A guide to anti-aging skin care for fabulous 40-somethings
As we enter our forties, early signs of aging become more noticeable, and new concerns may arise due to accelerated structural changes in the skin. The effects of sun damage and environmental stressors worsen. At Pua Manu Med Spa in Kapolei, Hawaii, we understand that while you love your parents as they are, you don’t want to age the same way—and you don’t have to!

Anti-Aging Skin Care for 40-somethings
Collagen loss, which begins in our 20s, increases due to hormonal changes. This can make mildly loose skin appear baggy. Additionally, fat loss alters facial shape. A youthful V-shaped face may appear bulkier as tissues fall, especially along the jawline, creating jowls. By age 50, we deplete half of our hyaluronic acid stores, which makes our skin dry and leathery.
As elastin weakens, dynamic expression lines that appear only when frowning, squinting, or smiling become static and permanently etched. Freckles may give way to larger “age spots” due to UV exposure. The following treatments help prevent further damage and replenish essential skin components.
- HydraFacial—This super-charged facial service cleanses, exfoliates, extracts, hydrates, and infuses antioxidants and HA serums into the skin. After removing debris, customized serums and “boosters” are applied to your skin for drinking. In 60 minutes, you can achieve a smoother, healthier, more glowing complexion.
- EVE 4 in 1 – This all-in-one treatment is one of the best natural services for prejuvenation on the market today. It takes the HydraFacial to the next level by incorporating microdermabrasion and microcurrent technology to exfoliate, extract, hydrate, and stimulate collagen and elastin. It provides an extra boost of lifting and tightening and improves the skin’s texture, overall quality, and appearance.
- SkinTyte™ — SkinTyte™ renews collagen and elastin by generating energy from a laser (broadband light or BBL). Unlike other treatments, SkinTyte™ is designed for the face and body—anywhere with stubborn fat deposits and/or loose areas that could use tightening. This system is fast, painless, and doesn’t require time away from work or “normal” activities.
- PiQo4 laser by Lumenis® – The “4” refers to the wavelengths used to optimally and safely treat the widest range of pigment-oriented concerns among clients with diverse skin types. It is particularly appropriate if you have stubborn discoloration, like those large brownish-gray splotches that are so typical of melasma. These hard-to-miss patches can arise due to hormonal changes as we age or that occur with pregnancy. This technology presents a way for us to effectively fade melasma without depigmenting medications such as hydroquinone, which research has implicated as a risk factor for cancer.
- Microcurrent brow lift—This “next-generation” facial service is powerful in strengthening and building facial muscles. A low-grade electrical current increases circulation, nourishes the skin, and promotes rejuvenation from within by repairing damaged elastin proteins and remodeling collagen. When applied to the brow area, it tones and lifts the treated skin and muscles for a more sculpted look without going under the knife for a surgical brow lift.
- Microcurrent frown – We can turn those frown lines around by using the above technology as a needle-free alternative to Botox® and other injectables that may fill in wrinkles and depressions. This treatment’s effects are instant and cumulative – the more microcurrent you have, the better the results will be.
- Microcurrent lip – Microcurrent therapy is an alternative to injectables like dermal or soft tissue fillers to augment or define deflated or aging lips. This affordable and natural-looking boost is perfect for brides-to-be and busy professionals as it rejuvenates without the wait, downtime, healing, and risk.
- Hyperbaric Oxygen Therapy (HBOT): Stem cells are critical in repairing injured tissues and assisting in the healing process. When treating aged or sun-damaged skin, we can slow down the rate at which blood cells age by boosting the number of stem cells eight-fold over a typical course of HBOT therapy. Such high-pressure oxygen minimizes the overgrowth of old and malfunctioning cells in the body to combat visible signs of aging.
Feeling confused with all the treatments?
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We also offer an entire category of anti-aging treatments that harness special types of energy to fight new or worsening concerns and damage that we encounter in our 40s and beyond: Radiofrequency (RF) and ultrasound. These treatments use electromagnetic waves and acoustic energy to trigger beneficial ages deep in the skin. Examples include:
- TempSure® — By unleashing the power of Radiofrequency energy, we gently yet deeply penetrate the skin to renew tight and dense collagen. With a supply of better, fresh collagen, the look of wrinkled, lined, and lax skin is gradually improved without needles, downtime, and invasive surgery.
- FlexSure® – This RF-assisted procedure works wonders on the body. It is designed to shrink areas of stubborn fat. The energy generated during this process targets and destroys fat cells. Once destroyed, cells can’t “regrow” in the treated area. So, you can finally see a firmer, trimmer abdominal area, thighs, hips, and more improvements to localized pockets of fat.
