Skin Ageing - What can we do about it?

Does our skin age because of what is going on inside our bodies – or what is going on outside? What can we do to slow this?  

Skin changes are some of the most visible signs of ageing. They include wrinkling and sagging as well as the development of "liver spots".  

What is going on inside our bodies that causes our skin to age? 

As we grow older the major components of skin (elastin and collagen) degenerate. Elastin allows skin to resume its shape after stretching or contracting. Collagen normally gives skin its fullness or plumpness. So their degeneration results in a gradual decline in skin elasticity and an increase in wrinkles.  

As we age we also lose muscle mass, a condition called sarcopenia. This can also affect theappearance of our skin.  A typical warning sign is the sagging of the skin over normal areas of muscle such as the legs and arms.  

The menopause and reduction in oestrogen production can have a further significant effect on skin wrinkling and ageing, as a 2013 article explains.   

A small scale study (of 60 women) published in 2015 suggested that poor sleep quality is also associated with increased signs of skin ageing.   

Stress is another factor that seems to be associated with skin ageing, for example according to a 2014 review.

Can this type of skin ageing be slowed down or reversed?  

Apart from cosmetic surgery (with all its pros and cons) two things we can do are "Resistance" exercises such weight lifting and eating protein rich foods such as lean chicken, turkey and fish. These help make good muscle loss as we age – which is one of the factors affecting skin ageing. Taking regular, appropriate, exercise may also help here, according to a review article in 2013.  

What are the major external factors that can accelerate skin ageing? 

Sunlight (UV light) A 2012 study described the sun’s effect on our skin as ‘photoageing.’ While a 2013 study of 298 Caucasian women concluded, ‘UV exposure seems to be responsible for 80% of visible facial ageing signs.’ However skin which is protected by naturally high levels of pigmentation (melanin) in ethnic groups with dark skin is less susceptible to these effects.    

Smoking - The profoundly damaging effects of smoking on skin wrinkling has been confirmed in many studies. It affects you if you smoke – or even if you spend time with a smoker. A study of 79 pairs of twins, published in 2013, found smoking particularly affected the middle and lower thirds of the face.

Air pollution. Traffic pollution is also associated with the signs of external skin ageing.

Interestingly, alcohol doesn’t seem to influence skin ageing and may even have a mild protective effect. That was the conclusion from a small scale study published in 2009, which compared 65 pairs of twins. 

Why external factors matter 

Skin ageing due to the natural process of ageing tends to be more subtle, generally producing finer wrinkles. Ageing caused by external factors (extrinsic aging) produces coarser wrinkles and can give the appearance of premature aging. This process varies between individuals and depends on initial skin pigmentation, with darker skins being more resistant.    

Ways of slowing external skin ageing  

  • Use sun-blocks and skin creams. A recent Australian study involving 903 adults aged under 55 showed that everyday application of sunscreen slowed the development of wrinkles and sagging skin. However this may be more relevant for summer than winter in countries like the UK – and, as we report elsewhere, modest daily exposure to the sun helps top up our Vitamin D levels. Sun screen can also prevent the two main types of skin cancer, melanoma and squamous cell carcinoma.
  • Stop Smoking. Tobacco smoke speeds up skin ageing. The skin of heavy smokers at the age of 40 can resemble the skin of non-smoking 70 year olds! 
  • Diet. Some studies suggest certain foods can slow skin ageing i.e. 
  • Fish oils.
  • Foods rich in  anti-oxidants such as vitamins E and C - and also resveratrol (in black skinned fruits such as blueberries and blackberries) and procyanadins (found in pomegranates)
  • Cruciferous vegetables, such as cabbages and sprouts.  

Use of skin hydrating creams. So called transepdermal water loss (TEWL) from the skin accelareates as we age. This has a marked effect on skin appearance. So the daily use of hydrating or ‘aqueous’ creams may be useful here.    

Vitamin based skin creams. Vitamin A derivatives (retinoic acid and the retinols) have been extensively investigated and the positive improvements well documented. Retinol exerts its anti-ageing benefits by increasing collagen production, and also through increasing elastin production. Additionally Vitamin C alone or with vitamin E, two powerful antioxidants, has been shown to be of some value when topically applied in face creams.

Creams containing N-acetyl glucosamine were reported to significantly improve firming and smoothing on the neck and décolletage in a small scale trial published in 2016. 


  • Avoid smoking, avoid prolonged exposure to strong sunlight unless you’re using a sunscreen and minimise time spent in air polluted city streets. This should minimise the effect of harmful external factors. 
  • Ensure your diet is high in vitamin C by eating plenty of fruit. Try also to ensure that you consume foods rich in vitamin E such as sunflower seeds, almonds, pine nuts, peanuts, olives and spinach. Also take in plenty of cruciferous vegetables such as cabbage and sprouts. 
  • Use hydrating skin creams to minimise skin water loss and to provide a barrier against chemical pollutants – with Vitamin based creams also helpful. 
  • Take plenty of exercise particularly using resistance exercises and ensure you eat enough protein – to minimise muscle loss. 
  • Try to address any problems that are leading to stress or poor sleep quality.                  

Richard Franklin. Reviewed and updated April 2016. Next review date February 2020.                

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