The treatments that will produce real results for middle-aged skin

My friend and fellow beauty journalist Triona McCarthy always maintains that nobody under the age of 36 should write about skincare, because aside from those with actual medical conditions, they have no challenges to face. So how do they know if something lifts, firms, renews or eradicates? They can slug, tape, infuse and inject all they want, and the end result may look terrific, but in truth, the products or treatments didn’t really have to work very hard in the process.

But once one hits the mythical age of 36, things start to change. The depletion of collagen that’s been going on for about a decade is manifesting in the form of fine lines, our lifestyle choices are beginning to let us down, and overall, skin cells are taking longer to renew so the complexion is less dewy. Add another decade and now you’re really talking… gravity is pulling, volume is migrating, sun and free- radical damage is making an appearance. As a bonus baddie, oestrogen is taking our feminine features with it, as it dwindles in our bodies. Welcome to the Middle-Aged Dread. That moment in life when we wonder, will any of this stuff actually work? Or are we playing a sort of King Canute game of fighting an inevitably incoming tide?

The good news is that this is possibly the best era in which to be tackling the effects of aging, because science has never been as advanced, and the results have never looked as natural. Think of the facelifts of the 1990s and compare them to Kris Jenner – enough said. Then, think back to the recent times of over-filled lips, cheeks and jawlines and again, note how this trend has simply fallen off a cliff. Why? Because there are better, and more natural-looking options out there, many of which use the body’s own muscles, cells and healing power to create a more rejuvenated face and body.

But before embarking on a glow-up, take stock and get strategic. This is not the time to try a bit of laser here, some toxin there, volume replacement somewhere else and skincare from the centre aisle (yes, there may be similarities, but no, it’s not a “dupe”). The first step is to stop and take an intelligent, professionally-curated approach. Try to keep the number of experts and therapists to a minimum and instead of taking the pick ‘n’ mix approach, place your faith (and your face) in the hands of someone you trust. Have a conversation, identify what needs to be done, and then opt for a suite of treatments that fit both your life and your budget. Give the project time and add expert-prescribed home care so results continue to compound.

When it comes to the specifics of what to do, obviously we are all different, but also very much the same. Protocols to assist maturing skin will most likely incorporate toxin injections to tackle wrinkles, microneedling to trigger collagen production, some form of radio frequency treatment to tighten skin (especially around the neck and jaw area), a course of polynucleotide injections to further stimulate fatigued skin cells to regenerate and force further collagen production, and IPL laser to smooth out the complexion, remove sun damage and any discolouration, and zap thread veins.

Those who’ve traditionally been fans of PRP – platelet rich plasma – treatments to fortify skin, joints and hairlines with one’s own growth factors can now get this boosted with the addition of exosomes (cell messengers) and peptides. In fact, some key aestheticians pride themselves in “secret sauce” blends to really turbo-boost patients’ skin. One such leader in this field is Dr Sach Mohan, a Harley Street practitioner who will be bringing his clinic, and his special blends to The Spa at The Merrion Hotel on regular intervals in 2026.

While demand for facial filler is on the decline, there’s still very much a need for smart needle work on the face to restore lost and sagging volume. Sculptra is a product that does this, working as a bio-stimulator to trigger collagen production in the specific area – usually the cheeks, sides of the face and temples. I tried this with Dr Tiernan King at Kerry Hanaphy in South William Street and have noticed results evolving over time, smoothing out lines, plumping temple hollows and overall, improving skin laxity. It’s a gentle, more nuanced approach to filler, applied over a course of treatments, that avoids the dreaded pillow face.

Jowls, double chins, turkey neck and disappearing jawlines are all issues that become common to most as we age. These can be addressed through radiofrequency treatments such as Ultherapy, Softwave and Thermage, where a hand-held device works across the skin’s surface, delivering the energy into the dermis. Over time (three-to-six months), the skin tightens to improve the silhouette. These treatments work, although as one is constantly fighting against gravity and ongoing age so it can be hard to be specific.

A treatment that takes things a step further, although still in its infancy, is called IgniteRF and is definitely one to watch. Here, the narrow, radio frequency-emitting device is placed under the skin (yes, through a keyhole incision) and targeted to melt pockets of fat. The treatment is then combined with a skin-tightening system, and often enhanced further by some radio-frequency microneedling to really amp up results. Performed under local anaesthetic for patient comfort, it’s extremely effective and has replaced liposuction and more invasive surgical procedures. South William Clinic is one of the first places in Ireland to offer this treatment under the name of FaceTite.

The “minimally invasive” category of treatments is one growing in popularity for those who really want to tackle rejuvenation. Blepharoplasties, to improve the appearance of drooping, or sagging eyelids, and/or eye bags underneath, are becoming more and more common as the need for knock- out anaesthesia and surgical theatres disappears. Instead, it’s forty minutes under local in a clinic environment. The expertise of the surgeon is paramount, and this procedure shouldn’t be taken lightly – the eyes being the windows to the soul and all that. Do good research, and consider an ophthalmologist surgeon where the speciality is in exactly these sorts of procedures. Dr Michéal O’Rourke at the Institute of Dermatologists is one such precision-lead expert.

Whatever treatments one might consider to fight the middle-aged dread, the effects of any can be significantly amplified by the right regular skin routine and products. Home care will undoubtedly include a retinol or bakuchiol product at night to trigger cellular rejuvenation, vitamin C by day, a niacinamide serum for overall skin clarity and glow and, as if it needs to be said, a good cleanser (maybe with acids) and a broad-spectrum SPF to protect against sun, pollution and blue light damage.

Further to treatments and topical products, regular GP visits are the third side of the triangle. A doctor with vision can prescribe a whole suite of things to address the myriad menopause symptoms – a bespoke solution that goes far beyond an oestrogen patch. Getting a panel of bloods done dives under the bonnet further, and will signal what medication and supplements will help your overall health profile further – from GLP1s and vitamin B12 injections, to prescription-strength vitamin D. My own GP solved my stubborn, rotten sleep issues by prescribing me strong, drowsy-inducing antihistamines instead of the sleeping tablets none of us want to get hooked on.

Thankfully, we’re not all after deep-plane facelifts from superstar surgeons, but as we all start to live longer and stronger, and want to show up in the world feeling our best, it’s good to have options. So now we’re really putting those skincare product and procedure promises to the test.

This article originally appeared in the Winter 2025 issue of IMAGE. Have you thought about becoming an IMAGE subscriber? Our Print & Digital Magazine subscribers receive all four issues of IMAGE Magazine and two issues of IMAGE Interiors directly to their door along with digital access to all digital magazines and our full digital archive along with a luxury gift from La Bougie worth €75. Visit here to find out more about our IMAGE subscription packages.