For years, mitochondria were described in textbooks as having one main function: producing energy. But their role in the body goes far beyond that.
Mitochondria regulate how and when a cell ages, becomes inflamed, or dies. They are involved in hormonal signalling, control oxidative balance, and are among the first structures to feel the impact of unhealthy lifestyle habits. When they begin to fail, it is not only the available energy that declines: the entire cellular biology becomes destabilised.
This is why, since 2013 —with updates in 2023— mitochondrial dysfunction has been recognised as one of the key hallmarks of ageing. It is not simply a consequence of the process, but one of its driving forces.
We age from the inside out
What we see on the skin —wrinkles, sagging, loss of radiance— is the visible result of something that has been taking place at cellular level for years. And in this process, the fibroblast plays a central role.
The fibroblast is the cell responsible for producing collagen, elastin and hyaluronic acid. As it ages, its mitochondria deteriorate, its energy production decreases, and it begins to generate chronic low-grade inflammation. In this state, it not only produces less of what the skin needs; it also becomes less responsive to the treatments applied to it.
This has a direct implication in clinical practice. In patients with marked photodamage, sagging or telangiectasia, applying fillers or biostimulators without first rehabilitating the tissue may worsen the situation. Before asking what the skin is lacking, we need to ask whether it is in a condition to respond.
Mitohormesis: the right kind of stress activates our defences
One of the most relevant findings in the biology of ageing is that the body has powerful mechanisms for mitochondrial repair, but these are only activated by certain stimuli. This phenomenon is known as mitohormesis: controlled doses of metabolic stress trigger regenerative responses that do not occur in conditions of comfort.
Intermittent fasting, high-intensity exercise, cold exposure, sauna and red light are examples of these types of stimuli. At the right dose, they activate mitochondrial renewal, help eliminate damaged cellular structures and improve the tissue’s ability to respond.
There is an important nuance to keep in mind: chronic excess antioxidant intake may actually block these very responses. More supplementation is not always better. Effectiveness lies in precision and timing, not quantity.
The new approach: an integrated protocol
Approaching well-aging through the mitochondria means working on several fronts at once. There is no single intervention that solves everything; the key lies in the right combination.
In clinical practice, the first step in patients with compromised tissue is cellular rehabilitation before aesthetic correction. Inbiotec Amber responds to this need: it combines high-molecular-weight hyaluronic acid —which activates cellular cleansing and renewal mechanisms— with succinic acid, which helps reduce local inflammation and improve mitochondrial function in the fibroblast. The standard protocol consists of three sessions spaced 15 days apart, ideally combined with biostimulation and at-home skincare. Once the tissue has been rehabilitated, the response to subsequent treatments improves significantly.
In terms of lifestyle habits, four pillars make a real difference: sleeping between 7 and 9 hours, moving with intensity, incorporating fasting windows of 12 to 16 hours, and following an anti-inflammatory eating pattern. No clinical protocol can compensate for biology that has been compromised by lifestyle.
In supplementation, NAD⁺ precursors —NMN and NR, between 250 and 500 mg daily—, coenzyme Q10 —100 to 200 mg—, omega-3 —2 to 3.5 g— and vitamin D with K2 are among the ingredients with the strongest evidence. Always personalised, always monitored.
For follow-up, blood testing focused on systemic inflammation —high-sensitivity CRP, homocysteine, apolipoproteins— every 3 to 6 months, complemented by standardised photography, allows real progress to be measured and the protocol to be adjusted with clinical criteria.
The mitochondrion is not a theoretical concept: it is a real point of intervention, with protocols that can be applied in clinical practice today. If you found this content useful and would like to explore the topic further, you can access the full recording of this session at the IT Pharma Academy, where you will find this and other training resources designed for aesthetic medicine professionals.
