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It began as a small calendar-based annoyance. Ten weeks post-Botox, the lines above my brows would begin their slow return. By 12 weeks, they’d resettled entirely. Meanwhile, a friend who went to the same clinic, had the same brand and roughly the same unit count, remained entirely unwrinkled for five months – zero top-up. A second revelation came following an otherwise minor surgical procedure. The general anaesthetic left me not just drowsy but genuinely unwell – weeks of mental fog and a recovery that persisted twice as long as predicted. After visiting every doctor and department available, the anaesthetist offered a familiar phrase: some people simply process things differently. Dissatisfied with the vagueness, I went looking for the why. I discovered not only what caused my body to process anaesthetic differently, but why my Botox doesn’t last, which diseases I’m predisposed to, and so much more. All thanks to my DNA.
My search led me to Dr. Leonard Josipovic, a board-certified plastic and aesthetic surgeon at Seline Clinic, who works in partnership with the genetic testing company RobGenes. He does not believe in guesswork. “DNA testing allows us to see and predict the future of our own health,” Dr. Josipovic explains. “We can prevent certain diseases, and we can influence how we age – whether that’s losing collagen, or looking at our genetics to know which peptides work better for us. We are in a world where people want to try everything and do everything, but treatments and supplements do not work the same for everybody. Genetics show us what actually works.” He reaches for an analogy. “It’s like baking a cake. To build collagen, I need certain ingredients. If I do not use the right ones, the cake will not turn out well. Genetic testing shows me what ingredients are missing and what I’m not absorbing properly, so I can find the supplements and treatments to change that. We can compare different products – even different Botox brands – and know which one works better for you.”
It makes you wonder how much of beauty has actually been educated guesswork all along. We spend thousands on skincare, injectables, and lasers, switching products and treatments the moment something stops working, rarely knowing why it worked – or didn’t – in the first place.
Professor Roberto Leandro Grobman, founder and CEO of RobGenes, believes the industry is finally starting to look at what is written into our biology. “For decades, beauty has been approached from the outside in. We looked in the mirror, observed wrinkles, pigmentation, acne, redness, dryness or loss of firmness, and then tried to correct what was already visible. Beauty was reactive. We waited for the skin to complain before asking why. DNA testing changes this completely because it allows us to look at beauty from the inside out.” In Dubai’s aesthetics world – where trends move at speed – clinics are becoming increasingly focused on personalisation. Rather than treating every face according to broad categories like ‘dry’, ‘sensitive’ or ‘ageing’, clinics are beginning to look at the biological systems shaping how that skin behaves. “For the first time, we can begin to understand why one person ages with pigmentation, another with sagging, another with inflammation, and another with early fine lines, even when they are the same age and may use similar products,” says Professor Grobman. “We are looking at the biological tendencies underneath it.”
Those tendencies include collagen production and breakdown, inflammation, oxidative stress, pigmentation pathways, and nutrient metabolism. Some people are genetically predisposed to lose collagen faster. Others are more reactive to inflammation or more vulnerable to pigmentation. Some tolerate aggressive treatments beautifully; others struggle with irritation after relatively gentle procedures. “Two people can buy the same luxury cream, receive the same injectable, and still have completely different outcomes,” says Professor Grobman. “The biology receiving it is different.”
Dr. Nathan Curran, a longevity and functional medicine physician at Biolite Clinic Dubai, believes this is where aesthetics is fundamentally changing. “Most skincare and aesthetic interventions are built on population averages: what works for most people, most of the time,” he says. “This approach ignores a fundamental biological truth – your skin is not average.” DNA testing, he explains, allows doctors to identify genetic variants that influence how quickly someone breaks down collagen, how efficiently they handle oxidative stress, and how strongly their inflammatory pathways respond. “These aren’t abstract data points,” he says. “They’re the systemic drivers that determine the biological terrain your skin is ageing within.” Dr. Curran returns repeatedly to the idea of ‘terrain’ – the internal environment sitting beneath the skin. In other words, the face is often reflecting processes already happening deeper in the body. “Your skin is a dashboard,” says Dr. Curran. “The fine lines, dullness, pigmentation, texture changes – they are real-time readouts of what’s happening systemically.”
