Longevity Medicine in Dermatology: Prevention, Diagnostics, and Evidence-Based Innovation

Dominik Thor discusses how longevity medicine may shape the future of dermatology by shifting care from reactive treatment to preventive, healthspan-focused strategies. Learn how multi-omic testing, AI-driven decision support, and continuous monitoring may help personalize aesthetic and dermatologic interventions, while clinicians balance patient demand for peptides, GLP-1s, and advanced therapies with evidence, safety, and regulatory considerations.

TRANSCRIPT

My name is Dominik Thor. I'm the president of the Geneva College of Longevity Science, which is the first educational institute in the world focusing entirely on longevity science. I also happen to be a visiting professor at Mayo Clinic and at Carol Davila University in Bucharest.

How do you see longevity medicine—particularly the shift from reactive to preventive, healthspan-focused care—impacting dermatology practice in the near future?

Dr Thor: Well, very much so. I think the impact is there because the patients are extremely interested in that. And I think it's an opportunity for us in order to ensure a trajectory that ensures healthy aging for all of us, because dermatologists or aesthetic practitioners usually see patients who are of a younger age who are not yet afflicted by age-associated disease. So, there is an opportunity to detect if something is off and maybe send them off towards a specialist. I think from a more aesthetic point of view, what's really important is that once you understand the drivers of aging, the hallmarks of aging, and what they are doing to your body, even in a way that is not visible, it is going to impact the outcome of aesthetic procedures. So very often you see patients where you don't achieve, as a practitioner, the optimal outcome, and that is not your fault, that is basically the fault of the biology of the patient who is not ready for the intervention. So, instead of simply having all your patients undergo the same procedures simply because, it's much better to focus and do it in a more personalized fashion. And if you use diagnostics, you might understand the level of inflammation in their bodies, chronic, low-grade inflammation, what we call inflammaging, which is one hallmark of aging, that might prevent these procedures from having the best outcome.

With tools like multi-omic testing, AI-driven decision support, and continuous patient monitoring emerging, which technologies are most relevant for dermatologists today?

Dr Thor: Well, the thing is, patients are looking for longevity interventions. This is why they come to the practice, and very often they use ChatGPT or other AIs to build a shopping list of peptides or other things they want to see prescribed. The fact is that from an interventional perspective, we have limited things that actually work where we have data that shows safety and efficacy. So we are down to very often using lifestyle interventions, right? Advice on how to lead better lives and to prepare yourself as you grow older. I would say that, of course, there are still things that you can do from an interventional side that make a big impact, but right now, this is where we are at. It's diagnostics. It's about a better understanding of the patient in order to time and select the interventions that you have available to you at the moment. Some of them are extremely interesting, so I think GLPs are a category of drugs that is now being prescribed a lot. I think in many cases it's not necessary. In other cases, it's extremely interesting or beneficial to a patient's health. And it's not just relevant from, let's say, an obesity perspective. It also impacts many of these so-called pathways of aging or hallmarks of aging and can give you better chances at healthy aging. But at the same time, it impacts the structure of the tissue of the skin. You see that fat loss, especially in the face area, can become a problem. Once again, it has to be a holistic move towards a better understanding of the patient using longevity technology, as in modern diagnostics, to make sense out of all of that.

Given the rapid growth of longevity interventions—from lifestyle optimization to advanced therapies like peptides and gene editing—how should clinicians navigate the balance between evidence-based care and innovation?

Dr Thor: Well, I think, first off, doctors need to understand the regulatory environment that they are in. We as a school educate. couple of hundred of doctors from across 45 countries now and some of these countries allow basically everything that you can think of. In Southeast Asia, you have countries where you have exosomes, peptides, stem cell interventions, and even gene editing, theoretically available to patients. In other jurisdictions, like Switzerland, where we are from, it's extremely strict. I would say that in the US, now the current administration is a little bit more in favor of some of these things, I'm talking about the peptides, and there is, which is a fact, of course, a lot of people that are using them already, getting them from gray market sources, sometimes with a dubious quality attached to them. So, what, as a doctor, you can do if a patient comes up to you, there is a good chance that they are going to do it anyway. So, when we're talking about the peptides as maybe the most popular category, if you get to talk to a patient and they come with that kind of shopping list that I mentioned before, they are doing that maybe already. So, I think what is most important is that you try to get good information on that, and by good information, I don't mean going on the internet and listening to some podcasters, but actually looking up results that you have in scientific literature. And this is basically what we are here for because a lot of doctors know where to get that information, but they simply don't have the time to do the research. So, the Geneva College of longevity science is basically all about filtering out the noise, the wrong information there is, and get you a better understanding of what could potentially work.

In terms of the peptides, I'm always coming back to that category because it, I think, is the one that is dominating the public discussion or the discussion with the patients as of now. The thing is, we have a lot of data that is animal-specific, so we have less so when it comes to humans, and if so, very often of a dubious quality because these are studies that were made in Eastern Europe decades ago. It's definitely interesting. So, there is something to be said. O

One of the downsides is that peptides are essentially short amino chains that naturally exist in your body; therefore, you can't file a patent on them. If you can't file a patent, then that means you can't recuperate any losses that you would get by investing in phase 3 clinical trials. Therefore, it's an industry issue we are not going to see medical products that are peptides, I think, in many cases. So, when you talk about TP500, BPC-157, and many others that are popular at the moment, then this is the thing. We are not going to get any better data than what is available right now. So, you have to look at that critically and then assess, is that something that could be of benefit? A. B, is that something for that patient that you are having in front of you? And is that the right time? I'm talking about this biological readiness that the patient has to be in. And that also is relating to other more traditional aesthetic procedures that you might be doing. You have to ensure that the patient is ready to do that.