Your Skincare Routine After 45: What to Keep, What to Stop, What to Add

One of the most common things I hear from patients at London & Glow is some version of: "I've been using the same routine for years and it just doesn't seem to work anymore." They're right — and the explanation is not failure of willpower or inconsistency. It is biology.

After 45, and particularly through perimenopause and menopause, the skin is fundamentally different. It has less collagen, holds less moisture, renews itself more slowly, and is more sensitive to certain ingredients. A routine designed for 35-year-old skin may not only be less effective — it may be actively counterproductive.

Here is how to audit and adapt your skincare routine for where your skin actually is.

What Changes After 45

Before rethinking your routine, it helps to understand what has changed and why:

• Slower cell turnover: The skin's renewal cycle slows from ~28 days in youth to 40–50+ days in your 50s. Dead cells accumulate, causing dullness and rough texture.
• Reduced moisture retention: Falling oestrogen reduces hyaluronic acid synthesis in the dermis. Surface moisturisers help but cannot fully compensate.
• Collagen loss: Approximately 30% of collagen is lost in the first five years after menopause. The structural scaffold that keeps skin firm and plump is genuinely diminished.
• Increased sensitivity: Thinner skin means a more compromised barrier, making it more reactive to harsh actives and climate extremes.
• Altered sebum production: Some women experience increased dryness; others with relative androgen excess experience chin and jawline breakouts despite drier overall skin.

What to Keep — And Upgrade

Broad-spectrum SPF 50+: This is the single most evidence-based intervention available in a bottle. If you are not using it daily, start today. UV is the primary driver of visible skin ageing, and unprotected exposure undoes everything else. After 45, consider switching from a chemical to a mineral SPF (zinc oxide or titanium dioxide), which tends to be better tolerated on sensitive skin.

A gentle, fragrance-free cleanser: Harsh cleansers strip the skin barrier that is already more vulnerable. If your cleanser leaves skin feeling tight, it is doing damage. Switch to a milk, balm, or low-foaming gel cleanser.

Hyaluronic acid serum: Still beneficial — but apply it to damp skin and seal it with a moisturiser immediately. On its own, HA can actually draw moisture out of the skin in dry climates like Edmonton's. Layer it correctly.

A rich moisturiser with ceramides: After 45, your moisturiser needs to do more barrier repair work. Look for ceramides, fatty acids, and niacinamide. Thicker cream formulations are often better tolerated than lightweight gels.

What to Reconsider

High-strength exfoliating acids (AHAs/BHAs): Glycolic and salicylic acid at high concentrations can be too aggressive for the more sensitive barrier of menopausal skin. If you've been using a 10–12% glycolic product daily, consider reducing strength and frequency. A 5% lactic acid used 2–3 times per week is often more appropriate and better tolerated.

Physical exfoliants: Scrubs, brushes, and rough exfoliating cloths are too physically abrasive for thinner menopausal skin. Put them away.

Fragrance: Whether synthetic or natural, fragrance is the most common cause of contact irritation in skincare. After 45, your barrier is more permeable and reactions are more common. Fragrance-free is the safer default.

Alcohol-heavy toners: If you're still using an astringent toner from the 1990s, your skin's moisture barrier would like a word.

What to Add

Prescription or high-quality retinoids: Topical vitamin A derivatives are the most evidence-based anti-ageing ingredient in existence. They stimulate collagen production, accelerate cell turnover, and improve pigmentation. But on menopausal skin, they must be introduced slowly: start with a low-concentration retinol (0.025–0.05%) applied two nights per week, and increase gradually. Prescription tretinoin (retinoic acid) is significantly more effective but must be managed by a physician to avoid irritation.

Peptide serums: Peptides signal skin cells to produce collagen and structural proteins. The evidence is less robust than for retinoids, but they are well-tolerated and add meaningful benefit. Look for products containing palmitoyl pentapeptide (Matrixyl) or copper peptides.

Vitamin C (layered carefully): Ascorbic acid supports collagen synthesis and addresses pigmentation. On sensitive menopausal skin, choose a stabilised, lower-pH formulation (10–15% L-ascorbic acid or an ascorbyl derivative) and use it in the morning under SPF.

When Topicals Are Not Enough

The honest truth is that topical skincare — however well chosen — cannot reverse the structural changes that menopause brings. No cream can replace the collagen and hyaluronic acid that hormonal change has removed from the dermis. No serum penetrates deeply enough to stimulate meaningful collagen synthesis in the way that in-clinic treatments do.

This is not a sales pitch — it is physiology. A well-chosen skincare routine maintains and supports what you have, protects against further damage, and optimises the surface. But when deeper structural changes need addressing, physician-led treatments (polynucleotides, microneedling, PRP, skin boosters) work at the level that topicals cannot reach.

The two approaches are complementary, not competitive. Most of our patients at London & Glow use a well-constructed home routine alongside periodic in-clinic treatments — and the combination produces better results than either alone.

A Practical Starting Point

If you're overwhelmed, start here:

1. Gentle cleanser, morning and evening

2. Vitamin C serum, morning

3. Moisturiser with ceramides, morning

4. SPF 50+, every morning

5. Hyaluronic acid serum, evening

6. Retinol (start 2x per week), evening

7. Rich night moisturiser, evening

Introduce one new product at a time and allow 4–6 weeks before assessing results. If you experience significant irritation, reduce frequency before abandoning a product entirely.