11 Top Skin-Care Problems for Women Over 50
'Maskne,' sensitive skin, flaky scalp and more
by Lois Joy Johnson, AARP, October 22, 2020
En español | Ready for some serious beauty talk? Along with our usual complexion woes — from forehead wrinkles to rosacea, the last seven months of stress and social distancing have taken their toll on our skin. I interviewed three board-certified dermatologists — Joshua Zeichner, M.D., director of cosmetic and clinical research at Mount Sinai Hospital in New York; Doris Day, M.D., clinical associate professor of dermatology at New York University Langone Health; and Lisa Chipps, M.D., assistant clinical professor at the David Geffen School of Medicine at UCLA — about the biggest concerns of women 50-plus now. Here's their expert advice, topped with my own beauty editor product recommendations, to make the solutions easy for you to follow.
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PHOTO BY: Target (2); CVS
Even women who embrace aging with a shrug and a smile find the complexion-bashing effects of daily mask-wearing annoying. The combo of friction plus trapped heat and moisture make noses, cheeks and chins targets for red spots and irritation. “This is not acne, it's a new situation,” says Zeichner. “Cloth masks are softer and less irritating than disposables, but just like makeup brushes and sponges they harbor bacteria unless frequently washed. I tell patients to double cleanse. Wash your face with a gentle foaming cleanser before putting on the cloth mask and wash your face again when you remove it for good at the end of the day ... then wash your mask, too.” Day agrees. “Disposable masks often contain fibers that can irritate sensitive skin,” she says. “Cloth masks — washed often and rotated — are a better choice, especially if you wear one for hours at a time at work, shopping, during dinner out or when traveling.” Try: Olay Cleanse Gentle Foaming Cleanser ($6, target.com), Neutrogena Ultra Gentle Daily Foaming Facial Cleanser ($8, target.com) or La Roche-Posay Toleriane Purifying Foaming Cream ($24, cvs.com).
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PHOTO BY: Walgreens (3)
2. Grungy-looking skin
Facial skin can look dirty, gritty or clogged if you get lazy or fearful of irritation and skip exfoliation. Blackheads and enlarged pores cancel out whatever topical do-gooders and makeup we apply. Zeichner says, “These are especially noticeable in the center nose to chin panel. As collagen decreases and skin sags, pores stretch and become blocked with dead cells and oil. Opt for ‘exfoliation light’ by using a very gentle scrub cleanser once a week. Manual exfoliation is easier to control than a chemical exfoliant like glycolic acid. You can determine the right level of pressure and sloughing and stop if and when necessary. Be patient. Clear, clean healthy-looking skin at 50 is a marathon, not a sprint.” Try: No7 Radiant Results Revitalizing Daily Face Polish ($9, walgreens.com), St. Ives Gentle Smoothing Oatmeal Scrub and Mask ($4, walgreens.com) or Cetaphil Extra Gentle Daily Scrub ($10, walgreens.com).
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PHOTO BY: Walgreens; Target (2)
3. Unpredictable breakouts
Even women with no history of acne or blemishes can suddenly get unstable skin at 50. Blemishes have popped up as a pet peeve, thanks to wobbling hormones, stress and not-so-healthy sugar binges. “Stress is a skin-wrecker,” says Zeichner. “It causes a spike in cortisol levels, which can increase inflammation, oil production and an urge to eat highly processed sugary foods ... all of which encourage breakouts to emerge side by side with wrinkles. Using a retinol cream at night counters blemishes and at the same time stimulates collagen to firm up saggy skin and improve lines and wrinkles.” Try: Palmer's Cocoa Butter Formula Night Renewal Cream ($9, target.com), Olay Regenerist Retinol24 MAX Night Face Moisturizer ($44, walgreens.com) or Neutrogena Rapid Wrinkle Repair Hyaluronic Acid Night Moisturizer with Retinol ($18, target.com).
