Reviewed by The Wellness Team.
The skincare market sells hundreds of products, yet the ingredients with solid evidence behind them form a short list. If you are over 40 and want to spend where it counts, it helps to know what doctors actually recommend, and what is largely marketing.
This page sets out that short list, explains where the evidence is thinner, and shows when a consultation is worth more than another serum.
Sunscreen, the best evidenced step of all
Daily broad-spectrum sun protection is the one intervention with randomised trial evidence for slowing visible skin ageing. In a four and a half year trial of adults in Nambour, Australia, published in the Annals of Internal Medicine in 2013, people assigned to daily sunscreen use showed measurably less skin ageing than those using it at their own discretion.
A broad-spectrum SPF 30 or higher, used every morning and reapplied with prolonged exposure, does more for how skin ages than any cream sold at a counter. It also reduces the cumulative ultraviolet damage behind most skin cancers.
Vitamin A at night, the most studied active
Topical retinoids are the most studied treatment for photoaged skin. Tretinoin, the prescription-strength form, has randomised controlled trial evidence for improving fine lines, texture and uneven pigmentation, confirmed in a systematic review and meta-analysis of controlled trials. Over-the-counter retinol is a weaker cousin that converts to the same active form more slowly.
The standard routine doctors describe is a vitamin A product at night, started two or three times a week and built up as the skin tolerates it. Dryness and flaking in the first weeks are expected and usually settle. In the UK tretinoin is prescription-only, which is where a consultation earns its place.
Where the evidence is thinner
Vitamin C serums have plausible mechanisms and some supportive trials, but formulations vary widely in stability and strength, and the evidence is not in the same class as sunscreen or retinoids. Peptide creams, growth factor serums and collagen supplements sit further behind again, with small studies and results that are hard to reproduce.
None of this means every premium product is useless. It means the order of spending matters. Sunscreen and a retinoid first, gentle cleansing and moisturising alongside, and only then the extras if you enjoy them.
What a GP consultation can do for your skin
Most skin concerns start with a GP. A GP consultation can assess a new or changing problem, advise on an evidence-based routine for your skin type, and prescribe where a prescription-strength treatment is appropriate, including retinoids where suitable. The General Medical Council requires an adequate assessment before any prescription, so expect the doctor to ask proper questions and, for some concerns, to want to look at the skin by video or in person.
Where something needs a dermatologist or a procedure, you will be told honestly and referred. A changing mole, a rash that will not settle, acne that is scarring, or pigmentation that bothers you are all good reasons to be seen rather than to buy another product.
To talk to a doctor about your skin, enquire by WhatsApp, telephone or email.
What a consultation costs
A telephone consultation is £59, a video consultation £150 and an in-person GP consultation £220. For skin concerns a video or in-person appointment is often more useful, because the doctor can see what you are describing. The team will confirm the right format before you book.
Ask a doctor about your skin, call 020 3951 3429 or email team@thewellnesslondon.com.
Questions people ask
What skincare actually works after 40?
The two interventions with the strongest evidence are daily broad-spectrum sunscreen and a topical retinoid at night. Beyond those, a gentle cleanser and a moisturiser that supports the skin barrier cover the essentials. Everything else is optional and should come after the basics are consistent.
Is tretinoin available over the counter in the UK?
No. Tretinoin is a prescription-only medicine in the UK. Over-the-counter products contain retinol or retinal, which are related but weaker forms. A consultation is the route to prescription-strength treatment, and the doctor will check it suits your skin and explain how to introduce it safely.
How long does a retinoid take to show results?
Expect weeks of adjustment before any benefit, with visible improvement typically judged over three to six months of regular use. Early dryness and flaking are common and usually settle. Stopping at week three because of irritation is the most common reason people conclude retinoids do not work for them.
When should a mole be checked by a doctor?
Promptly, if it is new, changing in size, shape or colour, itching, bleeding or simply different from your others. Any of those is a reason to book rather than watch. Most moles turn out to be harmless, but that judgement belongs to a doctor who has examined it, not to a photograph compared with the internet.