Here is the full evidence-based protocol to reduce the visible signs of skin aging. This is not purely a cosmetic concern — research shows that how youthful the skin appears correlates with biological age and overall health outcomes.
If people see a younger-looking face in the mirror, they are more likely to identify as being young and practice those healthy life habits.
These eight strategies are structured to follow a typical daily routine.
Table of Contents
- Introduction
- (Strategy 1) Sunscreen After Shower
- (Strategy 2) Moisturizers with Ceramides and Vitamin B3
- (Strategy 3) Diet
- (Strategy 4) Hyaluronic Acid Supplements
- Absorption Debate and the 2023 Study
- Evidence from Randomized Controlled Trials
- (Strategy 5) Collagen Peptides Supplements
- (Strategy 6) Exercise
- (Strategy 7) Retinoids at Night
- (Strategy 8) Alpha and Beta Hydroxy Acid Exfoliants at Night
- References
Introduction
Here is the full evidence-based protocol to reduce the visible signs of skin aging.
This is not purely a cosmetic concern. Research shows that how youthful the skin appears correlates with biological age and overall health outcomes [1]. And if people see a younger-looking face in the mirror, they are more likely to identify as being young and practice those healthy life habits.
These eight strategies are structured to follow a typical daily routine, from morning to bedtime.
(Strategy 1) Sunscreen After Shower
After showering, the first of eight strategies is sunscreen. It is critical to choose a sunscreen with certain ingredients, because there are legitimate safety concerns with some formulations.
To illustrate the power of sunscreen, consider a striking photo of a 92-year-old woman who used sunscreen on her face but not her neck for over 40 years [2]. The contrast between the two areas is remarkable.
In a landmark 2013 trial of 903 adults, the group who used sunscreen every day showed no detectable signs of skin aging after 4.5 years [3].
A follow-up study in 2016 showed that using sunscreen not only stops aging of the skin but can even reverse visible signs of skin aging [4].
Sunscreen is critical, but there are legitimate safety concerns with some sunscreen ingredients.
Broadly speaking, there are two main types of sunscreens: mineral sunscreens and chemical sunscreens.
While chemical sunscreens often give better protection against UV rays, are easier to apply, and are water-resistant, many of their ingredients can be absorbed through the skin. A 2020 study showed that all six tested active ingredients were absorbed into the blood and were above the FDA's safety thresholds [5].
The American Academy of Dermatology acknowledges this in their guidelines, noting that the FDA wants more data on 12 ingredients before confirming whether they are safe and effective [6].
Many people choose to avoid those 12 ingredients until the safety data becomes available, and many others make a judgment call based on the balance of benefit versus risk.
These concerns have steered many people toward mineral sunscreen ingredients, which are not absorbed through the skin. However, even some sunscreens marketed as mineral-based can be misleading. For example, EltaMD is a popular choice marketed as a mineral-based sunscreen, but its ingredients list includes Octinoxate [7] — one of the chemical sunscreen ingredients flagged in the 2020 study. Additionally, octinoxate was banned in Hawaii due to its potential toxic effects on marine ecosystems [8].
The only two mineral sunscreen ingredients the FDA considers generally safe and effective are titanium dioxide and zinc oxide. Zinc oxide protects against both UVB and UVA, while titanium dioxide mostly protects against UVB.
So when selecting a mineral sunscreen, it is important to ensure it contains Zinc Oxide for broad-spectrum protection against both UVA and UVB rays.
No matter which sunscreen is used, the American Academy of Dermatology recommends reapplying it every two hours, or more frequently when swimming or sweating.
ConsumerLab.com maintains a list of mineral-based sunscreens that are broad spectrum and may be less problematic. Even so, it is worth checking the label of any specific product.
One option that meets the above criteria is CeraVe 100% Mineral Sunscreen SPF 50. It contains both titanium dioxide and zinc oxide, and none of the 12 flagged FDA ingredients [9] [10]. It is relatively affordable and widely available. One practical limitation is that it can leave a white film on the skin, which some people find cosmetically undesirable — particularly on the face.
