Research AppraisalSystematic Review

Advances in the pharmacology and mechanism of anti-skin aging in Tonifying Traditional Chinese Medicines

Journal of ethnopharmacologyChen, Tingting, He, Xinglishang, Chen, Xuannan et al.10 May 2026DOI

Clinical Snapshot

35CEBM
Evidence: WeakSystematic Review

PICO Framework

P — PopulationHumans and animal models with skin aging
I — InterventionTonifying Traditional Chinese Medicines (TTCM) including Panax ginseng, Astragalus membranaceus, and other herbal compounds
C — ComparatorControl groups or placebo (not clearly specified)
O — OutcomesAnti-skin aging effects, molecular targets, aging biomarkers, signaling pathway modulation

Bottom Line

This systematic review examines Traditional Chinese Medicine approaches to skin aging but falls short of rigorous systematic review standards. While the authors identify multiple molecular pathways through which tonifying herbs may influence aging processes (MAPK, p53, Nrf2), the review lacks critical methodological elements including quality assessment, quantitative synthesis, and evidence certainty evaluation. The integration of traditional concepts with modern pharmacology is conceptually interesting, but without proper systematic methodology, the clinical utility remains unclear. Australian clinicians should be aware that most TTCM anti-aging claims lack robust clinical evidence meeting TGA standards. The review highlights potential research directions but provides insufficient evidence to support clinical recommendations for TTCM in anti-aging applications.

Evidence: Weak

Key Findings

  • P Value: Not reported

  • Effect Size: Not quantified - qualitative description only

  • Primary Outcome: Anti-skin aging effects through multi-component, multi-target, multi-pathway mechanisms

  • Nnt Or Sensitivity: Not applicable - mechanistic review without clinical efficacy quantification

  • Confidence Interval: Not provided

Clinical Application

Limited by lack of standardized preparations, dosing protocols, and quality control measures for TTCM products Limited applicability - TTCM products would require TGA approval as complementary medicines, with most lacking robust clinical evidence for anti-aging claims under Australian regulatory framework Individuals seeking anti-aging interventions, particularly those with cultural affinity for traditional medicine approaches

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE: According to the Traditional Chinese Medicine (TCM) tenet that "internal imbalances manifest externally," skin aging reflects deficiencies in qi, blood, and organ systems-particularly the liver and kidneys. Tonifying Traditional Chinese Medicines (TTCM) address these root causes, nourishing the skin and delaying aging through internal regulation, as documented in classical texts including the Shennong Ben Cao Jing and the Compendium of Materia Medica. AIM OF THE STUDY: This article systematically reviews the anti-skin-aging mechanisms of TTCM by integrating traditional applications with modern pharmacological evidence. It explores their multi-component, multi-target, and multi-pathway actions, evaluates current experimental models, and investigates the emerging role of artificial intelligence (AI) in advancing TTCM research. MATERIALS AND METHODS: We systematically searched PubMed, China National Knowledge Infrastructure (CNKI), Web of Science and Scopus for articles published from January 2015 to August 2025 with keywords such as "skin aging", "anti-aging" and the Latin names of TTCM (e.g. Panax ginseng, Astragalus membranaceus). Cellular, animal and clinical studies were analyzed for active constituents, molecular targets, ageing biomarkers and related signalling pathways. RESULTS: TTCM demonstrates anti-skin-aging effects through systemic regulation of organ function and qi-blood-yin-yang balance. At the molecular level, TTCM attenuates senescence through antioxidative, anti-inflammatory, extracellular matrix (ECM) stabilizing mechanisms, mediated by modulation of multiple pathways, such as Mitogen-Activated Protein Kinase (MAPK), Tumor Protein p53 (p53) and Nuclear factor erythroid 2-related factor 2 (Nrf2), exemplifying a "holistic regulation-targeted intervention" therapeutic paradigm. CONCLUSIONS: TTCM exerts anti-skin-aging effects through multi-component, multi-target and multi-pathway synergism. We strongly recommend the further integration of TTCM with modern medicine and in-depth mechanistic studies to promote translational applications.

References

  1. 1.Chen, T., He, X., Chen, X., Zhang, W., Li, B., Chu, C., Lv, G., & Chen, S. (2026). Advances in the pharmacology and mechanism of anti-skin aging in Tonifying Traditional Chinese Medicines. Journal of Ethnopharmacology, 121233. https://doi.org/10.1016/j.jep.2026.121233
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