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PHOTO BY: Dermstore; Target; Ulta Beauty
4. Extra dry skin
As estrogen levels decline skin feels thinner, parched and lacks “glow.” Add colder weather to that list, and you've got a complexion desert. “During the first five years of menopause women lose 30 percent of the collagen in their skin and body,” says Day. “I'm a believer in low-dose hormone replacement therapy to keep skin moist, firm and fresh, but this is an individual decision that must be made with your own doctor. I advise all women over 50 to include healthy fats in their diet with omega-rich foods like salmon, nuts and seeds to improve skin texture and radiance. A low-fat or no-fat diet is not helping mature skin at all.” Zeichner adds, “Aside from using a topical retinoid at night, treat skin all day long with moisturizers and serums that contain one or more proven ‘power’ ingredients like hyaluronic acid, ceramides, peptides, shea butter and vitamin B3 to bring back a dewy fresh look — they're game changers.” Try: Paula's Choice Omega+ Complex Moisturizer ($35, dermstore.com), Olay Regenerist Ultra Rich Hydrating Moisturizer Unscented ($29, target.com) or CeraVe AM Facial Moisturizing Lotion SPF 30 ($19, ulta.com).
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PHOTO BY: CVS (3)
5. Red, chapped hands
Who doesn't have this skin problem nowadays? “Remember to use fragrance-free hand creams after each washing to compensate for dryness from frequent cleansing and hand sanitizer use,” says Zeichner. “Hands can easily become red, scaly, rough ... but respond quickly to ingredients like shea butter and hyaluronic acid. Leave one on every sink and in every bag. You can only improve, not lose, with these.” Try: Neutrogena Hydro Boost Gel Hand Cream with Hyaluronic Acid ($7, cvs.com), Bioderma Atoderm Hand & Nail Cream ($10, cvs.com) or CeraVe Therapeutic Hand Cream Skin Protectant ($13, cvs.com).
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PHOTO BY: Walgreens (2); Ulta Beauty
6. Itchy scalp, hairline and brows
Many of us have been using more dry shampoo this year and washing our hair less. The result is contributing to an uptick in flaky, itchy scalp issues. “The cause may be dandruff caused by an overgrowth of a yeast on the scalp, an oily scalp or just truly dry skin — and sometimes it is genetic, but we are seeing more cases,” says Zeichner. “Dandruff can even affect the hairline right in front of your ears, eyebrows or smile lines. Usually an over-the-counter shampoo with zinc pyrithione, selenium sulfide or ketoconazole can do the trick. Since some medicated shampoos can affect processed hair color, try applying your usual conditioner before washing your hair with a dandruff shampoo. Use a Q-tip to cleanse and shampoo brows if this area is flaky.” Try: Head & Shoulders Clinical Strength Anti-Dandruff Shampoo ($7, walgreens.com) with selenium sulfide, Nizoral Anti-Dandruff Shampoo ($12, walgreens.com) with ketoconazole or Matrix Biolage Scalpsync Anti-Dandruff Shampoo ($19, ulta.com) with pyrithione zinc.
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PHOTO BY: Dermstore; Target; Sephora
7. More sensitive skin
Most mature women, if asked, will say their easily reddened and rash-prone skin is sensitive. “Skin sensitivity is often caused by a thinned, weakened protective barrier — also known as the stratum corneum — the skin's outermost layer made up of ceramides, fatty acids and cholesterol,” Zeichner says. “It protects your skin from water loss; environmental factors like cold, heat and wind; and unfriendly product ingredients that cause skin to feel tight or flare up. Using moisturizers with the ingredients niacinamide and/or hyaluronic acid helps boost moisture levels in the skin to help restore this barrier. Keep your routine simple, and wash with tepid water — not hot, too.” Try: Cetaphil Deep Hydration Healthy Glow Daily Cream ($17, target.com), La Roche-Posay Double Repair Face Moisturizer ($20, dermstore.com) or The Ordinary Natural Moisturizing Factors + HA ($6, sephora.com).
