I’M A DERMATOLOGIST – HERE’S HOW I LOOK AFTER MY SKIN IN MY 40S, AND WHAT I AVOID

Dr Anjali Mahto is a leading consultant dermatologist, founder of the Self London clinic on Harley Street, and the author of the best-selling book The Skincare Bible.

For our weekly series, Life Lessons, she shares her own daily habits that are informed by her research and experience in the field.

Good skin is less about skincare and more about the basics

It’s too easy to make the outside look pretty with fillers and lasers and botox, but if you’re not working on the inside you’re still not doing yourself any favours.

Your skin, from a dermatology point of view, is about your metabolic health. As a middle-aged woman that’s probably going to be hitting perimenopause (I’m 46 now), I am aware of making sure I’m maintaining my muscle mass, I’m thinking about my circadian rhythm, I’m doing procedures that will help my skin and I’m not using too many products on my skin that are going to damage my skin barrier. To summarise: I train lots, I walk a lot, I have a protein-rich diet, I eat loads of plants, and I’m pretty disciplined about not sacrificing my sleep. It’s all about consistency.

We’re always chasing the next, new exciting innovation. But for me it’s all about the foundations. They’re not super glamorous but they are things that I think really matter.

Too many people over-exfoliate, and now they’re paying for it

It was very popular for a while to over-exfoliate. If we think back to the pandemic there was a push of all sorts of acids on Instagram: salicylic, glycolic, lactic, mandelic. The truth is that those acids are important – we’ve been using them in dermatology since the 70s, they’re not new – but without any kind of regulation, people started over exfoliating and using several in a week. Ultimately, we know that (surprise, surprise) people have wrecked their skin barrier from overuse of actives.

A prime example is that both acne and rosacea can look quite similar. If someone doesn’t know they’re rosacea-prone and follow online advice about salicylic acid, they’ll see their skin is getting worse and worse. That’s no fault of their own, but that information wasn’t applicable to them. 

Now, the advice I give to patients is about the protection of the skin barrier, because inflammation of that skin barrier is going to cause problems to the skin longer term.

Stress can wreak havoc on the skin, so I’m learning to slow down

It’s so important to be conscious of the impacts of chronic stress and working long hours on you, including your skin. There’s a slightly heroic attitude and a badge of honour to working quite hard, but there is pretty clear science that chronic stress, sleep deprivation and dysregulation of your cortisol levels undermine your long-term health – be that your skin ageing, your cardiovascular risk, or your immune function. We’ve got to be very careful of this idea that how productive you are is your health. You have to be mindful and self aware about it: ask, “Am I tired now? Do I need a break? How do I reset before I go again?”

I used to overwork a lot, particularly in my mid-thirties. Now I’m much better at asking myself, “Do I really need to be doing this with my time?” I’m also much better at saying “no” now – without explanation. 

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Improving your posture with strength training means better skin

We know now that muscle is probably one of the most important organs we’ve got for our long term health, but we still don’t think about muscle as a metabolic organ. I started lifting in my thirties, but I wish I’d started in my twenties. This is for several reasons – particularly for my posture. 

The way that a lot of us sit and work – with our head tilted slightly forwards and our shoulders rounded – is putting a lot of pressure on your spine. It also increases skin ageing and neck ageing. Your head is not supposed to be tilted so much and you’re adding weight to your neck muscle in a way that also increases crepe-iness of the neck, changing the neck much earlier than it should.

It’s got so many knock-on effects. I also want to have an open posture that helps my breathing. If I have rounded shoulders, I’m not properly using my diaphragm, my rib cage. Breathing is a really important part of stress management.

If you care about cellulite, lift heavy

In terms of aesthetics, too: if you have muscular legs, muscular glutes, and a lot of lean skeletal muscle mass, then overall the skin quality is going to look better. It’s going to look like you’ve got less cellulite and the stretch marks will look better. 

I don’t wear sunscreen until March

The most important part of my skincare routine is making sure I wash my face twice a day.  I am not fussy about what I use – it doesn’t have to be super expensive or super cheap. I prefer to use a foaming cleanser, rather than a cream cleanser, because I have slightly oily, acne-prone skin, and don’t want the residue left behind.

I moisturise daily, but I don’t wear a separate sunscreen in the UK at this time of year. Between the months of October and March, I am indoors most of the day. Plus, because we are at such a northerly latitude, and I have South Asian skin, it’s not going to burn in this weather. 

I also intermittently use a prescription retinoid at night. Other than that, I don’t use a lot of creams and serums. But given I own my own clinic, we have about 10 different laser devices which I use all the time. These devices penetrate deeper and are always going to be more effective than something you apply topically, which is also why I’m able to keep my routine as simple as I do.

Collagen is a waste of money and energy

I’m skeptical of people needing supplements. We don’t need a cupboard full of things if you eat well, you sleep properly, you exercise, and your diet is pretty inclusive. The only one I take regularly, at this time of year, is vitamin Dk2 in a spray. For people who don’t eat fish, I recommend omega three, and if somebody’s having issues with sleep then there is a bit of data on with magnesium.

I wouldn’t say that others aren’t worth it, but it’s very personal – if you’re vegan or plant-based you could do with iron, B12, B vitamins and omega-3.

Collagen supplements, on the other hand, are a waste of money. Until the data gets better, this is a hill I will die on. The flip side, though, is it’s not dangerous. If you want to take it despite me telling you it’s not worth your time or money, go ahead.

A good personal trainer is always worth it

I train with my PT three times a week and he is just fantastic. At 46, I am stronger and lifting heavier than I was at 36, and definitely at 26. He takes the guess work out of it for me. When I go and train with him, I put my phone away for an hour and there’s something so nice about being phone free, and not feeling guilty.

I’ve had a PT pretty much since my early thirties. Even when I was an NHS trainee, I chose to spend my monthly NHS salary on having a PT. That’s always been something that’s worth the investment for me.

Go for consistency over novelty

A lot of the benefits we see as wellness can actually trace back to just moving a little bit more, chilling out more, and living your life a bit more gently.

It’s all about consistency, even with skin. I have started to say to patients that it’s not going to be one treatment and suddenly your skin looks amazing. It’s like going to the gym once and thinking you’re going to be fit. There’s got to be maintenance and consistency with whatever you’re trying to do, whatever organ you’re trying to address – even your skin.

2026-02-14T06:49:03Z