Age-related skin changes (wrinkles, elasticity)
A cosmetic category, not a clinical indication in the classical sense. Marketing supplements and nutraceuticals are positioned as agents that improve skin appearance. International dermatology recommendations for photoaging prevention rely on SPF 30+ sunscreens and topical retinoids.
7 drugs
Also known as: Skin elasticity decline, Photoaging
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DAstaxanthinNot recommended · Dietary supplements, carotenoids (local classification)Astaxanthin is a natural carotenoid antioxidant from algae, added to supplements and creams and marketed for wrinkles and skin elasticity. Solid benefit for this use hasn't been shown, and the evidence for skin rejuvenation is lacking. For age-related skin changes, the approaches with real support are sun protection, retinoids, and regular moisturizing.
- DGrape seed extract (Vitis vinifera, oligomeric proanthocyanidins)Not recommended · Plant polyphenol complex, supplement. Source of oligomeric proanthocyanidins (OPC), compositionally similar to pycnogenolGrape seed extract is sold as a «natural collagen protector» for skin firmness. No RCTs with clinical wrinkle assessment endpoints (Glogau, Fitzpatrick) or skin histology. AAD 2021 lists SPF 30+ photoprotection, topical retinoids (tretinoin, adapalene), azelaic acid first-line for photoaging, and procedures (laser resurfacing, botulinum toxin, fillers) for deep wrinkles. If grape seed extract was recommended as a retinoid or procedure substitute, consider seeking a second opinion from a dermatologist.
- DHyaluronic Acid (oral)Not recommended · Dietary supplement. Glycosaminoglycan produced by bacterial fermentation of Streptococcus zooepidemicus. AEMPS does not register oral hyaluronic acid as a medicine; intra-articular and topical forms (M09AX01, S01KA01) are registered medicinesOral hyaluronic acid is sold as «skin hydration from within» with promises to improve turgor and smooth wrinkles. Evidence base is limited: Patel 2017 systematic review (8 RCTs, n=300) and Japanese Kawada 2014 studies showed moderate stratum corneum hydration improvement over 6–12 weeks at 120–240 mg/day doses. All trials are small, mostly Japanese, funded by Kewpie and other manufacturers. Effect on visible wrinkles is not shown. EFSA has not approved any health claim for oral hyaluronic acid – no such claim is in the Reg 432/2012 register. AAD for skin aging recommends SPF, topical retinoids and topical antioxidants; oral hyaluronic acid is not in the recommendations. Evidence-based alternative for hydration is topical products with hyaluronic acid, ceramides and 5–10% urea. If oral hyaluronic acid was recommended as a substitute for sunscreen or topical products, consider seeking a second opinion from a dermatologist.
- DHydrolysed Collagen Peptides (type I and III)Not recommended · Dietary supplement, hydrolysate of animal or marine connective tissue. In Russia and Spain sold as dietary supplement. AEMPS does not register oral collagen as a medicineHydrolysed collagen is the top-selling beauty supplement on iHerb, in Mercadona and Spanish pharmacy chains, marketed for skin firmness, wrinkle smoothing and dermal density. Evidence base is limited: Moc 2019 systematic review (11 RCTs, n=805) showed moderate improvement in skin hydration and elasticity over 8–12 weeks, but 9 of 11 trials were industry-funded, samples 30–100 participants, and design largely non-double-blind. The biological mechanism is weak: collagen in the GI tract is broken down to amino acids without direct dermal uptake. AAD for skin aging recommends daily SPF, topical retinoids and antioxidants (topical vitamin C); oral collagen is not listed as a proven option. If collagen was recommended as a substitute for sunscreen or topical retinoid, consider seeking a second opinion from a dermatologist.
- DPycnogenol (French maritime pine bark extract, Pinus pinaster)Not recommended · Plant polyphenol complex, supplement. Standardised maritime pine bark extract with 65–75% oligomeric proanthocyanidinsPycnogenol is sold as a «natural anti-aging» supplement for skin firmness and glow. Several small RCTs in 60–100 postmenopausal women showed moderate increase in skin hydration and elasticity (cutometer) at 75 mg/day × 12 weeks vs placebo. Clinical endpoints (Glogau wrinkle scale, Fitzpatrick photodamage) were not assessed. AAD 2021 lists SPF 30+ photoprotection, topical retinoids (tretinoin, adapalene), azelaic acid first-line for photoaging, and procedures (laser resurfacing, botulinum toxin, fillers) for deep wrinkles. If pycnogenol was recommended as a retinoid or procedure substitute, consider seeking a second opinion from a dermatologist.
- DSilicon (organic silicon, silica from horsetail or bamboo)Not recommended · Mineral in supplement form. Not registered as medicine in EU or AEMPSSilicon and Silicium G5 are sold in Spain and France as «anti-aging skin products». EFSA 2009 approved no silicon claim for skin elasticity or connective tissue status. Barel 2005 RCT (n=50) showed moderate skin roughness and elasticity improvement with ch-OSA × 20 weeks, not reproduced in independent studies. Proven photoaging interventions are topical retinoids (tretinoin, adapalene), SPF 30+ sun protection and topical antioxidants (topical vitamin C). If silicon was recommended as a substitute for sun protection and topical retinoids, consider seeking a second opinion from a dermatologist.
- DSpermidineNot recommended · Dietary supplements, polyamines (local classification)Spermidine is a polyamine found in cells and sold as a supplement (often from wheat germ) with claims that it slows skin aging, smooths wrinkles, and restores firmness. No convincing benefit for age-related skin changes has been shown – there is no evidence base for this use, only lab data and theory. Taken orally at usual doses spermidine is harmless, but you should not expect it to affect wrinkles or elasticity. What actually changes aging skin is daily sun protection (SPF) and topical retinoids, which have proven effects.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit