O, The Oprah Magazine's beauty director, Valerie Monroe, reveals challenging truths that nobody ever tells you about aging—and how to face them.
You Start to See More Hair on Your Face
Here's why you have more of it than you did when you were 20: hormones. Though a significant minority of women of all ages have coarse dark hair growing on their chin and upper lip because of a genetic predisposition, most women who have excess facial hair have an underlying hormonal issue, says Doris J. Day, MD, clinical assistant professor of dermatology at New York University Medical Center. As we age, our bodies lose estrogen; testosterone, unopposed, causes us to grow more hair where men have it, on our faces (and to grow less on our heads).
If you occasionally have several dark (or white) hairs on your lip or chin, it's fine to whack them off with a razor; plucking isn't the best option, because the force of the pluck can irritate and leave a bump, says Day. A couple of staffers here at O have female relatives who shave their faces; most dermatologists don't recommend this for several reasons, among them the fact that the down on your face feels soft because it's been there for a long time; shave it off, and it's going to grow back stiff or coarse (though no thicker than before). Laser hair removal works only in certain situations, says Loretta Ciraldo, MD, clinical professor of dermatology at the Miller School of Medicine at the University of Miami. It's not effective on white hair, and if your skin is olive or darker, laser can cause postinflammatory hyperpigmentation, which looks like a dark stain, so it could leave you with something like a mustache even though there's no hair on your lip. Electrolysis—a procedure in which the follicle is destroyed by heat through an electrical current—is a good solution for stray hairs, says Ciraldo, but it's not good for large areas. The prescription cream Vaniqa inhibits the enzyme that hair follicles need to grow. Ciraldo advises applying it twice a day at first; if the hair stops growing within three months, she then suggests application once a day, followed by every other day, to determine the minimum amount needed to prevent recurrence of growth. She says that most of her patients find that Vaniqa gets rid of all visible hairs.
Ciraldo also points out that she can't see the facial hair on 75 percent of the women who complain to her until she's within a few inches of their faces. She attributes their concern—and I'd say, considering personal experience, that she's right—to magnifying mirrors. In an unlucky confluence of events, just as our eyes start to go and we need a magnifier to apply makeup, we start getting more facial hair. So stand at arm's length in front of a regular mirror, she says. If you can't see the hair on your face, you don't need to do anything about it. (Gosh, I hope I'm right that you can't see the hair on my face from arm's length, but I get rid of it anyhow in case I want to encourage someone to come in for a close-up. That seems reasonable, doesn't it?)
Being downier can present an unattractive problem with makeup. "Peach fuzz on the face can 'grab' powder and foundation," says Maria Verel, celebrity makeup artist. There are a couple of tricks to prevent that. Apply foundation the way you apply moisturizer: Rub it in and let it set (or dry), says Verel. Then buff it off with a cloth or a clean, slightly damp sponge. If you also wear powder (or a powder foundation), after application, lightly mist your face with water to settle the powder. You can just let that be, or pat it dry.
Hold on to your hat before you read this disheartening statistic: Fifty percent of postmenopausal women have noticeable thinning of the hair on their scalp. After age 50, approximately the same number of men and women suffer from thinning, says Ken Washenik, MD, PhD, medical director at Bosley, a surgical hair restoration medical practice, and clinical assistant professor of dermatology at New York University School of Medicine. The reason, again, is most likely loss of estrogen, which is protective of hair. You shed some hair naturally every day, but the loss is considered significant if you start to see thinning behind the hairline or your part is widening.
Washenik says the first thing to do if you notice thinning is to see a doctor, who can determine whether it's the result of a correctable condition (an overactive or underactive thyroid or low iron levels, for example) or medication (such as for high blood pressure or depression). If there's no underlying cause except age, Washenik recommends minoxidil (Rogaine) 2 percent. (Rogaine is available at 5 percent for men only; the FDA hasn't tested it or approved it at that strength for women.) Thinning hair has a shorter anagen (growth) phase than normal; that phase typically shortens as we get older. Minoxidil extends the growth phase. Apply it to the scalp at least once a day; if in three months you see no difference in thickness, it's not going to be effective. Minoxidil is a chronic maintenance therapy, which means that if you stop using it, it stops working.
As for styling, don't overload hair with product, because that will weigh it down, says Stephen Knoll, owner of the Stephen Knoll Salon in New York City. Overcompensating with too much volume results in thinner-looking, cotton candy hair, so go for a sleek style, he says. And avoid parting your hair in the center; an uneven side part will make your hair look fuller. Thickening shampoos can also make hair appear fuller.
