2026 Anti-Aging Evidence Rankings: What Really Works and What Is Just Marketing

Here, "anti-aging" can be divided into two types:

Skin aging = wrinkles, pigmentation, elasticity, photoaging, skin structure.

Whole-body healthy aging = delaying the risk of functional decline, muscle loss, cardiovascular disease, metabolic diseases, disability, and death.

Here's an explanation of why.

This may be the least expensive and most reliable intervention in the entire anti-aging field.

Ultraviolet radiation can cause:

UVA → Damage to dermal collagen and elastic fibers, wrinkles, and sagging.

UVB → sunburn, DNA damage, skin cancer.

Long-term UV exposure → dark spots, uneven skin tone, visible capillaries, and roughness.

A randomized controlled study lasting about 4.5 years with 903 participants found that people assigned to daily sunscreen use showed significantly less skin aging than those who used it at their discretion. The daily-use group experienced about 24% less skin aging.

Here's a very practical example:

One person uses about RMB 1,400 worth of serum every day

but is inconsistent about sunscreen.

Another person

uses a sunscreen that costs about RMB 46

and applies it consistently.

In the long run, the latter may be the more effective "anti-aging investment."

How to Choose

The practical standard is:

AAD also lists sunscreen and moisturizer as the two most effective foundations of over-the-counter anti-aging products.

Price

There is no need to buy an expensive formula.

For example, Biore UV Aqua Rich Watery Essence currently available in Japan:

SPF50+ / PA++++ / 70g, about 46 RMB.

High-end sunscreen priced at 180~460 RMB may not have stronger anti-aging effects than products priced around 46 RMB.

Higher prices usually pay for skin feel, fragrance, film formation, cosmetic finish, or packaging—not dramatically stronger protection against photoaging.

Recommendation

S-class.

If you can only choose one skincare and anti-aging product, prioritize:

Sunscreen.

Which topical ingredient has the strongest human evidence for wrinkles and photoaging?

The answer is straightforward:

Tretinoin (all-trans retinoic acid).

This is not merely a cosmetic marketing ingredient. It is a prescription retinoid that changes how skin cells behave.

A 2025 systematic review and meta-analysis included:

Eight randomized controlled trials with 1,361 participants, with the longest study lasting 2 years.

Tretinoin produced significant improvements in:

Fine lines

Coarse wrinkles

Photodamage

Long-term studies also show improvements in the skin's collagen structure, so the benefit is not simply the temporary softening of wrinkles that comes from moisturizing.

Benefits

The main points are:

Special attention should be paid to this last point.

No skincare product can truly restore severe facial sagging, bone loss, or displaced fat pads.

That is the practical limit of what topical skin care can do.

Common Strengths

Common clinical practices:

0.025% → 0.05% → 0.1%

Higher is not always better.

For many people, 0.025% or 0.05% is sufficient for long-term use.

The AAD recommends starting with a gentler retinoid, applying it every other night, and gradually increasing the frequency as tolerated.

Main Drawback

Irritation.

Common side effects include:

Dryness

Peeling

Redness

Stinging

Skin barrier discomfort

The more important question is not:

0.05% or 0.1%

It is:

Can you use it consistently for years?

Who It Is For

For those with fine lines, photoaging, uneven skin tone, roughness, and those seeking true anti-wrinkle effects.

Who Should Avoid It

Topical retinoids should be avoided during pregnancy. People with severe sensitivity, eczema, rosacea, or similar conditions should consult a dermatologist first.

Reference Prices (Converted to CNY)

Self-pay prices vary widely among clinics in Japan.

For example, the current price at a clinic in Tokyo is:

0.05%: about RMB 250

0.1%: about 350 RMB.

In terms of value for money:

Tretinoin is actually far more cost-effective than a large number of expensive beauty serums.

Retinol is the retinol found in many anti-aging skincare products.

The basic path is:

Retinol → Retinal → Retinoic acid

It requires transformation, so its effect is usually weaker than using Tretinoin directly, but the stimulation is often milder.

Randomized human trials show that 0.4% retinol taken three times a week for 24 weeks can reduce fine lines and increase type I procollagen.

Additionally, double-blind studies of Japanese women have also observed wrinkle improvement.

Suggested Strength

Beginner:

About 0.1%.