Suddenly, the Botox question starts to make more sense. It’s not that one person’s body is somehow ‘better’ at holding a neurotoxin than another’s; the biological starting point is simply different. “Two people, same product, same protocol, completely different outcomes,” says Dr. Curran. “What we now understand is that the outcome of any aesthetic treatment depends not just on what you apply, but on the biological terrain it is being applied to. And that terrain is influenced to a significant degree by your genetics.” He points to collagen-stimulating treatments as an example. “If someone carries variants in their COL1A1 gene that predispose them to faster collagen degradation, the same microneedling session that gives one patient dramatic results may produce a much more modest response in another.”
Dr. Josipovic sees the same pattern daily. “My patients can come to me, get a DNA test, and I can then create a bespoke treatment plan according to how their body is ageing, their inflammation levels, what ingredients or products I know will not work. It is totally bespoke, because no two people are the same.” Much of the science comes down to pathways. Dr. Curran organises them into clusters: collagen integrity and turnover, inflammation, oxidative stress defence, and pigmentation.
Variants in genes such as COL1A1 and MMP1 influence how quickly the body builds and breaks down collagen. Genes such as IL-6 and TNF-alpha mediate inflammatory response, while oxidative-stress genes such as SOD2 and GPX1 determine how effectively cells neutralise free radical damage. “Oxidative stress is recognised as one of the drivers of cellular ageing,” he says. “This genetic variability is one reason two people with identical lifestyles can age at very different rates.”
Professor Grobman adds pigmentation and detoxification to the list. “Genes such as MC1R, TYR and others may influence melanin behaviour, sun sensitivity, and pigmentation risk. This is very important in the Middle East because many patients are exposed to strong sun, heat, and pigmentation-triggering conditions.” It may also explain why some people spend years cycling through brightening serums with little lasting change. “Someone with MC1R or TYR variants that predispose them to melanocyte hyperactivity will produce excess melanin in response to UV, heat, inflammation, or hormonal shifts,” says Dr. Curran. “They can use the best brightening serums and still see pigmentation return, because the genetic instruction to overproduce melanin is still running in the background.”
The same logic applies to skincare, too. Retinol, despite being one of the most celebrated ingredients in dermatology, remains wildly unpredictable from one person to another. “Much of this variation is driven by genetic differences in skin barrier function, inflammatory response genes, and the activity of enzymes that convert retinol into its active form,” says Dr. Curran. “Genomic testing can flag patients who are likely to be slow converters or whose barrier function is genetically compromised, allowing us to start lower, support the barrier proactively, or choose an alternative pathway entirely.” Acids, lasers, and stronger resurfacing treatments can all trigger similar reactions in genetically reactive skin. Variants in the FLG gene, for example, may predispose someone to a thinner, more permeable barrier, meaning acids penetrate more aggressively than intended.
“This is why generic anti-ageing [treatment] is limited,” says Professor Grobman. “We need to ask which ageing pathway is active in this person.”
More and more, the focus is moving from correction to prevention. Stem cells, exosomes, peptides, growth factors, and polynucleotides are increasingly being used not simply to reverse visible ageing, but to support the skin before damage fully appears. “Traditional aesthetics was largely corrective,” says Professor Grobman. “We waited for wrinkles, volume loss, pigmentation, or sagging, and then we tried to repair what was already visible. The future is about preserving tissue quality, improving repair capacity, reducing inflammation, and supporting collagen architecture.” But even regenerative aesthetics, he says, should not be approached randomly. “Not every patient needs the same regenerative strategy.”
Dr. Josipovic agrees. “What’s inside determines the outside, and without that knowledge we can only do so much. Just injecting into the face is like treating the symptoms, not the cause. If we can go beneath the surface and look inside to see why we are ageing that way, we can get to the root of it and make profound changes from the inside out.” Of course, lifestyle, stress, sleep, hormones, and environment still shape how we age. A DNA test will not undo years of sun exposure or poor sleep. But it does offer something beauty has traditionally lacked: a clearer understanding of what the body is actually responding to – not necessarily in the form of better Botox or more expensive creams, but in understanding what works for our own bodies, and why.
Maybe beauty was never skin deep at all.
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