Your skin has been warning you. Time you paid attention.

Your skin, like the mirror it is reflected in, does not lie. Every zit is a report card of the body’s internal systems. See why you must pay attention when your skin ‘whispers’.

Hi, we’re starting a new series at the 1 am skincare club. Collaborating with others who also look at health inside-out, and experts in the field of nutrition, health, gut, and everything else that impacts your skin health.

To kick this off, we’re collaborating with Kavita Krishna, who is the founder of Never Too Late , an India-focused longevity platform that helps midlifers prepare for the 100-year-life. A journalist for over 25 years, in her newsletter, Kavita dissects the latest ageing research from an India perspective.

We hope this series brings you fresh perspectives on skin health! Happy reading…

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Creative by Anjul D.| Every patch of dry skin, every rash is data. Are you reading it?

Your skin is talking. Are you listening?

“Your skin is damaged.”

That was the last thing I expected to hear from an endocrinologist-friend who had known me for over 20 years. We were just chatting. I wasn’t in for a consult. Also, I hadn’t noticed anything different.

A cup of coffee and some questions later, he had a theory: “I suspect a thyroid issue,” he said. Bloodwork confirmed his suspicions. I had slightly elevated levels of TSH (thyroid-stimulating hormone), still normal, but not optimal.

And to imagine he got all that, just by looking at my face!

That sent me down a rabbit hole. What I found: the skin often acts like an ‘early warning system’ – alerting us to dysfunction within – if we are smart enough to read its signals. More often than not, we miss it.

Which is why I collaborated with Radhika x 1amskincareclub, schooled by life and her first-hand experience of frustrating skin issues, to co-author. Between her lived experience and research, and my reading, here’s our attempt at decoding what the skin whispers.

The skin is not just attractive packaging.

If you remember your high-school Biology, you will recall that the skin has three main layers – the epidermis (what you see outside), the dermis (the scaffolding and collagen store) and adipose tissue or fat.

What you may not know is that the skin is:

• The body’s first line of defence against infection and the external environment

• A natural thermostat – cooling down the body when it is too hot and warming it when cold

• The body’s most active producer of oils – in a way the largest exocrine tissue we have

• It absorbs things applied on it and thus, can be used as an entry point into the body

• A large sensory organ that helps you sense heat, cold, pain, danger and love.

More importantly, as any doctor will tell you, the skin signals changes within the body - which is why they check the back of your hand and the skin on your neck and ask about rashes or skin changes. Chronic diseases - like the thyroid imbalance I discussed earlier – also show up first on the skin.

But before we get to discussing the skin-health-longevity link, let’s understand what healthy ageing skin looks like.

What happens to our skin as we age?

What happens within:

The epidermis or the outermost layer of the skin starts thinning. Melanocytes or pigment-containing cells decrease. The skin shows the impact of years of exposure to the sun.

In the dermis, the blood vessels become fragile and bruise easily. Sebaceous glands produce less oil. Under the dermis, the subcutaneous fat layer also starts thinning.

In women, estrogen levels fall during menopause and collagen and elastin turnover reduces causing dryness, wrinkles, sagging skin, excess hair on the skin, acne and thinning hair.

What you see on the surface:

Skin that is drier than it was in your youth. Women typically experience this first, around perimenopause. Men experience it much later, typically after the age of 80. The skin is also thinner, paler, and clear (translucent) and more prone to injury.

You sweat less which is not a good thing because it increases the risk of sunstroke. Your tolerance for cold also reduces.

A lifetime of sun exposure catches up with us now. Especially in those who spend a lot of time outdoors, skin becomes leathery and weather-beaten because of loss of elasticity. Blemishes start showing, ranging from age spots or liver spots, large purple, red or brown-coloured bruises to growths like skin tags, warts and rough, brown patches.

These are all consequences of growing old, like wrinkles, and most could be harmless. However, there are some changes that could be cause for concern.

(Source: MedlinePlus| NIH)

When the Skin signals something is off…

The mirror and your skin, both don’t lie. Here’s how the skin tells you it is time to course-correct:

Severe Dryness that doesn’t respond to moisturisers? Consider getting medical advice. Diabetes and lymphoma and some drug reactions could make the skin itchy. Dryness could signal onset of a thyroid condition.

Severe Dandruff or seborrhea as doctors call it could signal underlying illness. As this American Academy of Dermatology article shows, patients with HIV or neurological conditions like Parkinson’s disease or stroke are more prone to developing severe dandruff.

Acne doesn’t end with college. Watch out if you have never had acne before and develop really severe acne. It could indicate an underlying hormonal abnormality, including polycystic ovary syndrome (PCOS) in women.

Discoloured skin that is yellow or orangish-coloured could signal kidney or liver disease. Brown or tan coloured spots on shins could mean blood circulation issues.

Rashes, unless you get them from an insect bite, are signals something is wrong within. Lyme disease, a bacterial infection that leads to joint, heart and nervous system complications is identified by its rash that looks like a bullseye. A butterfly shaped rash across the nose is an identifier for Lupus, a life-long, auto-immune disorder that affects skin, joints, kidneys and lungs.

Skin and chronic disease

Cardiovascular disease: Matters of the heart? They show up on the skin too.

Watch out for:

• Blue or purple coloured skin or a blue net-like pattern

• Swelling in your feet and lower legs

• Nails that curve downward with swollen fingertips

• Painful lumps in toes or fingers that come and go

• Small, yellow bumps around the eyes, Yellowish-orange, waxy growths on your skin, eyelids, corners of your eyes, lines on your palms, or the backs of the legs are a sign you must check cholesterol levels.

• Clusters of red, waxy bumps that look like a rash could indicate spiking cholesterol levels or diabetes.