After adapting:

0.2～0.3%

Very well tolerated, has been used for a long time:

Approximately 0.3~0.5%.

There's no need to chase the 1% crazily.

How to Use It

Use at night.

At first:

2~3 times per week.

After adaptation:

The next day, → every night.

Apply moisturizing cream at the back.

Recommendation

A+

For those who don't want to go to the hospital or find Tretinoin too stimulating, this is usually the easier choice to stick with long-term.

Retinal = Retinaldehyde = Retinaldehyde.

It is just one step away from converting tretinoin.

In theory:

Retinol

↓

Retinal

↓

Retinoic acid

So it's a very interesting compromise:

More direct than regular Retinol, but generally milder than Tretinoin.

Randomized trials have observed improvements in skin quality, moisture, and certain pigmentation levels with 0.05% and 0.1% retinaldehyde.

Useful Strengths

0.05%

Or

0.1%

Let's compare the following three ingredients together:

Retinol

Retinal

Tretinoin

The general order is as follows:

Effects: Tretinoin > Retinal > Retinol

And:

Mildness: Retinol > Retinal > Tretinoin

This is one of the few skincare ingredients that cannot be simply classified as "marketing ingredients."

In a double-blind, half-face controlled study, 50 women used 5% Niacinamide twice daily for 12 weeks, and the results showed:

Improvement of fine lines/wrinkles

Pigment improvement

Improvement of erythema

Improvement of skin yellowing

Improved elasticity.

But note:

Its effect intensity cannot compare to Tretinoin.

Where It Helps Most

Niacinamide has another advantage:

Improves the skin barrier.

So it's especially suitable:

Retinol users

People who get dry easily

Pigmentation

Slightly oily

For those who want simple anti-aging

Concentration

In fact:

2~5% is already sufficient.

No need to see that:

10%

15%

20%

They assume the effect is better.

High concentrations actually make it more irritating.

Recommendation

A-/B+。

It's an excellent supporting character, not a leading figure in anti-aging.

Vitamin C is indeed not a scam.

It is involved in:

Collagen synthesis

Antioxidant

Reduces oxidative stress

Melanin-related processes

The 2023 systematic review included 7 studies with 139 participants, and overall observed:

Smoother skin

Wrinkle improvement

Pigment improvement

However, the number of studies and sample sizes are still far less than those of tretinoin, and currently, the optimal concentration, formulation, and stability are not fully standardized.

This is also why Vitamin C products are very troublesome:

Also labeled "20% VC",

Formulation stability, pH, oxidation level, and vitamin C form can all be completely different.

Overall Assessment

If your budget is limited:

Sunscreen> Vitamin A > Moisturizing

Consider VC after completion.

Instead of:

About RMB 690 for Vitamin C essence

• Not using sunscreen seriously.

For example:

Glycolic acid

Lactic acid

In the study, 8% glycolic acid or lactic acid was used for about 22 weeks, showing some improvement in light-damaged skin.

The proportion of at least one improvement in overall photoaging is approximately:

Glycolic acid 76%

Lactic acid 71%

Control group 40%.

But the more obvious is this:

Keratin metabolism

Smoothness

Pigments

Rough

For true collagen reconstruction and wrinkles, the evidence for vitamin A is stronger.

Practical Advice

At home:

About 5~8%.

That's enough.

And at first, don't:

Retinoids + high-concentration VC + AHA

All of them are available every day.

This usually results in not triple anti-aging, but rather:

Triple the stimulation.

This is a very important distinction.

Moisturized skin:

Fuller

Fine lines appear lighter

The water content in the stratum corneum increases

Improved skin texture

This is the real effect.

But this is related to:

Reverses biological skin aging

Produces large amounts of new collagen

Stop aging

Not the same thing.

Therefore, hyaluronic acid essence, ceramide lotion, and similar products are better defined as:

An important tool for maintaining the skin barrier and youthful vision, rather than strong anti-aging drugs.

Moisturizer is especially important when using Retinol/Tretinoin.

This deserves to be discussed separately.

Many past studies and meta-analyses have indeed found:

Oral collagen → increases moisture, elasticity, and reduces wrinkles.

So many merchants promote:

"Numerous clinical studies have proven collagen effective."

This sentence was only half said.

A 2025 systematic review/meta-analysis reanalyzed 23 randomized controlled trials involving 1,474 participants.