- HIFU jowls—Our team may recommend High-Intensity Focused Ultrasound (HIFU) to restore a balanced, aesthetically pleasing facial shape. This innovative technology delivers targeted energy to areas like the lower face and jawline, commonly known as “jowls.” It effectively heats and repairs damaged tissues. The controlled and safe thermal energy promotes collagen production and encourages beneficial skin contraction.
- Scarlet® with PRP – Take your results to the next level! The Scarlet® system offers an innovative “twist” on conventional microneedling and Radiofrequency-assisted technologies. The RF energy is introduced to damaged and targeted tissue via small openings made by ultra-fine and sterile “micro-needles.” This process triggers tissue repair and stimulates the production of important skin components like elastin and collagen; however, we can elevate therapy further by introducing Platelet-Rich Plasma. Derived from your own blood, PRP is a concentrated “cocktail” of natural growth factors integral to tissue repair and wound healing.
- Hair rejuvenation – PRP may also be applied to regrow hair, stop hair loss, and boost your strands’ overall thickness and quality. You don’t have to undergo invasive surgery or hair transplants to get results. As appropriate, we can also discuss medications, supplements, lifestyle changes, and other therapies to restore the scalp health that supports your best-looking tresses.
Enjoy wisdom, not wrinkles! Contact Pua Manu MedSpa at (808) 900-4351 to schedule a consultation in Kapolei, HI.
Patient FAQ’s
Should I change my skincare regimen in my 40s?
That depends on several factors. First, if you are already following a regimen tailored to your needs by our team, minimal changes may be needed. If you incorporate aesthetic treatments into your routine, you may need to visit us more frequently due to increased needs as you age. For those who do not follow a professional skincare regimen yet, we recommend medical-grade products formulated for your skin type now (not what it was in your 20s). Our Skin Restoration and Stem Cell Factor Serum, for instance, promotes the production of collagen to address changes that become more pronounced in this decade.
What happens to collagen in my 40s?
This protein provides structural support to the skin, promoting its firmness and youthful, well-defined contours. Collagen is abundant until we reach our 20s when we make 1% less collagen each year. The process is accelerated among women in menopause. This transition usually starts in a woman’s mid-40s. Collagen declines by a staggering 30% during the first five years of menopause. When this happens, lines, wrinkles, and saggy skin look much more pronounced.
Is collagen loss the biggest issue in my 40s?
Facial fat loss is also a big challenge. Fat helps to provide structure and contour to our faces. When it is eroded due to the natural aging process (and the effects of sun damage and environmental stressors), hollow, sunken, and depressed areas surface. For example, deep undereye troughs make us appear perpetually tired. Changes in how fat is distributed also alter the shape of our faces, resulting in a heavy lower jawline as opposed to a balanced V-shape.
Why are my crow’s feet and frown lines worse?
Aside from collagen, your skin’s appearance depends on elastin. This protein supports the skin’s flexibility. When elastin is in abundance, your skin bounces back to its original form after it is stretched when making an expression. However, as elastin degrades with age and is further damaged by UV light from past tanning and sun exposure, the skin does not retain its shape as it once did. For this reason, crow’s feet may stick around even when you aren’t squinting, or frown lines are a permanent feature of your face, even when you are not frowning. These changes can make you always look angry, even when you are perfectly content.
Why is my skin so dry?
Hyaluronic Acid supports skin suppleness and softness. Unlike the above proteins, the body’s natural production of this molecule takes a dive with time. This process starts as early as age 20. So, by age 50, we will have lost half of our body’s HA. Since dry skin also tends to “age” you, making wrinkles look worse, HA can have a big and negative effect on the overall quality of our skin.
Why won’t my freckles go away?
A lifetime of tanning and sun exposure are likely to blame! In younger skin, freckles may only “come out” seasonally or during periods of intense sun exposure. As we age, the cells that produce the melanin pigment that gives our skin, eyes, and hair its color clump together. We may notice “age spots” larger than freckles and never disappear.
What can I do about these new or more apparent signs of aging?
The answer to question No. 1 is a good starting point. Of course, a good sunscreen (we like products by EltaMD) is essential in any decade. However, specific treatments or therapies to incorporate into your healthy skin regimen may include:
- For collagen loss – Next-generation microcurrent facials by TAMA, Scarlet and other energy-based devices (like ultrasound, Radiofrequency)
- For elastin damage – a combination of laser, microcurrent and facials on a regular basis
- For declining Hyaluronic Acid – Dermal fillers that contain HA, HydraFacials services, medical grade skin products and PRP (Platelet Rich Plasma)
- To fight excess melanin production – Laser and light-based therapies and medical grade skin products