Are your eyebrows getting patchy? Perhaps you'd like to consider an eyebrow transplant. Or perhaps you wouldn't: In the restoration procedure—which takes two to three hours in a doctor's office—individual hair follicles from the back or side of the head (where they aren't noticeable) are removed and placed into the brow area to re-create whatever density you like, says Washenik. But wait a minute: Why wouldn't the hair grow as long as it would if it were still on your scalp? It does, says Washenik. The transplanted follicles don't know that they've been moved, so you get something like bangs growing from your browbone. To avoid this potentially tragic state of affairs, forget transplants and try an eyebrow pencil or powder. Choose one that's a shade lighter than your haircolor, and with feathery strokes, fill in the patchy areas, says brow expert Sania Vucetaj. Brows grow a little longer as we age; brush them upward and trim.
Looking in the mirror one morning, I noticed this unpleasant surprise: My ears seemed to be larger than they used to be; not a lot, but definitely bigger. Then I started discreetly examining my friends and other older women. Slightly bigger ears on most of them. Was I imagining it? Evidently not. Though our ears are 90 percent grown by age 6, and our noses are almost fully grown by the time we're teens, both do change shape and appear to enlarge as we age. One theory about the nose is that it has a large number of sebaceous glands, which have a high cell turnover rate and therefore growth potential, says Neil Sadick, MD, clinical professor of dermatology at Weill Medical College of Cornell University in New York City. But both the ears and nose droop as soft tissue (skin, fat, and muscle) relaxes and structural support changes (bone recedes with time, so there's less foundation to hold the skin and cartilage up), says Alan Matarasso, MD, clinical professor of plastic surgery at the Albert Einstein College of Medicine of Yeshiva University in New York City. Plus, loss of elasticity and collagen in the skin causes sagging. He's seeing increasing requests for rhinoplasty and earlobe surgery among patients having facelifts. Heavy earrings can stretch the soft tissue of your earlobes; wear light ones. But if you've been hanging major bling from your ears, there's earlobe reduction, an in-office procedure that takes about 15 minutes per ear, requires a local anesthetic, and heals well, says Robert Klausner, MD, medical director at the Center for Cosmetic Surgery in Bonita Springs, Florida.
You can't entirely prevent your nose and ears from drooping, but you can minimize it by following Matarasso's advice: Avoid the sun, smoking, and weight fluctuation, and start using prescription-strength skincare products, including retinoids (which help preserve and regenerate collagen), in your 20s.
If you're long in the tooth, it's because your gums are deteriorating and have begun to shrink away from the crown portion of your teeth, exposing some of the root, says New York City dentist Marc Lowenberg. The length of the average front tooth is ten to 12 millimeters; with recession, including root exposure, it can become as long as 15 to 17 millimeters. In the same way that our skin loses collagen fibers, our gum tissue loses mass. The best preventive measure is to keep your gums free of bacteria—by brushing and flossing twice a day—because bacteria cause gum disease, which worsens recession. Also, overly vigorous brushing can scrub away gum tissue, so avoid it.
I love old, veiny, spotted hands. There's something beautiful, very wabi-sabi (the Japanese appreciation of transience) about them. Especially with a big, chunky, burnished pink-gold ring or some other imposing adornment, old hands look to me as if they've earned the right to carry heavy, important jewelry. But if you prefer the soft, plump, unmarked hands of youth, use the same antiaging products you use on your face, says Matarasso. That should include a retinoid, an AHA moisturizer, and—this is critical—sunblock. If you haven't been good about sunblock, you can have hyperpigmentation spots lightened with laser; veiny hands can be plumped up with Restylane, collagen, Sculptra, and fat injections. I'd rather use the money I could spend on rejuvenation on a cocktail ring.
I never tried polish on my toenails till after college—too busy before then rejecting feminine convention—but once I did, looking down at my brightly or delicately painted toes became one of the great little pedestrian pleasures of my life. I try not to wear shoes that strangle my feet, and you should, too, because your feet, breathing easier, will manifest your kindness in their pretty appearance. Eventually, though, we're all going to lose some elasticity and flexibility in the soft tissues—the tendons and ligaments—of our feet, which can lead to increased stress on the bones, potentially causing them to change shape. And when the bones start to change shape, you're looking at hammertoes and bunions. (All right, don't look at them, but there they are.) A tight Achilles tendon from years of wearing high heels can predispose you to such foot problems, says John Giurini, DPM, associate clinical professor of surgery at Harvard Medical School. So don't wear heels when you don't have to, he says. Also, stretch your Achilles tendon and the plantar fascia (the ligament that runs from your heel to the ball of your foot), wear supportive shoes, and if your feet are hurting, consider getting a doctor's evaluation—orthotics can prevent ugly problems from worsening. Orthotics? Take my hand. It won't be easy, but we'll hobble through this together.