Skin after fifty: what works and what does not

Skin ages for two reasons: time and sun. You cannot change the first. You can change the second.

A watercolour jar of face cream, a gold serum bottle and a pink rose with petals

Two kinds of ageing

Dermatologists separate intrinsic ageing, set by genes and time, from photoageing, caused by ultraviolet light over decades. Photoageing produces most of the deep wrinkles, the rough texture, the freckling and the uneven colour people call "age". Intrinsic ageing shows as thinner, drier, finer-lined skin.

That split is good news. A large share of what looks like age comes from sun exposure, and some of it responds to treatment.

Sunscreen is the best anti-ageing product with proof

The trial is from Nambour, Queensland. Researchers randomised 903 adults under fifty-five to daily broad-spectrum sunscreen or discretionary use, and followed them for four and a half years. Hughes and colleagues reported in 2013 that the daily group showed no detectable increase in skin ageing, and skin ageing was 24% lower than in the discretionary group. The authors note some outcome data were missing and power to detect moderate effects was modest.

Cancer Council recommends broad-spectrum, water-resistant SPF 50 or 50+ sunscreen on days the UV Index is forecast to reach 3 or above, applied 20 minutes before going out and at least every two hours outdoors.

What menopause does to skin

Skin collagen falls after menopause. A 1987 study by Brincat and colleagues found skin collagen content, skin thickness and bone mass each declined by 1 to 2% a year after menopause, and the declines correlated with one another.

Whether hormone therapy suits you is a decision for you and your doctor.

Retinoids: the other proven option

Retinoids are vitamin A derivatives. A 2025 meta-analysis of eight randomised trials (1,361 patients) found prescription tretinoin improved fine and coarse wrinkles in photodamaged facial skin compared with vehicle (Huang and Lee). A 2007 trial by Kafi and colleagues gave 36 elderly people (mean age 87) 0.4% retinol lotion on one arm and vehicle on the other for 24 weeks. Fine wrinkling improved on the retinol arm, and skin samples from small subgroups showed more glycosaminoglycan and procollagen I.

Retinoids irritate, so start two or three nights a week, use a moisturiser and always pair them with morning sunscreen. Avoid them in pregnancy.

Creams: ask for the trial

When a product or a diet promises to reverse ageing outright, ask for the trial in people, the size of the effect and who paid for it. A claim with no answer to those three questions is marketing.

Food and skin

AGEs build up in skin collagen with age, five-fold for some markers between ages 20 and 85, and faster in diabetes (Dyer and colleagues, 1993). Whether eating fewer refined carbohydrates changes this on your face is not shown. We examine one extreme diet built on a related idea in The Wai diet.

A simple routine that matches the evidence

Morning: gentle cleanse, moisturiser, broad-spectrum SPF 50 or higher.
Night: gentle cleanse, a retinoid if your doctor agrees, moisturiser.
Yearly: a skin check by a doctor, especially if you have a history of sun damage. Any changing mole needs an earlier visit.