From the Guidelines
Facial age is not a reliable clinical indicator of biological age, and while it can be improved, the underlying biological aging process cannot be reversed through facial treatments alone. When considering the relationship between facial age and biological age, it's essential to look at the broader context of overall health and lifestyle factors. According to a recent study published in JAMA Oncology 1, several social and behavioral modifiers of biological aging, such as obesity reduction, increased physical activity, better sleep health, and reducing socioenvironmental adversities, can improve outcomes and potentially decelerate biological aging.
Some key factors that can influence biological aging and potentially improve facial appearance include:
- Stopping smoking and increasing physical activity, which have evidence for improving health and may directly decelerate biological aging 1
- Calorie restriction, intermittent fasting, and consuming foods rich in antioxidants, which are being tested in gerontology research for their potential to decrease biological aging 1
- The use of drugs like metformin and senolytic agents, which may also decrease biological aging and lower the risk of cancer progression 1
While these interventions can contribute to overall health and potentially improve facial appearance, effective treatments for improving facial age include a combination of topical retinoids, broad-spectrum sunscreen, antioxidant serums, and consistent moisturizing, as well as more aggressive interventions like chemical peels, laser resurfacing, injectable fillers, and neurotoxins. Lifestyle factors such as avoiding smoking, limiting sun exposure, maintaining adequate hydration, eating a balanced diet rich in antioxidants, and getting sufficient sleep also play a crucial role in healthier-looking skin. However, it's crucial to understand that these approaches primarily address the symptoms of facial aging rather than the underlying biological aging process.
In real-life clinical practice, prioritizing interventions that address overall health and biological aging, alongside treatments specifically targeting facial aging, can offer the most comprehensive approach to improving both facial appearance and overall well-being. This multifaceted strategy acknowledges the complex interplay between biological aging and facial appearance, aiming to enhance quality of life and reduce morbidity and mortality by addressing the root causes of aging rather than just its visible symptoms.
From the Research
Facial Age as a Clinical Indicator
- Facial age can be a reliable clinical indicator of biological age, as it has been shown to be correlated with overall survival and prognostic performance in cancer patients 2.
- A deep learning system, FaceAge, has been developed to estimate biological age from face photographs, and it has demonstrated significant independent prognostic performance in a range of cancer types and stages 2.
Reversing Facial Age
- Certain skincare regimens, such as those containing retinol, adenosine, and hyaluronic acid, have been shown to provide beneficial effects on facial age, including improved skin smoothness and reduced fine lines and wrinkles 3.
- Botulinum toxin injections, combined with skincare regimens, can also provide beneficial effects on facial age, including improved skin appearance and reduced signs of aging 3, 4.
- Understanding the molecular and cellular mechanisms of facial aging can help identify specific targets for developing new treatment strategies to slow or impede the aging process 5.
Clinical Scales for Evaluating Facial Age
- There are over 100 clinical scales available for evaluating skin aging, but many of them have limited evidence supporting their measurement properties 6.
- The development of new instruments should be justified, and existing ones should be investigated for scale behavior using appropriate methods 6.
- Future research should aim to select and/or adapt existing scales to identify the "best" scales for clinical research and practice 6.