this case,” said Dr. Claude Dutouquet. “In contrast, dermatological therapies actually give results: cryotherapy (cold therapy); certain peelings (application of various chemicals to destroy the superficial layers of the skin); some lasers and pulsed light technology. These have been recently made huge advancements and really revolutionized the treatment of brown spots.”

We can treat the face, neck, cleavage, hands and possibly arms and legs. It often takes a few sessions, depending on the severity of skin lesions. Their prices vary substantially depending on the technique used by the dermatologist. It is obviously necessary to continue to protect oneself with sunscreen to avoid too rapid a recurrence of these imperfections.

Moreover, it is highly recommended to show one’s skin to a specialist at least once, some brown spots may actually be, or become, melanoma.

I SWEAT MORE THAN BEFORE, ARE THERE ANY SOLUTIONS?

Stress is a great amplifier to sweating. It is not for nothing that it is called “cold sweat”. In fact, some stressed women put on antidepressants or neuroleptics see in their sweating reduce significantly. Menopause may also be a cause, what with the famous flushes.

Hormone replacement therapy (HRT) prescribed by the gynaecologist (in the absence of counter-indications) may play a beneficial role in many patients. “Botulinum toxin is a good way to significantly reduce sweating (especially under the armpits),” adds Dr Dutouquet. The effect lasts for about seven to twelve months depending on the case, after which you can repeat injections.

MY HAIR is becoming SPARSE, IS IT INEVITABLE?

If you have abundant mane, menopause or otherwise, celebrate your achievements. Your hair may be a little dry, but all it takes is a simple hair mask to restore shine and flexibility. However, if you got the short end of the stick in terms of your hair genes, as a result of menopause, your hair will be much less tonic, thus may suffer from excess sebum and fall further. “In this case, the HRT is able to limit this phenomenon,” assures Claude Dutouquet.

If you do not want to, or cannot take this treatment, minoxidil-based products can result in a slight improvement.” Some (bad) habits accelerate hair damage. Hairdressers keep repeating that you must massage the scalp to better nourish and stimulate root growth. “But if you have a sensitivity (genetics) at your pillar receivers and you massage your scalp with force, you enable the passage of circulating male hormones and instead of improving things, you accentuate rather than decrease the effects of shedding hair,” warns the dermatologist.

Be careful also not to repeat dye-jobs – be content with just retouching the roots. Beware of brushing too hard as well – your hair has a limited life. Opt for natural bristle brushes, which are softer. Let your hair dry in the open air often without brushing (the more we pull, the more we loosen the hair roots) or, at least, let them breathe a bit before using the hair dryer. Banish stick-on hair extensions. Wash your hair every day if necessary, with a mild shampoo for frequent use. Seborrhea aggravates hair fall, so be wary of shampoos claiming to be meant for “greasy hair”. They are sometimes too strong and may cause a reactionary sebum secretion.

Advice to smokers: decreased nutrient intake and production of smoking-related free radicals causes accelerated capillary genome (genetic code of the hair) aging. The hair becomes duller, more brittle and falls faster. When it comes to hair, genetics is not involved. When hormones decline, the hair fades. With HRT, we take the problem from the root.

I AM BOMBARDED WITH STRANGE HAIRS. IS LASER TREATMENT EFFECTIVE?

Laser hair removal is often more effective on light skin and black hair. “For facial hair (above the upper lip, for example), it is rarely advisable to try it out there at the beginning, as lasers could lead to early stimulation of the follicles,” warns Dr Claude Dutouquet.

We recommend waiting until the hairs are more visible and stronger. In the meantime, you can lighten with bleaching solutions and oxygenated water. Moreover, those who do not have the ability or do not wish to have laser sessions can apply Vaniqa cream (Lab. Shire, by prescription only) which inhibits hair growth.”

It is used quite widely in Asia, but be careful not to spread over too large and indefinite an area. The laser removal of body hair is generally very effective and sustainable over time (except in the case of special medical problems). However, for facial hair, being more pronounced under hormonal influence, the new hairs will probably remain apparent. It is then necessary to undergo a new round of laser therapy sessions.