There are also newer chemical sunscreen ingredients that offer the best of both worlds. One example is bemotrizinol (bis-ethylhexyloxyphenol methoxyphenyl triazine) [11]. It provides excellent UVA and UVB protection, but it is a large molecule that does not get absorbed through the skin. It has been used in sunscreens for decades in Europe and Australasia and is awaiting FDA approval in the USA [12]. This makes it an appealing option for people who want broad-spectrum coverage without the absorption concerns associated with older chemical filter ingredients.
Four well-regarded Korean sunscreen brands that use newer ingredients like bemotrizinol include options available at hikoco.co.nz, such as Beauty of Joseon Relief Sun and similar Korean formulations [13,14,15,16]. These brands have built a strong reputation precisely because they use photostable, non-absorbed UV filters that have been accepted in international markets for years. Any of those options would be a reasonable choice for those who have access to them.
For the body (arms, back of neck), mineral sunscreens like the CeraVe SPF 50 option remain a practical everyday choice where cosmetic finish matters less than on the face [10].
For swimming, mineral sunscreens tend to wash off too quickly to be practical. In that situation, a water-resistant chemical sunscreen such as La Roche Posay Anthelios XL Wet Skin SPF50+ [17] may offer better protection. Some products in this category contain FDA-flagged ingredients, but the balance of benefit versus the risk of UV radiation exposure is a decision each person makes based on their circumstances.
(Strategy 2) Moisturizers with Ceramides and Vitamin B3
The second of eight strategies to reduce the visible signs of skin aging is to use a moisturizer containing a couple of critical ingredients.
Ceramides are like the glue that holds skin cells together, keeping the skin barrier strong and healthy. A 2019 study showed that ceramides can reduce wrinkles and improve skin texture [18].
Another helpful ingredient is Vitamin B3, also known as niacinamide. Niacinamide can improve fine lines, wrinkles, spots, redness, and elasticity. It also helps the skin produce ceramides naturally [19].
A moisturizer containing both ceramides and niacinamide — such as CeraVe PM Facial Moisturizing Lotion [20] — applied a few minutes after sunscreen is a practical and well-supported choice. Applying it while the skin is still slightly damp can enhance penetration and seal in moisture more effectively. Many dermatologists recommend niacinamide-containing products as a daytime moisturizer because niacinamide does not degrade in sunlight the way some active ingredients do.
(Strategy 3) Diet
The third of eight strategies is diet.
No single diet will be perfect for everyone. However, clinical guidelines indicate that a diet featuring plentiful fresh fruit and vegetables, herbs, nuts, beans, and whole grains; moderate amounts of seafood, dairy, chicken, and eggs; and occasional red meat is associated with good skin health [21].
The diet fundamentals most supported by dermatology evidence are a diet high in lean protein and fiber, with unsaturated fats such as extra-virgin olive oil and avocados, while minimizing sugar, processed foods, and salt. Collagen synthesis in the skin is a protein-dependent process, so adequate overall protein intake is relevant not just for muscle but for dermal structure as well. Polyphenol-rich foods — including berries, green tea, and extra-virgin olive oil — also have emerging evidence for reducing UV-induced oxidative damage in the skin.
(Strategy 4) Hyaluronic Acid Supplements
The fourth strategy involves a supplement with strong evidence from human clinical trials for reducing skin wrinkles by up to 18%: Hyaluronic Acid (HA).
Hyaluronic acid is found in every connective tissue and organ in the body [22]. The skin contains the largest quantity of HA, with about 50% of total body HA present there. Unfortunately, the quantity of HA in the skin gradually decreases with age.
Rebuilding HA levels is comparable to adding new springs back into a mattress, restoring some of that original support and resilience [23].
Absorption Debate and the 2023 Study
There are two ongoing controversies around HA supplements:
1. Can the body actually absorb hyaluronic acid supplements?
In the 2000s and early 2010s, animal experiments demonstrated that HA supplements can be absorbed and distributed to the skin, bones, and joint fluid [25]. However, a 2023 study has significantly revised that understanding [26].
This 2023 study found that gut bacteria completely break down hyaluronic acid into short oligosaccharides and short-chain fatty acid metabolites, which are then absorbed. It appears to be those broken-down fragments — not intact HA — that influence skin biology [26].
Because the HA is broken down before absorption, purchasing expensive high-molecular-weight HA supplements is probably not necessary. Intact HA absorption appears to be very poor (~0.2%) [26].
