Sagging Skin — What You and Your Doctor Can Do

Gravity does take its toll, but something else is at work here: Over time, the skin's underlying structure breaks down, robbing our faces of their definition, youthful plumpness, and resilience. Skin also renews itself much more slowly than it once did. Thanks to all these factors (not to mention genetics, weight changes, and sun damage), skin starts to sag and hang (that's where jowls come from). And some doctors say that once skin starts to slacken, pores often look larger, as if they've been stretched out of shape.

WHAT YOU CAN DO AT HOME

No easy fixes here. "Tightening sagging skin requires more intervention than any other problem," says Ranella Hirsch, M.D., spokesperson for the American Society for Dermatologic Surgery. A good moisturizer will plump skin temporarily, Dr. Hirsch says. But if the cream is too heavy, it will clog those oversize pores. The best at-home solution: what the beauty industry calls an "active" treatment, such as an over-the-counter vitamin A (known as retinol) cream, vitamin C serum, and alpha or beta hydroxy acids (AHAs or BHAs). These usually go on at night and help skin renew itself faster and look firmer. Try Garnier Nutritioniste Ultra-Lift Firming Moisture Cream ($15, drugstores), which contains vitamin A.

As for pores, you can't shrink them, but you can minimize their appearance, says Jeanine B. Downie, M.D., a dermatologist in Montclair, NJ. "Pores will look smaller if you keep your skin clean and protected from the sun," she says. If they really bother you, try pore-minimizing makeup or a cream like Dermadoctor Picture Porefect Pore Minimizing Solution ($40, sephora.com). And, of course, daily sunscreen is a must. Try Skin Effects Sun Effects Sunscreen Lotion ($16, CVS).

WHAT A DOCTOR CAN DO

Not interested in a face-lift? That's fine — there are noninvasive procedures worth investigating. Both infrared and laser treatments help stimulate the development of new collagen and "get heat deeply into the skin to help tighten fibrous bands," explains Dr. Weiss, who is also vice president of the American Society for Dermatologic Surgery. Ask your doctor about the Palomar Lux DeepIR, Cutera Titan, or CoolTouch. "Although we haven't found the perfect device for dealing with sagging skin, the technology is getting better all the time," Dr. Weiss says. And while these treatments are pricey and you'll need several sessions, the results are visible and impressive. To help improve the look of enlarged pores (and speed up skin's renewal process) at a much lower cost, ask a doctor about a prescription for Retin-A. "Whether you're dealing with acne or wrinkles, it's been proven to work on many levels," says Dr. Hirsch.

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