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PHOTO BY: Nordstrom; Sephora; Proactiv
8. Skin product reactions
We've become skeptical about trying any new product — from laundry detergent to moisturizer, topical oils to eye cream. “Mature skin is very reactive to product use and misuse — from extreme stinging and burning on one end to flare-ups of rosacea or adult acne to a mild uncomfortable feeling at the other extreme,” says Day. “I suggest women choose skin-care products with soothing, calming ingredients like niacinamide and aloe or green tea, use gentle cleansers and just a dab of over-the-counter hydrocortisone on small, irritated red spots. Stick with fragrance-free detergents, and check with your dermatologist if your normally well-behaved skin becomes incredibly reactive. Heightened sensitivity can indicate a condition like eczema or rosacea or allergic contact dermatitis, and only a board-certified dermatologist can tell the difference.” Try: Mario Badescu Aloe Moisturizer ($24, nordstrom.com), It Cosmetics Bye Bye Redness Neutralizing Color-Correcting Cream ($34, sephora.com) or Proactiv Green Tea Moisturizer ($40, ulta.com).
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PHOTO BY: Ulta Beauty; Colorescience; Target
9. Confusion about sun-damage protection
"Mask-wearing is not an excuse to skip sunscreen,” says Day. “The choice of using a mineral sunscreen with zinc oxide/titanium dioxide or a chemical sunscreen is up to your individual preference. Any sunscreen is better than none. I advise patients to wear an SPF 30+ sunscreen daily rain or shine, solo or under/over their makeup and under their masks. A brush-on powder sunscreen is one of the best solutions for touching up sun protection during the day and also [to] absorb excess oil and perspiration without looking pasty or cakey.” Zeichner adds, “I suggest a mineral zinc oxide sunscreen if your skin is sensitive, prone to redness or experiencing breakouts. It sits on top of the skin and forms a protective barrier. Since zinc is safe enough to be used in sunscreens and diaper creams [for] babies, you can feel confident about getting full protection that's unlikely to irritate.” Try: Peter Thomas Roth Instant Mineral Broad Spectrum SPF 45 Sunscreen ($30, ulta.com), Colorescience Sunforgettable Brush-On Sunscreen SPF 30 ($65, dermstore.com) or Olay Regenerist Mineral Sunscreen Hydrating Moisturizer SPF 30 ($29, target.com).
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PHOTO BY: Motortion/iStock/Getty Images Plus/Getty Images
10. Brown spots on hands and neck
Even if you've been pretty careful about using a daily facial sunscreen, most likely your hands and neck haven't been getting the same protection. Working near a window, sitting outside at a restaurant, driving or just walking the dog exposes hands and necks to vulnerable to UV rays. “Continued long-term sun damage often shows up on these two prominent spots,” says Zeichner. “Unlike the face, which can get coverage benefits from makeup, your hands and neck are always on display. Be sure to include them in your face-care product routine as you cleanse, moisturize and sun protect daily rather than consider them as part of your body care."
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PHOTO BY: Luis Alvarez/DigitalVision/Getty Images
11. Skin cancer scares
The doctors agree yearly skin-care checks are essential and should not be postponed. However, in pandemic times women are canceling seasonal office visits and putting off biopsies and treatment of precancerous lesions. Zeichner advises we “stay vigilant and pay attention to anything new going on — from changing brown spots to nonhealing scabs. Take phone photos of suspicious growths, and monitor them and share with your doctor. Most dermatologists now offer virtual online telemedicine consultations, which are helpful in determining if an office visit is necessary. While this is no substitute for a biopsy to determine if a suspicious growth is skin cancer, it may be enough to calm you down or encourage you to schedule an appointment.” Looking for a new dermatologist? Go online to the Skin Cancer Foundation/Find a Dermatologist link. “As a dermatologist and Mohs surgeon, I know serious skin cancer is a big issue for women over 50,” says Chipps. “Oral vitamin B3 — also known as niacinamide — has been shown in studies to decrease the incidence of basal and squamous cell skin cancers. That makes this vitamin a possible addition to topical sunscreen and UPF sun protection clothing. Ask your doctor about it."