What can the skin really tell us about how we age — and when does a measurable biological change become evidence that we have actually influenced the ageing trajectory?
At the recent INNOCOS summit, BioAgeDiagnostics co-founder and Managing Partner Bettina van Wylich-Muxoll joined leading experts in skin biology, cellular ageing and longevity science for the panel “From Wrinkles to Resilience: What Skin Can Really Tell Us About Ageing.”
The discussion moved beyond wrinkles and other visible signs of ageing to address a more fundamental challenge facing longevity science:
How do we distinguish cosmetic improvement, biomarker change and genuine improvement in biological resilience?
Skin is one of the most visible manifestations of ageing. Wrinkles, pigmentation, loss of elasticity and changes in texture can all reflect processes occurring over time.
But appearance alone provides only part of the biological picture.
A central theme of the discussion was resilience: the capacity of a biological system to respond to stress, maintain function and recover.
This shifts the question from simply asking “How old does the skin look?” to asking:
How well does the system respond, adapt and recover?
At the cellular level, this may involve multiple interconnected processes, including mitochondrial function, inflammation, oxidative stress, cellular senescence, extracellular matrix remodelling and the capacity for repair.
Importantly, no single measurement captures all of these processes.
Skin may therefore provide a valuable biological window, but understanding ageing requires looking beyond isolated signals and towards the behaviour of biological systems over time.
Mitochondria were another major focus of the panel.
Their role extends far beyond energy production. Mitochondrial biology is closely connected with cellular stress responses, redox balance, signalling, inflammation and cellular adaptation — processes highly relevant to ageing biology.
This has also made “mitochondrial health” an increasingly common claim across longevity, skincare, supplements and therapeutics.
But the panel raised an important scientific distinction:
Demonstrating a change in a mitochondrial biomarker is not the same as demonstrating improved mitochondrial function — and neither automatically demonstrates that ageing has been reversed.
A biomarker can move for many reasons. Its biological significance depends on what is being measured, the validity of the endpoint, the magnitude and durability of the change, and whether that change corresponds with improvements in function or resilience.
This leads to a principle that is central to the BioAgeDiagnostics approach:
A biomarker moving ≠ ageing trajectory changed.
Much of healthcare still relies on biological snapshots: a laboratory value, a scan, a molecular measurement or a biological-age estimate taken at a single point in time.
These measurements can be highly informative. But longevity is inherently longitudinal.
If we want to understand whether an intervention is associated with meaningful biological change, baseline measurement is only the beginning.
We need to ask:
This is why longitudinal measurement is central to precision longevity:
Measure → Intervene → Re-measure → Verify.
The objective is not simply to generate more data. It is to determine whether an intervention is associated with a measurable and sustained change in biological trajectory.
One of the most important questions discussed by the panel was also one of the most challenging:
If a company claimed tomorrow that its intervention reverses ageing, what evidence should we require before considering that claim credible?
The longevity field is expanding rapidly, with interventions ranging from nutrition and lifestyle programmes to pharmaceuticals, regenerative medicine, peptides, devices and advanced therapeutics.
As the claims become more ambitious, the evidence supporting them must become correspondingly stronger.
A visible improvement is not necessarily evidence of systemic rejuvenation.
A change in one biomarker is not necessarily evidence of improved biological function.
And even a change in a biological-age measure does not, in isolation, establish that an intervention has altered the underlying ageing process.
Credible evidence should increasingly combine validated biomarkers, appropriate controls, functional outcomes, longitudinal follow-up and reproducibility. Where claims extend to systemic ageing, evidence across multiple biological systems becomes particularly important.
Ultimately, the question should not simply be:
“Did something change?”
It should be:
“What changed, what does that change mean biologically, and is the effect sustained over time?”
This discussion also reflects a broader challenge in biological-age measurement.
Ageing does not occur uniformly throughout the body.
Cardiovascular, metabolic, immune, neurological, reproductive and other physiological systems may follow different trajectories within the same individual. A single biological-age number can therefore be useful as a summary, but it may obscure biological heterogeneity underneath.
The same principle applies to skin.
Skin ageing is not one pathway, and systemic ageing is not one pathway.
For precision longevity, the opportunity is therefore to move from isolated measurements towards multidimensional biological profiles and longitudinal trajectories.
That means integrating different layers of biology — including genetics, epigenetics, metabolic biomarkers, clinical measurements and, increasingly, other molecular and real-world data — and understanding how they change together over time.
Bettina joined Dr Lieve Declercq, Chief Scientific Advisor of Proya Cosmetics and Vice President of Proya Europe Innovation Center, and Dr Maria Cavinato, Head of the Laboratory of Cellular Senescence and Skin Biology at the University of Innsbruck.
The session was moderated by Dr Dominik Thor, President of the Geneva College of Longevity Science.
Together, the panel brought perspectives from skin biology, cellular senescence, industry, diagnostics and longevity science to a shared challenge: moving the longevity conversation from compelling claims towards measurable biology, appropriate endpoints and credible evidence.
For BioAgeDiagnostics, that challenge extends far beyond the skin.
The future of precision longevity is not simply about measuring more biomarkers. It is about connecting those measurements to biological function, understanding how different systems interact, following those systems over time and determining whether an intervention produces a meaningful and sustained change.
Because measuring change is only the beginning.
The real question is whether we have changed the trajectory — and whether the evidence can prove it.