An all-inclusive pathway to better health

The evolving field of longevity science and its intersection with regenerative aesthetics is creating a vibrant path within cosmetic dermatology. New insights continue to support the long-held theory that skin health reflects systemic wellness, and that early intervention may be the key to aging better and longer.

According to Saranya Wyles, MD, PhD, director of the Regenerative Dermatology and Skin Longevity Laboratory at the Mayo Clinic in Rochester, Minnesota, the shift from focusing solely on lifespan to enhancing health span — the quality of life during aging — is rooted in prevention, especially in preserving the skin’s structure and function.

“It’s about preservation, especially in a regenerative organ like the skin that constantly faces external insults,” Dr. Wyles said. “When we talk about the ‘longevity dividend,’ we’re referring to the final decade of life, which for many is marked by chronic diseases like diabetes, heart failure, and cancer. The real challenge is: How do we compress or delay that period so people can live not just longer, but healthier, more fulfilling years?”

The skin as a portal to systemic health

The health span concept is driving our goals to start as early as our 20s and look at preventive and reparative measures like regenerative medicine, Dr. Wyles said. The skin offers critical clues to internal health, she said, and dermatologists can often detect signs of diabetes, cancer, or vascular dysfunction by observing the skin.

Saranya Wyles, MD, PhDDr. Wyles believes that healthy habits are gateways to beauty and healthy skin, and she encourages her patients to develop healthy living routines, such as a balanced diet and exercise, as well as to manage existing chronic diseases that benefit both appearance and overall health.

From a cosmetic dermatology approach, there are other regenerative measures dermatologists can do to reduce the longevity dividend of the skin, including platelet exosomes, skin-relevant peptides, growth factors, and polynucleotides, although the contents may be variable, Dr. Wyles said.

“Regenerative aesthetics is a toolkit — ways that we can utilize these different sources, typically from the body,” she said. “These are signals that are human sources, and the idea is how to improve better signaling in the body and repair.”

The ABCs of regenerative aesthetics

Using a vivid analogy, Dr. Wyles described amino acids as letters; peptides as words; and growth factors as sentences; each representing increasing levels of biological signaling. Although growth factors launched the regenerative aesthetics movement, peptides offer a more sustainable and versatile approach, she said, noting the game-changing use of the GLP-1 analog peptide as injectable drugs for metabolic disease.

However, peptides are more singular in action and are more difficult to break the skin barrier, Dr. Wyles said, making them less beneficial in all cosmetic instances. That’s where exomes shine — to an extent.

“Exosomes can be called the ‘greatest story of trash-to-treasure,’ since we discovered them as cell debris in the 1980s,” she said. “Their cell-free communicator properties may be gaining attention for their regenerative potential, but this is only speculation, currently.”

Dr. Wyles cautioned against unverified claims of exosome “miracle drugs,” urging transparency and scientific validation when choosing to use such products.

Then there are polynucleotides. These DNA fragments, often derived from sources like salmon sperm, have been implicated in pathways promoting collagen synthesis and reducing oxidative stress. Yet, she warned that marketing claims often outpace science, and none of these products are FDA-approved for injection in the United States.

“All of these tools have brought us to a very exciting convergence in time of regenerative medicine and longevity science,” Dr. Wyles said. “I would say that although the prospects are bright, dermatologists need to be cautious about their use, regulatory status, and whether it’s right for the patient.”

The aging cell’s ripple effect and conquering cellular senescence

Carolyn I. Jacob, MD, FAADIn further assessing regenerative cosmetic tools, Carolyn I. Jacob, MD, FAAD, said she believes all signs point to the positive effects of new technology to conquer cellular senescence — the point at which, “aging cells stop dividing and begin leaking inflammatory signals.” Dr. Jacob is founder and director of Chicago Cosmetic Surgery and Dermatology and clinical assistant professor of dermatology at Northwestern Feinberg School of Medicine.

“It’s like one bad apple spoiling the bunch. This process contributes to visible aging and skin deterioration and is now a key target for both topical and device-based interventions,” she said.

Because markers such as P16, CDKN2A, and lamin B1 help identify senescent cells, treatments aim to reduce these markers and promote healthier, more youthful skin.

Dr. Jacob highlighted several new topical peptide and bioactive complex products designed to combat cellular senescence:

• OS-01 peptide: This peptide from OneSkin is included in eye and face creams to help rejuvenate skin at the cellular level.
• Octapeptide-45 and magnolol: Featured in TriHex Technology 2.0, this is part of Alastin’s new Restorative Skin Complex.
• BioBlend technology: Used in INVO’s Rejuvenating Complex, this blend calms senescence markers and promotes collagen and elastin growth.

“These aren’t chemicals, they’re peptides,” Dr. Jacob said, noting their low risk for irritation and suitability for sensitive skin.

She also shared two device-based solutions, citing their noninvasive, high-tech benefits:

• SoftWave is a parallel ultrasound beam technology with a larger handpiece for treating broader areas and stimulating collagen production.
• EmFace Eye, by BTL, is a low-and-slow radiofrequency and high-intensity electrical stimulation device that tones undereye muscles and reduces wrinkles and puffiness, without needles, downtime, or topical products.

“These results are dramatic,” Dr. Jacob said, with the caveat that the treatments are still new and their impact on skin damage due to chronic disease is not yet proven. She reminds her patients that maintaining healthy skin may help reduce risks of skin cancers and inflammatory conditions.

“It’s like going to the dentist,” she said. “You get the treatment you need, but you still need to brush and floss at home.”