Three very burly men meet in a dimly-lit bar…
They don shaggy beards, loose t-shirts, and generic jeans.
They greet each other with strong handshakes and order beer.

And the inevitable question arises when I meet them, “So…what do you do?”
I reply, “I play with people’s faces,” which draws their curiosity. I explain, “I am a cosmetic physician … I sculpt people without the use of surgery…you know, botox, fillers, and lasers.” Then I flash a large smile, and await their response.

Most guys get a little uncomfortable and half-jokingly ask if I can give them fuller lips. But a bizarre phenomenon unexpectedly occurred that night…these guys started talking about how much botox they use to tame their angry 11’s. They asked how much I charge for botox. They asked what else I would recommend for them.

I was floored, yet felt quite honored to have been privy to such information. I honestly didn’t believe heterosexual men would be discussing such things so freely…with a total stranger…and with other heterosexual men…in public. It was like I was on National Geographic.

But, I digress…

Why is it that men seem to age more gracefully than women do? Women experience a precipitous decline in the female sex hormones during menopause. The ‘male menopause’ or ‘andropause’ condition has been in the limelight recently. However, this is not a proper representation of the changes associated with aging males. True, men do experience declines in hormonal levels but not nearly to the extent that females do. Their testosterone promotes a better foundation (bone density and muscle mass) to their faces from the start, so the skin has more to hold on to than women’s when things start to go south.

Men today are feeling the pressures that many women are already used to. Working later in life means competing with younger men in the workforce and the playing field. Trends in the cosmetic procedures also reflect these changes. Men are heading to their doctor’s offices to get nipped, tucked, and polished before heading out for a second chance.

Here is the Handy Dandy Guide to Men’s Skin – Basic Skin Tenets for all humans…

• Stay hydrated, meaning half your body weight in ounces (80 ounces if you weight 160 lbs) as a baseline, PLUS two cups of water for every cup of caffeine or alcohol…and more if you exercise.
• Cleanse (wash) your face and body
  • Don’t borrow your significant other’s…you’re probably not the same skin type. And don’t use Dial Soap or other harsh body washes. Most thoroughly in the evening…use a face cleansing brush (looks like a mushroom brush … okay, looks like a really large toothbrush) with nice soft bristles to flick the dirt and oil out of your pores, so they can appear smaller
    Splash with lukewarm water after working out … helps prevent acne.
• Sunblock: spf 30 minimum.
• Apply 30 minutes prior to exposure.
• Reapply every hour (the waterproof version is good for only 80 minutes) while exposed.
• Don’t forget the back of the neck and ears (those baseball caps won’t protect them), and hands.
• Remember, most clothes have a UPF of 5, so apply SPF on your skin underneath. Another defense tactic: Wash your clothes with a laundry additive called SunGuard (sunguardsunprotection.com). One wash gives any shirt an SPF of 30—the same as a UV-shielding shirt—and the protection lasts for 20 wash cycles.
• Despite your thicker skin, American men have a greater incidence of skin cancer than women.
• And, this should go without saying … avoid tanning booths … they are pure cancer boxes with unadulterated UVA(ging) and UVB(urn=cancer) rays
• Look for lighter versions of sunblock that do not clog skin … give it a week to get used to wearing a moisturizer…it will feel heavy at first, then your skin will realize it’s helpful, and accept it.
• Do not smoke cigarettes … even secondhand. You’re just asking for a whole lot of badness, skin- and health-wise.
• Get enough sleep. It will help keep off the weight (control Leptin levels) and allows for your body to do its remodeling and regenerating. Guys need beauty sleep too!
• Exfoliate. Our skin does not turn over as fast as we age. Exfoliate mechanically with a face brush or microdermabrasion (sand-blasting), or chemically with Alpha Hydroxy Acids or retinoids at home, or chemical peels in the office. Retinoids, compounds related to vitamin A that seem to work by inducing collagen production in the dermis and altering melanin, the pigment that causes liver spots. This helps you maintain an even and bright complexion. Men, fortunately, exfoliate with a razor every day, so limit the exfoliation to the upper half of your face.
• Avoid alcohol. It dries out your cells and often leads to poor choices.
• De-stress with exercise, yoga.
• Exercise consistently. Past the age of 40, we lose approximately one percent of our muscle mass each year. Laxness of facial muscles and loss of muscle mass are just two factors that lead to facial sagging. Our facial bones continue to change over time, with some expanding, and others slowly breaking down or melting away in a process called retrusion. Exercise helps build bone and muscle mass.

Concerns specific to the aging male…

Receding hairline. This process can be delayed by the use of rogaine and propecia. Hair transplants usually begin in the thousands of dollars.
Ear hairs. Tweezing or laser hair removal.

Droopy eyelids. CO2 fractional laser can be used near the eyes to build collagen and strengthen and tighen the skin around the eyes. Blepharoplasty is a surgery that removes excess tissue and sometimes fat pads from the eye area. If the ptosis is severe enough, your insurance may cover the cost of this surgery.

Jowls. Mesotherapy can be used to dissolve spot fat. Liposuction is usually avoided above the jawline due to the salivary glands and nerves in the area. Skin Tightening with the IPL, or the CO2 fractional laser also help tighten the skin;.

Pseudofolliculitis (ingrown hairs from shaving) can be reduced by shaving in the direction of the hair growth to prevent driving bacteria under the hair follicle. Also, use a single blade or a blade covered with wire; shave every other day, if possible. Unless you feel compelled to grow out all your facial hairs and have a wild man experience, you may consider doing laser hair removal (at least on the neck) to reduce your chances of nicking yourself and creating lifelong scars.

A related condition, pseudofolliculitis nuchae, occurs on the back of the neck, often along the posterior hairline, when curved hairs are cut short and allowed to grow back into the skin. As for aftershave and moisturizer, you need to use both. All aftershave really does is returns the pores to a normal size; moisturizer keeps the skin from dehydrating.

Gynecomastia (aka Man Boobs) are usually present with obesity and are a result of testosterone being converted to estrogen. Get your hormones balanced, then address the cosmetic appearance with mesotherapy to dissolve the spot fat, or liposuction.