Kream Elizabeth, Fabi Sabrina G, Boen Monica
Cosmetic Laser Dermatology, San Diego, California, USA.
J Cosmet Dermatol. 2025 Sep;24(9):e70432. doi: 10.1111/jocd.70432.
With the rise of regenerative medicine and geroscience, translational research has shifted focus from lifespan to healthspan-years lived in good health. Applied to aesthetic medicine, the authors introduce the concept of "skinspan," to both describe the period during which skin maintains a youthful, healthy appearance, and additionally to serve as a tool for the cosmetic consult.
The aim of this comprehensive review is to illuminate "skinspan" as a framework for guiding long-term skin health. The authors review the molecular drivers of skin aging along with appraise current evidence-based interventions and synthesize evidence into an algorithm to expand skin span.
A comprehensive literature review was conducted to examine the molecular hallmarks of skin aging: genomic instability, mitochondrial dysfunction, cellular senescence, and proteostasis decline, and how they are targeted by lifestyle modifications, pharmacologic agents, and aesthetic procedures. Each intervention discussed in this paper is categorized based on the strength of the available evidence for augmenting skinspan.
Proactive interventions, including lifestyle interventions, topical agents, systemic therapies, and noninvasive procedures, show promise in mitigating aging mechanisms and preserving skin health. We recommend a first-line strategy of sun protection, topical retinoids, and antioxidants. Second-line interventions include laser and energy-based devices. Clinicians may also consider emerging therapies-including stem cell-based treatments, sirtuins, nicotinamide, and natural SIRT activators-as adjunctive third-line add-ons, while continuing to monitor the evolving evidence base.
The skinspan framework offers a holistic, evidence-based approach to skin longevity, promoting prevention, continuity of care, and patient education beyond isolated aesthetic interventions. To expand skinspan based on current evidence, we recommend a first-line approach of sun protection, topical retinoids, and antioxidants. Second-line interventions include procedures such as laser and energy-based devices. Clinicians may also consider emerging therapies-including stem cell-based treatments, sirtuins, nicotinamide, and natural SIRT activators-as adjunctive third-line add-ons, while continuing to monitor the evolving evidence base. A need exists for more randomized controlled trial studies to strengthen the evidence base.
随着再生医学和老年科学的兴起，转化研究的重点已从寿命转向健康寿命——即健康生活的年限。应用于美容医学领域，作者引入了“皮肤寿命”的概念，既用于描述皮肤保持年轻、健康外观的时期，也作为美容咨询的一种工具。
本综述的目的是阐明“皮肤寿命”作为指导长期皮肤健康的框架。作者回顾了皮肤衰老的分子驱动因素，评估当前基于证据的干预措施，并将证据整合为一种算法以延长皮肤寿命。
进行了一项全面的文献综述，以研究皮肤衰老的分子特征：基因组不稳定、线粒体功能障碍、细胞衰老和蛋白质稳态下降，以及它们如何通过生活方式改变、药物和美容程序来靶向改善。本文讨论的每种干预措施都根据增加皮肤寿命的现有证据强度进行分类。
积极的干预措施，包括生活方式干预、局部用药、全身治疗和非侵入性程序，在减轻衰老机制和保持皮肤健康方面显示出前景。我们推荐防晒、局部维甲酸和抗氧化剂的一线策略。二线干预措施包括激光和基于能量的设备。临床医生也可考虑将新兴疗法——包括基于干细胞的治疗、sirtuins、烟酰胺和天然SIRT激活剂——作为辅助三线补充措施，同时继续监测不断发展的证据基础。
皮肤寿命框架为皮肤长寿提供了一种全面、基于证据的方法，促进预防、持续护理以及超越单纯美容干预的患者教育。为根据当前证据延长皮肤寿命，我们推荐防晒、局部维甲酸和抗氧化剂的一线方法。二线干预措施包括激光和基于能量的设备等程序。临床医生也可考虑将新兴疗法——包括基于干细胞的治疗、sirtuins、烟酰胺和天然SIRT激活剂——作为辅助三线补充措施，同时继续监测不断发展的证据基础。需要更多的随机对照试验研究来加强证据基础。
