Why Your Skin Is Smarter Than Your Skincare Routine

The beauty industry has spent decades focusing on what we should and shouldn't be putting on our skin. Iuliana Cotocel thinks the more interesting question is what is happening inside the body that the skin is trying to tell us.

With 24 years of professional experience across aesthetics, wellness and personalised health optimisation, Iuliana brings a rare dual perspective to her work as Head of the Wellness and Longevity Department at Este Medical Group. Trained as both an Aesthetician and a Functional Medicine Practitioner, she works at the intersection of internal health and external appearance - looking at hormonal balance, metabolic health, gut function and inflammation as drivers of how skin ages, rather than focusing on the surface alone.

Her approach is precise, evidence-led and quietly radical in an industry that still defaults to selling solutions rather than asking the right questions. Here, Iuliana is in conversation with L'Officiel Arabia.

Delna Mistry Anand: Epigenetics tells us that our genes are not our destiny. How much of skin ageing is actually determined by our genes, and how much can be influenced by lifestyle, environment and the way we care for our skin?

Iuliana Cotocel: I always tell my clients: your genes load the gun, but your environment and lifestyle can influence whether you pull the trigger. Genetics absolutely plays a role in how our skin ages - collagen production, pigmentation, antioxidant capacity, inflammation and even how we respond to environmental stressors can have a genetic component. But genes are not the whole story.

From a functional medicine perspective, I look at gene expression rather than simply the genetic code. Sleep, chronic stress, nutrition, blood sugar regulation, inflammation, hormonal changes, UV exposure, pollution and even our gut health can influence the biological environment in which our genes operate.

This is why two people of the same age, with relatively similar genetics, can have completely different-looking skin. Skin ageing isn't just something happening to the skin. It is also a reflection of what is happening inside the body.

DMA: Stress, poor sleep, pollution, UV exposure and diet can all influence biological pathways involved in skin ageing. Which factors have the greatest impact, and which are the most modifiable?

IC: There isn't one single culprit, and that's actually the point. UV exposure is probably one of the biggest external drivers of premature skin ageing, which is why daily photoprotection is non-negotiable. But I also see the cumulative effects of chronic stress, poor sleep, metabolic dysfunction, nutrient deficiencies and an inflammatory diet.

The good news is that many of these factors are highly modifiable. You cannot change your chronological age or your genetics, but you can improve your sleep, nutrition, blood sugar regulation, stress response, muscle mass, micronutrient status and protection from environmental damage.

This is why I don't believe in treating the skin in isolation. If someone has persistent inflammation, acne, pigmentation or accelerated aging, I want to ask why. What is happening hormonally? How is their gut functioning? Are they metabolically healthy? Are they sleeping? Are they eating enough protein and micronutrients? The skin can be the symptom, not always the root cause.

DMA: Skincare brands are increasingly using the word epigenetic to describe their ingredients and formulas. How can consumers distinguish genuine science from sophisticated marketing?

IC: This is where consumers need to become a little more sceptical. The word "epigenetic" sounds incredibly scientific, but putting it on a product doesn't automatically make the product scientifically meaningful. I look for several things: Is there good human clinical data? Is the ingredient actually being studied in relation to the claimed biological pathway? Is the research on the finished product, or only on an isolated ingredient in a laboratory? And, importantly, does the study demonstrate a meaningful improvement in skin, not simply a change in a molecular marker? We are still learning how complex epigenetic mechanisms are in human skin. So I would be cautious about any product promising to "reset your skin age" or "reprogram your genes." For me, evidence always comes before the marketing story.

DMA: Could UV radiation's role in skin aging involve epigenetic changes that alter how skin cells function over time, beyond the visible damage we already know about?

IC: Absolutely, and this is one of the most fascinating areas of research. UV radiation doesn't simply create visible pigmentation or break down collagen. It can trigger oxidative stress, inflammation, DNA damage and changes in cellular signalling, and research suggests that UV exposure can also influence epigenetic regulation. But this is another reason I don't think SPF should be viewed purely as an anti-wrinkle product. You are protecting the biological health of your skin.

And I would go even further: photoprotection is one piece of the puzzle, but so is supporting the body's ability to deal with oxidative stress. A nutrient-dense diet, adequate antioxidants from whole foods, good metabolic health and reducing chronic inflammation all contribute to the skin's resilience. So yes, SPF is essential but healthy skin is not created in a bottle.

 

DMA: How close are we to skincare or aesthetic treatments that can genuinely influence the biological age of skin at a molecular level rather than simply improving how ageing skin looks?

IC: I think we are moving in that direction, but I would be careful with the word "reset." We already have treatments that can influence cellular behaviour, collagen remodelling, inflammation and tissue regeneration. The field of regenerative aesthetics is becoming much more sophisticated, and we are learning more about cellular signalling and the skin's ability to repair itself. But I don't think we can honestly say that we can currently reset someone's biological skin age. And perhaps the more interesting question is: why are we aging faster than we should in the first place? If someone has chronic inflammation, insulin resistance, poor sleep, hormonal imbalance, nutrient deficiencies or significant oxidative stress, improving those underlying factors may be just as important as what we apply or do to the skin. My approach is always: don't just ask what treatment does the skin need. Ask what the skin is trying to tell me. That is where I think the future of aesthetics is heading - less symptom management, more understanding of biology.

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