In this interview, Dr. Stephanie Manson Brown explains how her exposure to aesthetic medicine conferences sparked an interest in longevity medicine, noting a gap in mechanistic research linking aesthetic treatments to the aging process. She argues for a paradigm shift from merely treating visible signs of aging toward maintaining healthy skin by addressing biological age. Dr. Brown outlines intrinsic (genetic, metabolic, endocrine) and extrinsic (UV radiation, pollution, smoking) factors that drive skin aging, describing common manifestations such as fine lines, laxity, wrinkles, and pigmentation. She introduces the concept of healthspan—enhancing quality of life in later years—rather than simply extending lifespan, and ties this to skin health. Practical, evidence‑based lifestyle interventions are discussed: prioritizing high‑quality sleep (citing a Swedish study linking sleep restriction to poorer facial appearance), consistent broad‑spectrum sunscreen use from the 20s onward, daily exposure to nature (10‑15 minutes improves mood and cardiovascular markers), cold showers (potentially stimulating mitochondrial biogenesis), and a balanced diet with regular exercise. Throughout, Dr. Brown emphasizes early, proactive measures, the importance of reducing inflammation, and giving oneself credit for healthy habits, positioning these strategies as foundational to both skin health and overall longevity.
Chapters
My interest in longevity medicine was really sparked by attending a lot of the aesthetic medicine conferences that are very much, you know, focused at dermatologists and plastic surgeons. And really for me, there was just a lack of presentations and focus of science looking at the actual mechanisms of the aesthetic progress as it relates to the aging process. And it was something that I thought, you know, there's definitely a need here to be able to bring the two together. And I think that that really is an opportunity to better educate UK, our doctors and our injectors who are focusing on treating people who are showing signs of aging. And really, you know, I do believe that we're going to move away from treating the signs and symptoms of aging and actually start to focus on the root cause. I personally prefer the idea of maintaining healthy skin as a different concept to the notion of actually looking younger, and I believe that the future focus of application of treatments will be maintenance of health, where the benefits will build up over time. The whole industry at large is definitely guilty of talking of this drive to to look youthful, to look younger. And I think that there's just a lot to be said of kind of focusing on biological age versus chronological age. And I know in previous podcasts you've discussed that with your other guests, and that's really something that at the moment we still continue to be, especially in the aesthetics industry, focused on chronological age. And I think that that can have very much a negative impact on individuals, whereas aging is a privilege, and some people actually do want to embrace growing older, but I think it's for us to give the options to be able to bring in interventions to at least be aging in a more healthy manner and also maintaining that skin health and maintaining that health as it relates to skin aging. As skin is an outermost protective layer of the body, it is exposed to both intrinsic— so internal factors, for example, genetic, metabolic, and endocrine factors— as well as extrinsic— so external factors such as ultraviolet UV radiation, environmental pollution, and smoking. We know that it's the most perceptible organ to show the initial signs of aging. So that's when people do tend to notice that you see the fine lines, you see the skin laxity, and as well as the wrinkles, as well as skin aging spots, which is pigmentation. And also you see that loss of elasticity and loss of smoothness. There's several ways to maintain healthy skin, and you can look at them both as the kind of the general approaches for improved healthspan. And again, you've discussed this on previous podcast, but you know, just for your audience, when we talk about healthspan, we talk about putting the life into our years. And so instead of kind of expanding necessarily lots of years onto the lifespan, it's about ensuring that we've got a healthy life within kind of living into our later decades and improving overall quality of life. And so this I think can be also looked at for skin health. So for example, good quality sleep is one of the key fundamentals, and we know that chronic inadequate and poor quality sleep accelerates intrinsic aging, and poor sleepers have significantly diminished capacity to to recover from stress. There was a study conducted by a group in Sweden that looked at restricted sleep and how that can affect facial appearance. And so they actually find that it negatively impacts facial appearance and decreases others' willingness to actually socialize with the sleep-restricted person. So I think that that's something, you know, certainly kind of hit me. I'm really bad at making sure that I have my 8 hours within 24 hours. And we know that social engagement is really important factor for promoting longevity as well. So all of this just very much interplays. I think one One of the important things to note is the earlier you start to take measures to reduce the impact of damage and inflammation, the better. And I think that's really kind of the big factors here is the inflammatory elements impacting tissue and organ health generally. But speaking here about skin health, there's been a lot of discussion around protecting against ultraviolet radiation, UVA and UVB. It is of good practice to be using a high broad spectrum sunscreen from an SPF 30 or above. Daily, and that's critical. And you need to remember to keep reapplying it as well. I think that there's a kind of a misconception that once you put it on in the morning and then actually you've sorted for the day. That is not true. The best way to have great looking skin in your 50s and 60s and beyond is to apply sunscreen in your 20s. And I've surprised myself at how adaptable I am to a new routine and actually setting down proper routine. So I start the day now with walking the dogs. It's something that is a really important focus for me and, and really gets me off on the right grounding because I think being in nature is, is incredibly important for me. And there's lots of different studies that have demonstrated that even 10 to 15 minutes being in natural spaces can improve your mood as well as focusing on some of the psychological markers, like improving blood pressure and heart rate. And I also start the day with a cold shower. And there's again, growing evidence to suggest that this may be linked to mitochondrial biogenesis by increasing the, the cell's energy demand that you're are actually triggering off increased mitochondrial activity, which then will help with the overall health of the cells. And do you actually manage a full cold shower? Because I'm still working on it, but I'm still quite at the end. I turn it cold and I take a few deep breaths and, um, I'm the same Claudia von Boeselager. I'm the same. I have a normal shower and then I turn it to cold for a couple of minutes at the end. But for me, that's enough and it certainly wakes me up and certainly brings quite a shock to the system, which I think I'll have to say is the benefits of it. Pushing yourself out of your comfort zone really makes you feel alive. And there's a lot to be said at really just embracing the opportunities that life puts in front of you rather than thinking of the, well, what might happen and, and thinking of what the negative impact would be. I think there's a lot to be said of even learning from your mistakes as well by taking measures. And they can be as simple as diet and exercise. So eating a really healthy diet and making sure that you incorporate exercise regularly into your lifestyle, as well as getting good sleep. These are really important factors, but we also need to give ourselves some credit when we actually do incorporate them because it's demonstrating that you're taking a proactive approach to your general health and your longevity.
