Some of the clients I have looked after longest are now in their sixties and seventies, and many people first come to see me at that age. They are rarely looking to turn back the clock. More often they want to look as well as they feel — rested, healthy and still recognisably themselves. That is a very reasonable goal, and at any age it is the one I work towards.

What changes in later life

By our sixties, the changes that begin in our thirties and forties have had time to accumulate. Skin is thinner and drier, with less collagen and elastin, so it creases more easily and recovers more slowly. Underneath, the bone of the cheeks, jaw and around the eyes gradually remodels, so the face loses some of its support. Fat pads thin and shift, and years of sun exposure show as pigmentation, broken veins and a rougher texture.

None of this is a problem to be fixed. But understanding it helps explain why the right treatment in your seventies often looks quite different from the right treatment at forty — and why skin quality usually matters more than volume. Our guide to how skin changes in your 30s, 40s and 50s covers the earlier picture.

Your health history matters more than your age

Age on its own very rarely rules treatment out. What matters is your health, and that is the part of the consultation I spend most time on. Please tell us about:

  • Any medicines you take, including blood thinners such as warfarin, apixaban, rivaroxaban, clopidogrel or daily aspirin, which can increase bruising
  • Conditions such as diabetes, autoimmune or skin conditions, and anything affecting healing or circulation
  • Previous facial surgery, implants or earlier filler treatments
  • Any history of skin cancer, or a mole or patch of pigmentation that has changed

Please do not stop or change any prescribed medicine before treatment unless your own doctor advises it. Where it helps, I may suggest checking something with your GP first. A new or changing mark on the skin should always be seen by your GP or a dermatologist before any light or laser treatment.

Treatments that can help mature skin

Every plan is individual, but these are the treatments most often discussed with clients in this age group:

  • Skin quality: Profhilo, polynucleotides and skin boosters aim to improve hydration, texture and the look of thin, crepey skin, including on the neck
  • Gradual support: Sculptra stimulates your own collagen over several months — well suited to those who prefer change that is slow and understated
  • Structure, used sparingly: small amounts of dermal filler can restore some support to the cheeks or jawline. In mature skin, less is almost always more
  • Sun damage: IPL can reduce brown pigmentation and thread veins, once any marks have been checked
  • Hands: hand rejuvenation addresses thinning skin and visible tendons and veins
  • Gentle resurfacing: lighter skin peels can brighten dull skin, with stronger peels considered more cautiously

Being honest about limits

Some things are better said plainly. Where there is a lot of loose skin on the lower face or neck, non-surgical treatments such as HIFU will make only a modest difference, and I will tell you if a surgical opinion would serve you better. Adding a lot of filler to compensate for loose skin tends to look heavy rather than youthful. And laser hair removal relies on pigment in the hair, so it does not work on grey or white hairs.

Healing and timing

Mature skin often bruises a little more easily and can take slightly longer to settle, particularly if you take a blood thinner. It is sensible to allow extra time before a family occasion or holiday — our guide to timing treatment before an event gives typical intervals. Our aftercare guide explains what is normal afterwards and when to call us.

The foundations still matter

Whatever treatment you choose, daily care makes the biggest long-term difference: a broad-spectrum sunscreen every day, a gentle cleanser and a good moisturiser. A retinoid can still help in later life, introduced slowly. Our guides to SPF and ageing and building a simple skincare routine go into more detail.

Your consultation at ELM

Consultations are unhurried, and you are very welcome to bring a family member or friend. It helps to bring a list of your medicines. I will talk you through what is realistic, what each option involves and what it costs, and there is never any pressure to go ahead — deciding to do nothing is a perfectly good outcome. Our guide to your first consultation explains what happens on the day.

I qualified as a nurse in 1999, trained in the Plastic and Reconstructive Surgery unit at St James’s Hospital and have been in private aesthetic practice since 2007. I plan and carry out every injectable treatment myself; IPL, laser and skin peels may be carried out by Georgia Abrams, our Skin & Laser Therapist. A deposit will be required to secure a treatment appointment.