Evidence from Randomized Controlled Trials
Despite the absorption questions, multiple human randomized placebo-controlled trials (from 2001 to 2023) show that HA supplements improve skin hydration and decrease wrinkles [22,27,28,29,30].
For example, a 2021 randomized controlled trial showed significant improvements in wrinkles and skin hydration with 120 mg daily of HA after 12 weeks [27]. Another 2021 trial showed an 18.8% reduction in wrinkle depth after only 28 days [28]. A larger 2023 trial with 129 participants again demonstrated skin improvements from HA supplements [30].
Safety Considerations
Some individuals may experience gastrointestinal discomfort. The most frequently raised safety concern relates to cancer. In single-cell studies, HA can fuel cancer cell growth, but in animal studies, giving HA supplements to tumor-bearing mice did not affect tumor growth [31,32]. Current data therefore support that orally administered HA is safe for most people.
Research on sodium hyaluronate — a stable, water-soluble form of HA with a smaller molecular size — indicates this form may have particularly good characteristics for absorption and bioavailability [23]. A daily dose of 200 mg sodium hyaluronate, taken with a meal, is the range used in several of the positive clinical trials.
From the MicroVitamin range
MicroVitamin includes 200 mg of sodium hyaluronate — the stable, smaller-molecular-size form used in clinical HA research — as one of its 25 evidence-selected ingredients. MicroVitamin.
(Strategy 5) Collagen Peptides Supplements
The fifth of eight strategies is collagen peptides, another supplement with strong clinical backing for skin health.
Evidence from multiple clinical trials shows that collagen peptide supplements reduce skin wrinkles by approximately 8% [33].
Collagen peptides are shorter, partially broken-down collagen proteins designed to aid absorption. Critics suggest that adequate dietary protein is sufficient, but research indicates specific peptide transporters help collagen peptides be directly absorbed and transported to the skin [34].
But does the evidence show that collagen peptides offer benefits beyond simply adding more protein?
In a 2020 randomized controlled trial of burn patients, one group was given standard protein supplementation while the other received collagen peptides. The collagen peptide group experienced a significantly higher wound healing rate, suggesting that collagen peptides do indeed have benefits beyond simply supplying amino acids [35,36].
A 2023 meta-analysis confirmed that collagen supplements improve skin hydration and elasticity [37].
Research trials have typically used doses ranging from 10 to 15 grams of collagen peptides daily.
(Strategy 6) Exercise
The sixth strategy is exercise. A 2023 paper examined resistance training's effects on skin aging and found that aerobic training improved skin elasticity and upper dermal structure — but not dermal thickness — whereas resistance training improved dermal thickness [38].
The overall picture from the research is that exercise has powerful effects on the skin, just as diet and sleep do. Prioritizing both resistance training and aerobic exercise appears to support skin health through complementary mechanisms.
(Strategy 7) Retinoids at Night
Coming to the end of the day, the seventh strategy is using a night cream containing retinoids.
Retinoids strengthen the skin's protective barrier, reduce water loss, and inhibit enzymes that break down the skin's structural proteins [39].
Tretinoin is the oldest and most studied retinoid. Approved in the early 1990s to treat fine wrinkles and uneven coloration from sun damage, a large review of 180 studies found that tretinoin improves signs of photoaging as early as one month after starting [40]. A case study showed striking improvements in just three months [41].
Adapalene is a third-generation retinoid that is highly targeted and causes less irritation. A 2018 trial showed that adapalene at 0.3% was equivalent to tretinoin at 0.05% for reducing visible signs of skin aging [42].
In most places, tretinoin requires a prescription. Adapalene 0.1% gel is often available over-the-counter, while 0.3% typically requires a prescription.
Retinol-based cosmeceuticals generally have a weaker evidence base compared to tretinoin or adapalene [43].
Retinoids are recommended for nighttime use because they can increase sun sensitivity and degrade when exposed to sunlight. They should be avoided during pregnancy. Common side effects include dryness, redness, and stinging, which typically diminish over time. Starting slowly — every third or fourth night — and gradually increasing frequency as the skin adapts is the standard approach.