• Red or purple lines under your nails are typically injuries. But get a doctor to check if you don’t recall injuring your nail.

Diabetes: Insulin resistance – a precursor to diabetes - shows up on the skin in the form of darkened skin in the armpit, back or sides of the neck and/or skin tags. If you spot these, consult a doctor. You may be able to buy yourself some time.

Uncontrolled Diabetes is signalled by a host of skin issues. These include round or oval brownish-red spots on the shins, hard, thick, and swollen-looking skin on the upper back, shoulders and neck. Poor circulation and nerve damage from diabetes causes open wounds called diabetic ulcers. It could spike triglyceride levels which show up as reddish bumps on the skin that are tender and itchy.

That’s not all. As ageing research gains ground, there is now more evidence that the skin also has a role in driving disease and ageing.

The Skin-Ageing-Longevity link

The most visible form of skin ageing – wrinkles – occur because mitochondrial energy drops in the epidermis.

Now, mitochondria are the power centre of the cell. The dip in energy impacts cell turnover, pigmentation, collagen production – all of which manifest as wrinkles.

So yeah, romanticise that first wrinkle all you like. But it is your skin telling you that your body is running low on fuel.

There’s more. Heard of ‘Inflammageing’?

The skin, it turns out, plays a starring role here too.

So, you know how we develop a fever to fight infection. That is the body’s inflammatory response at work and is good for you. However, as we get older, the body experiences an almost permanent state of low-level inflammation. This is caused by wear and tear from cell and mitochondrial damage and also by high visceral fat, stress and other factors which triggers the release of chemicals called cytokines in the body.

Cytokines accelerate ageing and increase risk of chronic diseases like cardiovascular disease, diabetes, dementia, cancer etc. Ageing skin, scientists now believe, further increases levels of this chemical cocktail in the body. Because the skin is omnipresent, this cocktail eventually reaches key organs like the heart, affecting them.

In fact, research has already shown that skin diseases like Psoriasis and Dermatitis could increase risk for heart disease, lending the ‘skin inflammageing’ theory more street-cred.

So, as you can see, not only is the skin an indicator of internal health, it also drives disease and ageing. Reason enough to give it some TLC, don’t you think?

Skin ageing: do you need to slow it down, and if yes, how can you?

Source: Feature Paper - Cosmetics in 2025

Before we dive into how to slow down ageing, let’s get one thing straight: ageing is normal, and your skin is meant to change with time. It’s meant to wrinkle, undergo collagen decline and pigmentation shifts.

Ageing is not a problem to solve, but ‘accelerated ageing’ is. It’s driven by multiple factors like chronic sun exposure, oxidative stress, diet, sleep, smoking, and long-term inflammation.

Skin ageing happens in two ways:

1. Extrinsic ageing: Caused by external factors like UV radiation and pollution.

2. Intrinsic ageing: Caused by internal factors like hormonal health, poor sleep, internal inflammation, natural cellular damage, and mitochondrial slowdown.

Slowing down ageing isn’t about looking ‘18 till I die’ (sorry for the bad pun, Bryan Adams!). It’s about controlling inflammation, maintaining the skin barrier’s integrity, and keeping internal systems like cell turnover and collagen production steady. When you support these systems, your skin ages predictably and normally, not prematurely.

5 dermatologist-backed ways to slow down skin ageing:

1. Support Systemic Health

Your skin does not function in isolation. It is a system influenced by hormones, stress levels, sleep, and more. Chronic stress, smoking, poor sleep and unstable blood sugar increase inflammatory signalling in the body. Over time, this can impair collagen repair, recovery, and accelerate visible ageing. No topical skincare product can outwork chronic inflammation. So, if you care about your long-term skin health, regulate your sleep, manage stress, keep insulin levels in check, and support your metabolism.

Note: Supplements can help: Vitamin D, omega-3 fatty acids and certain antioxidants have evidence supporting skin and inflammatory health.

2. Wear Sunscreen Daily
UV rays activate enzymes (specialised proteins) that break down collagen and elastin, two critical proteins that give skin its structure and strength. Without sun protection, your skin is at risk of developing not just wrinkles and pigmentation, but also some kinds of skin cancers. Using a broad-spectrum SPF 50+ is ideal. It reduces photoaging and lowers the risk of skin cancer.

3. Protect Your Skin Barrier
Your barrier regulates hydration and defends against irritants. Avoid over-exfoliating it and layering too many potent actives together (like exfoliating acids, retinoids, etc). Instead, use a barrier-supporting moisturiser with ingredients like ceramides, panthenol and squalene. If you have acne-prone skin, avoid physical exfoliants, as these can irritate your skin barrier.

Note: If you have acne-prone skin like mine, always use products free of comedogenic (AKA pore-clogging) ingredients, fragrances and harsh preservatives.

4. Use Retinoids Thoughtfully
Prescription retinoids have the strongest evidence for improving fine lines and supporting collagen production. Store-bought retinol and retinal products can also help, though results are gradual. But, they are potent ingredients, so always start slow, and consult a dermatologist before use. Using moisturiser and SPF is critical if you’re using retinoids.

5. Incorporate Antioxidants
Ingredients like vitamin C help neutralise oxidative stress from UV exposure and pollution. Using a vitamin C serum in the morning can help reduce uneven pigmentation over time. This doesn’t replace sunscreen; if anything, it complements it. Think of it as an additional protection against daily environmental stress.

To sum, there is no miracle cream that can smooth over your woes immediately. Body or skin, the rules are the same. Eat right, drink sufficient water, move more and sleep well consistently. Your body will get healthier. And your skin will follow suit!

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Before you go

Yeah. We get it. There are reams of research on why you must care for the skin. But how do you put it into practice? How does this change what’s in your bathroom cabinet?

Hit play and find out.