The next big thing in anti-aging is pretty controversial

Anti-aging medicine is advancing fast, especially as the demand for regenerative and age-delaying therapies grows. Bank of America predicts the anti-aging market will expand to a soaring $610 billion by 2025.^[] The demand is driven by an increased paying capacity of the aging population and new research into cellular regeneration.

Exploring the research

A  team of researchers from the Human Cell Atlas (HCA) project is creating a detailed map of how human skin develops. By studying fetal skin from 7 to 17 weeks post-conception, they've observed how skin layers and structures form through interactions between cells like keratinocytes, fibroblasts, and macrophages.^[]

Professor Muzlifah Haniffa, a lead researcher on the project, said in an interview with BBC, “If we can understand how cells change from their initial development to aging in adulthood, you can then try and say, 'How do I rejuvenate organs, make the heart younger, how do I make the skin younger?' If we can manipulate the skin and prevent aging, we will have fewer wrinkles.”^[]

While this vision is still in development, their current research provides some new insights into how our body’s largest organ grows and maintains itself.

Is fetal skin the key to scar-free healing?

One big discovery from the HCA is that early fetal skin heals without scars.^[] Scarless healing in prenatal skin is associated with the downregulation of genes involved in inflammation, extracellular matrix (ECM) formation, and collagen deposition. Genes favoring tissue regeneration and immune suppression, namely, MDK, RAMP2, WNT2+, and CD200, are upregulated in early-stage prenatal fibroblasts. These anti-inflammatory and tissue-repair genes fade during the later stages of gestation, correlating with the appearance of scar-forming collagen deposits.

Lab-grown skin and hair

Another major finding from the HCA team is that macrophages modulate the development of neurovascular bundles, scarless repairing of skin, hair follicle formation, and fibroblast homeostasis in skin tissue.^[]

By simulating this immune-mediated vascularization in the lab, researchers also grew small blobs of skin from stem cells.^[][] The researchers created a macrophage-rich environment in lab-grown skin organoid (SkO) cultures by introducing autologous macrophages derived from induced pluripotent stem cells (iPSCs). This inclusion of macrophages resulted in a more organized and elaborate vascular network. The resultant SkO was structurally similar to natural skin, complete with tiny hair follicles, which opens the door to various applications.

Beyond healing, these lab-grown samples also bring the potential for hair regrowth solutions, addressing common issues like baldness or hair loss. "Another example is that if you can build hair follicles, we can actually create hair growth for bald people,” noted Professor Haniffa.^[]

But is it ethical?

Creating lab-grown skin is a win for medicine, but we're entering a gray area as organoids become increasingly complex and resemble human tissues. A 2023 systematic review raises concerns that organoids might be considered synthetic human life.^[]

The need for embryonic stem cells also sparks ethical debates, especially around embryo destruction, which some view as ending a potential human life.

Using lab-grown skin for therapeutic ends has strong support. But what if this technology shifts toward cosmetic or elective treatments? Would it exploit stem cell research for aesthetics instead of focusing on real medical needs? And if so, who sets these boundaries? The next steps in this technology’s development will require not just scientific rigor but also ethical clarity.