(Strategy 8) Alpha and Beta Hydroxy Acid Exfoliants at Night
The eighth and final strategy is another night-time skincare approach: using exfoliants like lactic acid and glycolic acid. Over time, these exfoliants work on the deeper layers of the skin, promoting collagen and elastin regeneration and reducing the appearance of fine lines [44,45].
Both alpha hydroxy acids (such as lactic and glycolic acids) and beta hydroxy acids (such as salicylic acid) help remove dead skin cells and promote skin renewal.
Using both an AHA and a BHA on alternate nights — for example, twice a week — and leaving them on overnight is a protocol used in several dermatology studies [46].
For most people, using retinoid creams at the same time as AHA/BHA exfoliants on the same night is not recommended, as combining them can significantly inflame the skin. The approach is to use one or the other on any given night. Products such as Paula's Choice SKIN PERFECTING 8% AHA Gel Exfoliant & 2% BHA Liquid [46] are widely used for this purpose.
Completing the day with quality sleep rounds out this skin health protocol. Evidence consistently shows that sleep quality directly influences skin repair and regeneration.
References
[1] https://academic.oup.com/biomedgerontology/article/68/2/145/544529
[2] https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.17660
[3] https://pubmed.ncbi.nlm.nih.gov/23732711/
[4] https://pubmed.ncbi.nlm.nih.gov/27749441/
[5] https://jamanetwork.com/journals/jama/fullarticle/2759002
[6] https://www.aad.org/media/stats-sunscreen
[7] https://eltamd.com/products/uv-clear-broad-spectrum-spf-46
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648445/
[9] https://www.cerave.com/sunscreen/face/hydrating-mineral-sunscreen-face-lotion-spf-50
[10] https://amzn.to/4eWVJr6
[11] https://dermnetnz.org/topics/allergy-to-bemotrizinol
[12] https://www.usatoday.com/story/news/health/2024/05/17/fda-behind-sunscreen-skin-cancer/73672619007/
[13] https://hikoco.co.nz/collections/beauty-of-joseon/products/relief-sun-aqua-fresh-rice-b5-spf50-broad-spectrum
[14] https://hikoco.co.nz/products/birch-juice-moisturising-sunscreen-spf50-pa
[15] https://hikoco.co.nz/products/madagascar-centella-hyalu-cica-water-fit-sun-serum-spf50-pa
[16] https://hikoco.co.nz/products/black-rice-moisture-airyfit-daily-sunscreen-spf50-broad-spectrum
[17] https://www.chemistwarehouse.co.nz/buy/93032/la-roche-posay-anthelios-xl-wet-skin-spf50-250ml
[18] https://pubmed.ncbi.nlm.nih.gov/31585489/
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[20] https://amzn.to/3SqMEic
[21] https://dermnetnz.org/topics/collagen
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[23] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299688/
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[25] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512263/
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[27] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308347/
[28] https://pubmed.ncbi.nlm.nih.gov/34933842/
[29] https://www.jle.com/fr/revues/ejd/e-docs/oral_intake_of_a_new_full_spectrum_hyaluronan_improves_skin_profilometry_and_ageing_a_randomized_double_blind_placebo_controlled_clinical_trial_321540/article.phtml?tab=texte
[30] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661223/
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[32] https://pubmed.ncbi.nlm.nih.gov/24894153/
[33] https://pubmed.ncbi.nlm.nih.gov/36516059/
[34] https://www.sciencedirect.com/science/article/abs/pii/S0308814614002763
[35] https://pubmed.ncbi.nlm.nih.gov/31859087/
[36] https://eprints.iums.ac.ir/24135/1/The-effect-of-a-hydrolyzed-collagenbased-supplement-on-wound-healing-in-patients-with-burn-A-randomized-doubleblind-pilot-clinical-trial2020Burns.pdf
[37] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10180699/
[38] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290068/
[39] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/
[40] https://pmc.ncbi.nlm.nih.gov/articles/PMC9112391/
[41] https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/023010019.pdf
[42] https://pubmed.ncbi.nlm.nih.gov/30105991/
[43] https://academic.oup.com/asj/article-abstract/30/1/74/199813?redirectedFrom=fulltext
[44] https://dermnetnz.org/topics/alpha-hydroxy-acid-facial-treatments
[45] https://pubmed.ncbi.nlm.nih.gov/8784274/
[46] https://amzn.to/45YM1Q9
