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Here's an evidence-based skincare routine that I personally follow and recommend to my patients. There are fundamental steps that help support and protect skin from the inside out, followed by the topical applications, and lastly, the advanced methods that can bring about more noticeable changes and faster.
My aim here is to present you with a variety of options so that you can select the ones that best suit your budget, your schedule, and your level of comfort, while creating significant and lasting changes to the signs of skin aging.
Skin aging occurs as a result of two types of factors: intrinsic (from the inside) and extrinsic (from the outside).
Extrinsic factors occur from the outside and are primarily due to exposure to UV rays from the sun. Intrinsic factors occur from within. As we age, our skin undergoes a series of intrinsic changes that occur simultaneously:
These changes lead to the signs of skin aging that we all recognize: fine lines and wrinkles; dryness; sagging skin; reduced elasticity; and discoloration.
You cannot stop the process of aging, but you can significantly impact the rate of these changes.
Your skin begins internally. The three inside-out foundations are among the most critical factors that determine general health.
Diet affects the skin through multiple pathways:
Research continually shows that there is a dietary pattern that resembles a number of other health-oriented diets:
Mediterrean and DASH-type eating patterns are examples of the types of diets that match this pattern.
Key diet-related nutrients for skin health often include: vitamin A and carotenoids; vitamin C; and numerous types of plant polyphenols. This aligns with the general guidelines in healthy eating made simple.
In a 2023 meta-analysis of 26 randomized controlled trials, researchers found that collagen peptides were associated with improvements in skin hydration and elasticity. Both of these characteristics decrease with age. More details can be reviewed in the article: what science really says about collagen peptides.
Hyaluronic acid maintains the skin's ability to retain moisture and helps maintain its smoothness and plumpness. Research indicates that supplementation with hyaluronic acid may improve wrinkling and hydration. Researchers in a recent trial noted a mean improvement in wrinkling of approximately 18.8% with hyaluronic acid treatment compared to very little improvement in the placebo group. Researchers in a larger 2023 study demonstrated comparable benefits in skin health with hyaluronic acid treatment.
Supplements can be beneficial, however, they are most effective when used on top of a solid diet plan, not as a replacement for a healthy diet.
While exercise is commonly viewed as a means to improve the skin, the evidence base clearly demonstrates that regular physical activity can positively affect skin health.
Researchers recently conducted a study comparing 16 weeks of aerobic training versus resistance training in previously sedentary middle-aged women:
Therefore, it is reasonable to assume that the combination of both types of training will be the most effective method. Additional information regarding the use of exercise to rejuvenate the skin can be found in can exercise rejuvenate skin.
One of the least recognized ways to positively impact your skin is through quality sleep.
During sleep, the body is transitioning towards repair and regeneration. Numerous studies demonstrate that individuals who do not obtain sufficient sleep experience more pronounced visual signs of aging, as well as reduced recovery from stressors such as UV exposure.
Poor sleep was also associated with the following:
Only a couple of nights of limited sleep can cause reductions in moisture and elasticity, as well as increases in oxidative stress.
Therefore, if you desire healthier skin, improving your sleep quality is crucial. For additional information regarding the importance of sleep for overall health, see how to optimize your sleep for better health.
After establishing a solid internal foundation, the effectiveness of topical strategy is greatly enhanced.
The majority of visible facial aging is attributed to UV radiation, and it also increases skin cancer risk.
Daily application of sunscreen represents one of the most potent anti-aging tools available. A landmark study found that consistent sunscreen users did not develop any measurable new signs of skin aging over a number of years. Follow-up research also suggested that sunscreen can also reverse some signs of aging.
A problem with many chemical sunscreens is the issue of absorption. A study demonstrated that several common chemical sunscreen ingredients were detectable in the blood at levels exceeding established safety limits. That does not indicate harm; it merely raises concerns that have not yet been thoroughly addressed.
Mineral sunscreens employing zinc oxide and titanium dioxide are commonly regarded as the safest options since they are not absorbed through the skin to the same extent as chemical sunscreens.
There are also newer chemical filters being used in various countries that appear to offer broad-spectrum protection without appreciable skin penetration due to their larger molecular size. However, availability differs.
More detailed information is provided in the articles sunscreen vs. skin cancer: what's happening.
Moisturizers aid in maintaining skin hydration, and support skin barrier function.
Ceramides are particularly valuable as they perform the role of "mortar" between skin cells and assist in reducing moisture loss and increasing hydration. Studies have demonstrated statistically significant increases in skin water content within days in those with dry skin.
The simplest evidence-based routine that addresses the greatest gains would be as follows:
Morning:
Night:
Foundational Steps:
As stated earlier, skincare does not need to be complex. However, it does require planning.
If you focus on developing a solid internal foundation, applying sunscreen daily, and adding a scientifically-supported nighttime agent (such as a retinoid), you will address the majority of the essential elements. All additional options can be incorporated into your routine as desired, based upon your financial situation, time constraints, and personal tolerance.
If you want to achieve the maximum return on investment in terms of your skin, begin with prevention.