The structural foundation of your skin is provided by something called the dermal extracellular matrix. This matrix is composed of molecules such as collagen, elastin and glycosaminoglycans (e.g. hyaluronic acid—active ingredient in skin fillers). Aging and environmental factors such as sun exposure, stress, pollution and smoking lead to the breakdown of these substances, leading to wrinkles, crepiness, and sagging skin.
Lifestyle changes can help to address the environmental causes of sagging skin. The first and most important step is to limit sun exposure and to always wear a broad-spectrum, mineral-based sunscreen when outdoors or when exposed to sunlight through glass (i.e. one with zinc oxide and/or titanium dioxide).
Avoiding exposure to first and secondhand tobacco smoke is also of critical importance. Tobacco smoke contains a high concentration of free radicals, which are highly oxidative and damaging to all human tissue. Additional lifestyle changes to promote youthful, vibrant skin include maintaining adequate hydration with lots of water, a well-balanced diet, and the avoidance of excessive alcohol use. Alcohol is a diuretic, which means it will deplete your body’s natural store of water, and in excess, can also be toxic to your health.
Countless cosmetic products claim to firm or lift the skin. Although few results are documented with high-quality and objective evidence, based on decades of clinical experience, it is clear that limited benefits for sagging skin can be achieved with topical products. These topicals work primarily to stimulate the formation of collagen, elastin and other structural components of the skin matrix. In addition, good moisturizers, when used in a regimented manner, can provide modest improvements by hydrating the skin.
The highest level of medical evidence supports the use of retinoids. Retinoids, such as retinol, tretinoin, adapalene and tazarotene, are closely related to Vitamin A and are well recognized for their ability to stimulate collagen production, and to enhance the appearance of skin by effacing fine wrinkles, lightening age spots, firming skin and improving surface texture. They also imbue the skin with a flattering rosy glow.
Hydroxy acids, also called fruit acids, are some of the most widely used and studied anti-aging skincare compounds. When applied to the skin, they increase epidermal proliferation and thickness, and restore hydration. Clinical trials have shown the effectiveness of these ingredients in reversing the effects of photoaging and improving wrinkles, skin elasticity, tone and hydration. Alpha hydroxy acid, such as glycolic acid, and beta hydroxy acid, such as salicylic acid, are the two main classes of hydroxy acids.
More generally, antioxidants, such as Vitamins C and E, as well as various plant extracts and peptides have been used with some success to address the various pathways involved in sagging skin. Plant extracts and certain peptides target the extracellular matrix to address the loss of supportive structure and elasticity, and the antioxidants protect against contributing environmental factors.
EltaMD UV Restore Broad Spectrum Sunscreen SPF 40
Alastin Restorative Skin Complex
Alastin Restorative Neck Complex
SkinCeutical C E Ferulic
SkinCeuticals Triple Lipid Restore
La Roche Posay Toleriane Double Face Moisturizer
Topical treatments are best for the treatment of early signs of sagging skin and the prevention of future worsening. Advanced stages of sagging skin require medical procedures to correct.