MY HANDS ARE LESS BEAUTIFUL, HOW do i give them a little youthful boost?

In order not to weaken your hands, “finish” them with the same protective day and night creams that you apply on your face. Rubber gloves will also relieve you of all things wet and traumatic. Think about it if you always do gardening, wash dishes or even pottery.

Also note that hormonal decline will have an impact on your nails. They will be thinner and more brittle. HRT, again, it is able to strengthen then. Dietary supplements labelled for “skin, nails, hair” can be beneficial because they are rich in B vitamins and sulphurous amino acids which play a part in the formation of keratin. Their action is balancing and toning. Be careful not to use too much solvent (it weakens and dries the nail).

You should also exercise caution with allergies caused by nail varnishes, for the nail plate can become brittle and yellow.

MY FACE DRIES AT THE SPEED OF LIGHT, DOES ANY MAGIC MOISTURIZING TREATMENT EXIST?

Hormone dips, the sun and the wind…all these internal and external factors will cause or accelerate skin dryness. HRT can reduce the phenomenon thanks to the contribution of oestrogen build-up. Gynaecologist and endocrinologist Juliane Berdah reported this very instructive study, performed on 100 women aged 30 to 55.

These women presented themselves, and investigators conducting the study estimated their age. Then they measured their estradiol levels. Women who had the highest female hormone levels could appear up to eight years younger than their age, and vice versa. On the external front, “the solution is not through skin hydration as one would imagine, but the fight against dryness,” said Dr Claude Dutouquet. “Depending on age and skin condition, you should choose a cream containing more or less fat.” The basic Nivea cream (in its famous little blue box) is certainly one of the best among non-dermatological products on the market.

MY WRINKLES ARE GOING ON THE OFFENSIVE. SHOULD I GO FOR ANTI-WRINKLE CREAMS OR FILLERs?

After 40, all factors work together – sun, tobacco, hormonal aging. Deep wrinkles become deeper, rosacea is more common, bags under the eyes (genetic) increase in volume. We must therefore be vigilant with sunscreen, avoiding smoking, and anti-drying treatments.

“Besides that, we can stimulate the reproduction of skin cells using acid-based preparations,” notes Dr. Claude Dutouquet and adds, “according to the case and the possibilities, you can go for lasers, pulsed light, radiofrequency… If you want tackle the wrinkles yourself, there are fillers based on hyaluronic acid injections. Some practitioners also use collagen. ”

AND NOW, HOW SHOULD I BEHAVE WITH THE SUN?

After 40 years, you can expose yourself wherever you want, be it in the mountains or at sea, but keeping in mind that you should always be well equipped with your hat, sunglasses, and stay ultra-protected with regular applications of high protection sunblock and creams.

ARE PHYTOESTROGENS (SOY) GOOD FOR MY SKIN?

They seem to have very little effect on the skin, and certainly less than HTR does.

ARE SCRUBS BENEFICIAL?

On the body, they are useful, for example if you want to spread on tanning lotion for the perfect result. On the face, their usefulness is less obvious. For brightness, opt instead for peeling masks (available in cosmetic section of department stores). “But if you want a real improvement in the texture, tightness, and colour, it is best to choose deeper peels performed by specialists,” said Dr. Claude Dutouquet.

CAN SPORT IMPROVE THE QUALITY OF MY SKIN?

“Regular physical activity or sport is good for everything, including the skin, says physiotherapist Paul Daniel. It builds up the strength of the bone structures, the muscles that support the skin, and the blood supply that feeds the body.” So, yes three times yes to sports, provided our skin is protected against the cold or the sun, using creams suitably adapted to the conditions we are in.

SHOULD WE NOW stop using SAUNAs, STEAM ROOMs AND HOT TUBs?

Avoid excessive temperatures and limit exposure to moisture or steam during bath time. The more the skin is exposed to moisture, the more it dries out. After each session, apply a nourishing cream or milk to make the skin more flexible and keep it better protected.

Read the sequel of our report: “15 questions to ask your dermatologist after 40”
Skin: Which skincare routine should I adopt for maximum efficiency?
Skin: What happens after 40? And 50?

Rica ETIENNE