Skin inflammation is more than visible redness. It can reflect a disrupted biological network involving immune overactivation, microbiome imbalance, barrier fragility and impaired repair signalling.
When these systems lose coherence, the skin may become more reactive, slower to recover and less able to regulate inflammatory load over time. In ageing skin, this can be especially relevant: inflammation can become persistent, recovery can become less efficient, and visible signs may begin to reflect deeper biological stress.
At AWvi, inflammageing is understood as a biological process, not simply a cosmetic concern. The objective is to support skin physiology from within and at the surface, helping restore regulation across the gut-skin axis, microbial ecology, barrier function and tissue recovery.
A case study supervised by Prof. Jonathan Roos and Dr Rachna Murthy
This AWvi case study involved a 54-year-old patient assessed through VISIA Skin Analysis at baseline and after 20 weeks. The protocol was conducted under medical supervision and introduced alongside upper lid surgery. It combined daily oral intake of The Skin Biotic with twice-daily application of The Gentle Cleanser and The Active Cream.
Over five months, serial VISIA imaging showed a reduction in inflammatory expression and improved skin stability. The trajectory suggests better regulation of inflammatory burden, microbial balance and recovery capacity while post-surgical healing remained well supported.
This is an individual case study and should not be interpreted as a guaranteed outcome. Skin inflammation, surgical recovery and visible response vary according to individual biology, lifestyle, medical history and clinical supervision.
Prof. Jonathan Roos and Dr Rachna Murthy are ophthalmic and oculoplastic surgeons who lead FaceRestoration. Maison Restorative lists Prof. Jonathan Roos as Lead Surgeon and Medical Director, and Dr Rachna Murthy as Consultant Ophthalmologist and Oculoplastic Surgeon.
Expert insight
'Skin inflammation is the clinical expression of a disrupted biological network linking microbiome imbalance, barrier dysfunction, and persistent immune activation.
In this 54-year-old patient, serial VISIA imaging over five months showed that, when we treated biology consistently through an inside-out and outside-in approach, inflammatory load declined while post-surgical recovery remained well supported.
Effective care must move beyond short-term suppression and instead restore regulatory balance across the gut-skin axis, microbial ecology, barrier competence, and lifestyle factors that shape inflammatory tone.
Durable improvement begins when cutaneous physiology is stabilised, not merely concealed.'
Prof. Jonathan Roos
MB BChir MA PhD (Cantab)
FRCOphth FEBO
Ophthalmologist, Oculoplastic and Reconstructive SurgeonDr Rachna Murthy
FRCOphth
Oculoplastic, Aesthetic and Reconstructive Surgeon
Why inflammageing requires biological regulation
Inflammation is part of the body’s defence and repair system. The issue arises when inflammatory signalling becomes persistent or poorly regulated. In the skin, this may contribute to redness, barrier weakness, sensitivity, delayed recovery and visible tissue stress.
The gut-skin axis is relevant because gut and skin microbiomes can interact with immune signalling and barrier function. Reviews on the gut-skin axis describe links between microbial dysbiosis, impaired gut and skin barriers, immune activation and inflammatory skin conditions.
In this case, the clinical focus was therefore structured around five priorities:
→ Rebalance the gut-skin axis to reduce systemic inflammatory load
→ Restore skin microbiome stability to limit pro-inflammatory shifts
→ Reinforce barrier integrity to lower inflammatory reactivity
→ Support controlled tissue repair after upper lid surgery
→ Maintain long-term inflammatory control through daily biological regulation
The AWvi protocol used in this case study
Step 1: The Skin Biotic
The Skin Biotic formed the inside-out layer of the protocol.
Its role was to support the underlying factors associated with skin inflammation by contributing to a more balanced gut microbiome, aiding immune regulation and helping maintain a healthier cutaneous environment.
This internal support is central to AWvi’s approach. When inflammatory tone is shaped by systemic biology, skin care cannot be limited to the surface. Supporting gut-skin signalling helps address one of the pathways through which inflammatory patterns may be sustained.
Step 2: The Gentle Cleanser
The Gentle Cleanser was used twice daily.
For skin prone to inflammation, cleansing should reduce surface impurities and excess build-up without disrupting barrier comfort or microbiome balance. In this protocol, The Gentle Cleanser helped maintain a balanced cutaneous environment while preserving physiological pH and barrier integrity.
This matters particularly in reactive or ageing skin, where aggressive cleansing can intensify fragility, water loss and inflammatory reactivity.
Step 3: The Active Cream
The Active Cream completed the topical protocol.
Its role was to support inflammation-prone skin by restoring barrier lipids, calming inflammatory reactivity and reinforcing cutaneous defences with biomimetic ingredients designed to work in synergy with skin physiology.
For inflammageing, this barrier-focused step is essential. A stronger barrier can help reduce reactivity, improve comfort and support the skin’s capacity to recover from environmental, inflammatory and procedural stress.
Post-surgical recovery and skin stability
The protocol was introduced alongside upper lid surgery. In this context, the skin needed to be supported not only for visible inflammatory improvement, but also for recovery.
The case highlights the importance of maintaining barrier competence and inflammatory control during periods when the skin and surrounding tissues are undergoing repair. The observed VISIA progression suggested reduced inflammatory burden while recovery remained well supported.
This does not mean that AWvi replaces medical care, surgical follow-up or clinical treatment. It means that a consistent systemic and topical protocol may support the biological environment in which skin recovery takes place.
The patient’s lived experience
The patient described inflammation as a long-standing, unpredictable issue that had been difficult to manage with standard skincare. He wanted an approach that was structured, evidence-based and tailored to his case.
Starting AWvi at the same time as upper lid surgery, he observed lower inflammatory activity, better skin stability and a calmer overall response. What he valued most was the clinical focus on mechanisms: microbiome balance, barrier function and inflammation control, rather than short-term cosmetic correction.
For him, the protocol was not only about appearance. It was about reducing a chronic inflammatory pattern and improving skin behaviour over time.
AWvi’s perspective
Inflammageing is not simply ageing. It is ageing shaped by persistent inflammatory signalling.
This case reflects AWvi’s central method: support the skin from within and at the surface, while respecting the biological mechanisms that influence visible skin behaviour.
The Skin Biotic supported gut-skin regulation.
The Gentle Cleanser helped cleanse without destabilising the barrier.
The Active Cream reinforced barrier lipids and supported cutaneous resilience.
Together, these steps created a coherent inside-out and outside-in protocol designed to support long-term skin stability.
For AWvi, durable improvement begins when the skin’s physiology is stabilised, not merely concealed.
Sources:
FaceRestoration: Our Team
Maison Restorative
The gut-skin axis: Emerging insights in understanding and treating skin diseases through gut microbiome modulation
Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions
