When people talk about firm, bouncy skin, they usually mean the dermis, the layer beneath the surface. The dermis is held together by the extracellular matrix (ECM), a network that cells called fibroblasts build and repair.
What the ECM is made of
- Collagen, mostly types I and III, gives skin strength
- Elastin lets skin stretch and spring back
- Hyaluronic acid and other molecules hold water, so skin stays plump
What happens with age
From adulthood, the amount of collagen in skin falls slowly every year. Sun exposure speeds this up: UV light switches on enzymes that break collagen down, while the skin rebuilds more slowly than before. The result is thinner skin, fine lines and a loss of firmness.
What actually helps
- Daily sunscreen. In a randomised trial, adults who used sunscreen every day showed no detectable increase in skin ageing over 4.5 years, compared with the group that used it at their own discretion.
- Treatments that prompt skin to rebuild, such as some injectables, energy-based devices and microneedling, chosen to suit each person's skin.
- Looking after the whole body, including sleep and not smoking, because the skin rebuilds better when the body is in good shape.
If you are not sure where to start, the doctor can assess your skin and plan step by step.
