with CoverGirl was a huge success. She said: ‘CoverGirl is part of my DNA and I’m thrilled to be back with my family. I’m excited to promote a new product developed specifically for women like me, who want flawless coverage combined with the latest science in skincare. I’m looking forward to working with the brand at a time when there is so much innovation.’ But there is as little real evidence for the benefits of agents that prevent facial ageing as there is for medical treatments.

In April 2009 there was a report that a new product from the chemist Boots, which works by stimulating the production of a protein that promotes skin elasticity, made a significant difference to the wrinkles of 70 per cent of volunteers aged between 45 and 80. This was a properly conducted trial by the University of Manchester and so seems an important advance. It led to a stampede to Boots’ shops which is still continuing. In one month, February 2010, Boots sold more than 700,000 anti-ageing creams. However, other experts say that only one in five users will get something more than from using common moisturisers. A new product of a quite different nature is a device that electrically stimulates the muscles in the face; there are claims that it is safer and more effective than plastic surgery, and acts due to stimulation of the facial muscles, but there are no reports of proper trials.

The links between ‘expert opinion’ and the commercial interests behind a product are always worth considering. A recent report in the Boston Globe said that when a 73-year-old patient recently asked a prominent dermatologist how she could look more youthful, he had a ready answer. He suggested she visit a drugstore across the street to shop for a specific brand of anti-ageing, wrinkle-fighting, and lip-plumping creams. The products were part of the doctor’s own line of cosmetics.

The use of wrinkle creams twice a day can plump up the skin temporarily, which causes the wrinkles to be less visible. These creams may also be excellent moisturisers, and they may smell and feel good. But no matter how expensive they are and no matter what they claim to do, they won’t turn back the clock. An important way to avoid wrinkles is to practise sensible sun avoidance and use sun screen. Yet are wrinkles really such a terrible sign of ageing compared to certain other indicators?

Weight and other factors can affect how one looks. A study in the USA of the photographs of 186 pairs of identical female twins together with detailed interviews showed surprising results. One twin aged 70 could look six years younger than her sister if she had more weight, as this filled in the wrinkles on her face. Antidepressants and alcohol made a twin look older, as did suntan and cigarettes. Before 40, the lighter twin looked younger and more attractive, but over 40 the heavier twin looked younger, the weight difference being about 24 lbs. So it may well be that what you eat has a more beneficial effect than what you dab on your skin in the war against wrinkles. But being overweight, of course, can have many ageing effects on one’s health.

There are studies that suggest that hair is more important than wrinkles in judging someone’s age—it can make a differences of 4 to 5 years in one’s appearance. Also important is the fullness of lips, which makes a face appear much younger and is almost entirely determined by a person’s genes. This accounts for the large number of cosmetic surgery procedures for lips, some leading unfortunately to ‘trout pout’.

It is reassuring to learn from the attitude surveys that many think real beauty comes from the inside, not the outside. And in spite of the enormous amounts of facial treatments to avoid looking old, there are those who argue that we should learn to live with this universal process. Anne Robinson, a well-known TV presenter in her 60s, had a facelift at 61 and currently uses Botox. An article in the Daily Mail recognises that it is tough to still be a TV presenter at her age; but would it not be better, it argues, for someone like Robinson, who is a role model for women, to champion the rights of women as they grow old? When women like her resort to cosmetic surgery it puts unwelcome pressure on women of a similar age. As a cosmetic surgeon comments, facelifts are dangerous, and he is dismayed that injectible fillers for wrinkles are advertised on TV.

All these procedures can lead to an obsessive desire to achieve an ideal beauty. An article in the London Evening Standard offered ten tips to make ladies look ten years younger: remove dead cells from your skin using a wrung-out face cloth every night; fill out the volume of your face with injections; get baby Botox to get rid of embedded frown lines; wear sunscreen every day; use an expensive serum to exfoliate; get rid of uneven skin tone using a light concealer; get made up by an expert; get advice on hair colour and shape; tint eyelashes and eyebrows; make sure your teeth are a harmonious shade of pale. How much time will be left in the day for life’s other pleasures?

Oscar Wilde found a way to prevent the signs of ageing in The Picture of Dorian Gray. Dorian is a cultured, wealthy, and exceptionally good-looking young man who has his portrait painted. He curses his excellent and attractive portrait, which he believes will one day remind him of the looks he will have lost as he ages. In a fit of distress, he pledges his soul if only the painting could bear the burden of age and infamy, allowing him to stay young for ever. This wish is fulfilled and he does not show signs of ageing, but the portrait does. Only when he dies does the portrait turn back to a youthful image, while his body show all the wrinkles. A well-known quotation from the book says: ‘The tragedy of old age is not that one is old, but that one is young.’

Perhaps Lucille Ball got it right: ‘The secret to staying young is to live honestly, eat slowly, and lie about your age.’

10. Treating

‘Age appears to be best in four things: old wood best to burn, old wine to drink, old friends to trust, and old authors to read’

— Francis Bacon

Evolution cares not for the old once they no longer contribute to reproduction or the care of those who can reproduce. And while love for children is universal and genetically determined, since reproduction is what life is for, attitudes towards the old are not. How the old are treated can vary in different cultures; even within a single society people do not look upon the aged as belonging to one clearly defined category, and attitudes are diverse.

Largely as a result of increases in retirement age, and of people living and working longer, attitudes to ageing and being old have changed, and nobody really knows what ‘old’ is any more. A recent UK survey found that, on average, the public believed that ‘youth’ generally ends at 45 years of age, and that ‘old age’ starts at 63 years of age. Older respondents considered that youth continues longer and old age starts later than did younger respondents. The oldest age group of those in the survey thought that old age started at just over 70, whereas the youngest group estimated old age started at around 55. In terms of the end of youth, the oldest estimated age for this was 57, whereas the youngest was 37. Categorisation of ‘old’ and ‘young’ is so variable that an older person assumes someone is still in their youth at 57, whereas a younger person assumes that by this age they are already old. Ageing now happens more slowly, and people get ‘old’ later. This post-modern attitude to ageing reflects a feeling that while ageing comes to everyone, how you deal with it by keeping active, both physically and mentally, can put off ‘getting older’. But there are many views that make those who are ageing, and particularly women, refuse to tell even friends their true age.

‘Implicit ageism’ is the term used to refer to the unconscious negative thoughts, feelings and behaviour relating to older people. Becca Levy, whose research explores psychosocial influences on ageing, focuses on how psychological factors, particularly older individuals’ perceptions of ageing, affect cognition and health in old age, and reports that they ‘tend to be mostly negative’. One can compare these attitudes with those of the Nambikwara Indians, who live in the south-western part of the Brazilian Amazon, and who have only one word for young and beautiful, and another for old and ugly. The old are on the whole viewed as physically unattractive. This makes sense, as since the old no longer reproduce, from an evolutionary point of view they have lost all beauty; but they can help children and younger people, which does not require attractiveness.

* * *

It is far from clear whether views of the old in ancient times have affected modern views. In ancient Greece, Sophocles, Euripides and Plato lived productively into their 70s, and the views they espoused of the elderly were positive and respectful. But we should remember that there were only a few old in those times, with life expectancy being around 30, and half of those born not passing the age of 10. The chief killers were infectious diseases such as

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