What causes sagging skin and can you reverse it?

What to do if you're concerned about a sagging face.

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Jessica Bahr
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As we get older, whether we like it or not, our bodies and our faces begin to change. One thing you might notice as the years go by is loose or sagging skin on certain areas of your face and neck.

While some people might not be bothered by loose skin, it is something many of us feel self-conscious about and might wish to prevent, reduce or reverse. There are several treatment options available — from preventative regimes to non-surgical alternatives and surgical procedures such as a face or neck lift.

So, what actually causes saggy skin, how do you prevent it, and is it possible to reverse?

Why does my face sag?

There are numerous potential causes of saggy skin. The general ageing process, or intrinsic factors, will happen to all of us and are determined by genetics and time [1]. Other extrinsic or external factors, such as our lifestyle and environment, can also have a significant impact on our bodies and skin.

Potential causes of saggy skin can include:

Ageing

As we get older, our collagen and elastin production slows down [2]. Elastin helps provide stretch and skin elasticity, and — combined with other proteins — is integral to maintaining healthy skin structure, function, youthful appearance, and skin elasticity [3].

Collagen production is also a major component of youthful skin and promotes firmness, elasticity and strength [4]. As collagen and elastin production slows down, we begin to experience skin sagging and thinning, as well as the appearance of fine lines and wrinkles.

Older skin is also simply more susceptible to the effects of gravity, which is often why people will develop sagging skin around the jaw or bags and lines under the eyes [2].

Weight loss

After losing a significant amount of weight, many people will tend to have loose or saggy skin. When we gain weight, the skin stretches, and when we lose it, sometimes this skin can bounce back.

However, when a person has been at the larger size for an extended period of time, elastin and collagen fibres are no longer able to help the skin retract to its original size, resulting in loose and saggy skin.

Illness and medical conditions

In addition to age and lifestyle, certain types of illness or medical conditions can also contribute to minor skin sagging as well as more severe skin sagging.

Dermatosparaxis Ehlers-Danlos syndrome (dEDS), for example, is a rare disease caused by defects in collagen [5]. This can result in soft and fragile skin, saggy skin (especially facial skin), hernias and joint hypermobility.

Hyperelastic skin is the name associated with skin that has stretched beyond normal levels and as a result, has lost its capacity for elasticity [6].

In addition to dEDS, defective connective tissue beneath the skin's surface can also lead to hyperelastic skin, as can Marfan syndrome, subcutaneous T-cell lymphoma, osteogenesis imperfecta, and pseudoxanthoma elasticum (PXE) [6].

Can you fix saggy skin?

If you have already developed saggy skin, it can, unfortunately, be difficult to completely 'fix' or reverse (particularly through creams or lotions at home), but there are certainly a few treatments and cosmetic procedures you can consider.

For those looking to tighten loose skin or reverse sagging skin without undergoing a surgical procedure, you can achieve modest skin tightening and lifting through a variety of non-surgical and relatively non-invasive treatments [7].

These include ultrasound, radio frequency, intense pulsed light, laser therapy, or laser resurfacing. The cost, recovery time and efficacy varies, but each of these options can tighten skin while still being non-invasive or minimally invasive, and have fewer potential side effects compared with plastic surgery, as well as a faster recovery time [7].

Of course, we highly recommend consulting a doctor before undergoing any of these treatments. Even though they are not classified as invasive, they still do have associated risks, require aftercare and a time commitment, and can be a little painful.

For those who are looking for more dramatic results, a surgical procedure such as a facelift or eyelid surgery will have the biggest impact.

Can you prevent sagging skin?

The good news is, if you're hoping to prevent sagging skin, there are a few things you can try.

It's important to understand there are no guarantees and no foolproof hacks, and results will vary from person to person, but finding the right skincare routine is a great first step.

Software's prescription ageing treatment is tailored to your specific needs and features customised prescription formulations developed by dermatologists, along with ongoing follow-up support.

The formulations include ingredients such as prescription retinoids (which can promote collagen production, speed up skin cell production and help shed old skin cells quicker), niacinamide, hyaluronic acid, azelaic acid, and oral antibiotics if needed.

Together, these ingredients can help firm sagging skin, improve redness, reduce fine lines and wrinkles, strengthen the skin barrier, hydrate and plump skin, fight bacteria, prevent clogged pores, and generally reduce visible signs of ageing skin.

Another non-surgical skin tightening treatment option or preventative step is Software's Advanced Ageing Set. This regimen is designed to brighten and firm skin, stimulate collagen production, reduce fine lines and wrinkles, and deeply hydrate skin.

These hard-working products, which include the Vitamin C + Ferulic Serum, Ceramide Repair Balm, Salicylic Acid Foaming Wash, Retinol Complex Oil and Solar Fluid, can not only target the ageing process and improve skin laxity but also promote healthy skin at any age.

What else can you do to avoid developing a sagging face?

In addition to having a great skincare regime, certain lifestyle factors such as a healthy diet, drinking lots of water, limiting sun exposure and wearing sunscreen every day can work wonders for your skin and be highly effective when it comes to slowing down the skin ageing process.

Sun exposure, in particular, can prematurely age your skin, as can smoking and exposure to air pollution [1].

There are also a few ways you can try to stimulate collagen and elastin production, which — as we've discussed above — plays a major part in firm skin.

There are a lot of oral collagen supplements on the market at the moment, but we can't necessarily recommend these as the industry is not well regulated and scientific evidence is somewhat limited.

However, there are several non-surgical treatment options you can opt for, as well as topical treatments you can try at home.

Skin needling, facial rejuvenation, laser treatments and light therapy can all stimulate collagen production, while skincare ingredients such as vitamin C and retinol or prescription retinoids can have similar effects.

How can I treat sagging skin?

The best treatment options for sagging skin can vary depending on the body part.

Under the eyes is one of the most common parts of the face to develop saggy skin, so if this is your concern, you are definitely not alone!

Saggy skin under the eyes can be addressed through topical treatments such as retinoids or vitamin C serums, or through procedures such as injectable fillers, chemical peels or laser resurfacing.

For more dramatic results, you could consider a blepharoplasty procedure, which tightens skin and soft tissue around the eyes and removes excess skin and fat from the eyelids [8].

Blepharoplasty is also a popular sagging eyelids treatment and can be performed on either the upper or lower eyelid under local anaesthetic. Sagging jowls and a saggy neck are also extremely common side effects of skin ageing, and areas many people look to treat or reduce.

Sagging jowls treatment options can include fillers and laser treatments, or plastic surgery such as a facelift or neck lift [9]. There are a few different types, but a facelift is essentially a surgery to lift and tighten loose skin on the face and neck. It can also be combined with procedures like a brow lift, blepharoplasty, or nose reconstruction.

As with other skin tightening options, a facelift or neck lift can reduce sagging skin and make you look temporarily younger, but it doesn't completely stop the ageing process and results don't last forever; generally somewhere between 5-12 years.

If you are considering a facelift, it's important to make sure you are physically healthy first, understand the risks, and have realistic expectations. Make sure you have thorough conversations with surgeons in advance and make sure you are absolutely sure before going under the knife.

Plastic surgery and cosmetic treatments can offer impressive results but is absolutely not necessary in order to feel comfortable and happy in your skin — regardless of whether that skin is a little saggy.

Photo credit: Getty Images

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