When should you start anti-ageing treatment?

Key takeaways

• There is no correct age for injections or machines. There is a correct reason.
• Daily broad-spectrum sunscreen is the one step with trial evidence that it slows visible skin ageing.
• Decide where you want your face to be in five years, then work backwards to the smallest step that gets you there.
• Small, spaced treatments over years look more natural than a lot done at once.
• If you cannot name what is bothering you, it is usually too early for treatment.

Is there a "right age" to start?

People ask me this at every age from 24 to 60. Normally they have seen a friend or a reel and they are worried they are late. So let me answer honestly.

There are two different things here, and people mix them up.

1. Protection. This starts in your twenties and never stops. Sunscreen, no tobacco, sleep, a basic routine. It costs very little and it is where most of the long-term difference comes from.
2. Treatment. This starts when there is a real change you want to address: a frown line that stays when your face is relaxed, cheeks that have flattened, skin that has started to sag at the jaw. Not before.

The age at which treatment makes sense varies a lot between people. Research on facial ageing points to genetics as probably the most powerful internal factor, with sun, smoking, body weight changes, alcohol and hormones speeding things up from outside. Two people of 35 can have very different faces.

What does "preventive" anti-ageing really mean?

See, what happens is, the word "preventive" gets used to sell treatments to people who do not need them yet. I am careful with it.

What genuinely prevents visible ageing is protection from ultraviolet light. In a randomised trial in Nambour, Australia, 903 adults under 55 were followed for four and a half years. Those who used broad-spectrum sunscreen every day showed 24% less skin ageing than those who used it when they felt like it. That is real prevention, and it is cheap.

Some doctors use small doses of anti-wrinkle injections (botulinum toxin) in people whose lines are only visible on movement, to stop those lines from setting in. That can be reasonable for some people with very expressive foreheads. But it is a choice, not a requirement, and it needs repeating every few months. If you are 26 and you see nothing at rest, I will usually tell you to wait.

What should you do in each decade?

This is a general guide. Your own face decides the details.

Research on facial ageing describes changes in the bone of the mid-face that may begin after 30, and a sharp fall in elastin production by 40 to 50. That is why the conversation in your forties is often about structure and skin quality, not just lines. You can read more in how skin ages after 30.

How do I decide if I am ready for a treatment?

I learnt chess at three and a half, and my coaches taught me the endgame first. I plan faces the same way. So before any treatment, I ask three questions.

• What exactly bothers you? "I look tired" is a start. "The line between my eyebrows stays even when I am relaxed" is something I can actually work with.
• What is causing it? A line from muscle movement, a hollow from volume loss and a sag from loose skin need completely different treatments. Treating the wrong cause is how people end up looking odd.
• Where do you want to be in five years? If the goal is to look rested, not different, the plan is usually smaller and slower than people expect.

If you cannot answer the first question, that is fine. It probably means you do not need treatment yet. Protection is enough.

Why small steps over years work better

Basically, faces age slowly, so treatment should keep the same pace. When someone does a lot in one sitting, the change is visible to everyone, and that is exactly what most of my patients do not want. When we do a little, review it and add only if needed, the change stays quiet. The aim is that you look rested, not different.

There is also a practical reason. Every treatment has some risk, and every injectable has a cost that repeats. A plan built on the fewest necessary steps is safer and easier to sustain over ten years. I would much rather you come back in a year and we do nothing, than do something today that you did not need. That is very important to understand.

Signs it may be time for more than protection

• A line that is clearly visible when your face is completely relaxed
• Hollows under the eyes or flattening of the cheeks that make you look tired in photos
• The jawline losing its edge, or skin starting to fold at the jowl
• Uneven pigment or texture that sunscreen and a basic routine have not helped

None of these is urgent. They are simply reasons to get an assessment and a written plan.

How we approach this at Dr Tvacha

At our centres in Thane, Andheri, Bandra and Dahisar, the Long Game Anti-ageing Plan starts with a Rs 499 face assessment. We look at lines, volume, skin quality and laxity, agree where you want to be in five years, and write the plan down with prices before anything is done. The order is assess, protect, restore, maintain. Often the honest answer is to protect now and review later. You can read about the Long Game Anti-ageing Plan or find your nearest centre.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.