All studies are calculated together:

It does show effectiveness.

But after further breakdown, the researchers found:

Research without pharmaceutical company funding → had no significant effect.

High-quality research → also showed no significant effect.

The final authors concluded that there is currently insufficient clinical evidence supporting the use of collagen supplements to prevent or treat skin aging.

As a result, the overall rating was lowered to:

C-level.

Isn't it said:

"Eating 100% is useless."

Instead:

The evidence is far less certain than the advertisements claim.

If you spend about 230 RMB per month:

Sunscreen wasn't done well

Not enough protein

Vitamin A is useless

But drinking collagen every day,

The priority is clearly wrong.

If beauty is set aside and discussed:

50 years old

60 years old

70 years old

80 years old

For those who truly "age slowly," muscle mass is a very important indicator.

As you get older, you may encounter:

Muscle mass decreases

Strength declines

Insulin sensitivity decreases

Decreased bone density

Balance ability declines

Increased risk of falling

So strength training is essentially about resisting very specific age-related declines in function.

WHO recommends for adults the following weekly:

150~300 minutes of moderate-intensity aerobic

Or:

75~150 minutes of high-intensity cardio

And:

Muscle strength training at least 2 days a week.

Doesn't that sound cool:

NAD+

telomeres

SIRT1

mTOR

But the evidence for a real human outcome is much stronger.

Among the many so-called anti-aging supplements, the ones truly worth prioritizing are:

Creatine monohydrate

It will be very far ahead.

Not because it "makes cells 20 years younger."

but because it can help solve a real aging problem:

Loss of muscle and strength.

In a meta-analysis involving 22 studies and 721 participants, elderly people who added creatine to strength training compared to training alone:

Lenet tissue increases by about 1.37 kg

Additionally, the improvement in upper and lower limb strength is more pronounced.

A newer research summary still supports that creatine+ strength training provides additional benefits for strength and lean body mass in older adults.

Dose

It's very simple:

3~5 g/day.

No looping is needed.

Nor is it necessary to "eat for a month and stop for a month."

For general long-term users, loading phases are not necessarily required.

Price

500g per bag:

Currently, many Japanese products cost around 70~180 RMB.

If 5g per day:

500g = 100 days.

Equivalent to approximately:

RMB 21~55 per month.

This means its cost-performance ratio is actually very high.

Best Suited For

Middle-aged and elderly people

People who do strength training

People with insufficient muscle mass

Vegetarians may especially be worth considering

What It Does Not Prove

It has not been proven to:

Extend human lifespan.

What it truly confirms is:

Healthy aging indicators such as muscle, strength, and athletic performance.

These two concepts must be separated.

Especially after the age of 50~60.

The European Clinical Nutrition Guidelines for Older Adults generally recommend healthy older adults:

About 1.0~1.2 g/kg/day of protein.

In cases of illness, malnutrition, etc., the requirement may further increase to about 1.2~1.5 g/kg/day, but this should be adjusted according to the specific disease.

For example, a person weighing 70kg:

1.0g/kg：

70g/day

1.2g/kg：

84g/day

This is the total daily food intake, not an extra 84 grams of protein powder.

Moreover, the combination of protein + strength training provides strong evidence for age-related muscle loss.

This research is worth discussing.

CALERIE is a true randomized controlled study on humans.

220 non-obese adults over 2 years.

The experimental group originally requested a 25% reduction in calories, but the actual average was achieved:

Approximately an 11.9% decrease.

Results:

DunedinPACE epigenetic aging rate decreases by about 2~3%.

However:

PhenoAge has not changed significantly.

GrimAge has not changed significantly.

And the author makes it very clear:

It is still unknown whether this biomarker change will ultimately reduce chronic disease or death.

So here it is:

A very interesting piece of evidence for human anti-aging.

But you can't say:

"Eating 12% less increases human lifespan by 10%."

Currently, science has not proven this.

And you must not let the following be:

Too thin

Malnutrition

Sarcopenia: Elderly people

Extreme dieting for "longevity."

This may be the most typical example in today's anti-aging health supplement market.

The theoretical mechanism is excellent:

NMN

→ NAD+

→ Energy metabolism

→ Mitochondria

→ DNA repair

→ Sirtuin-related channels

Sounds almost perfect.

Moreover, human experiments have indeed proven:

Taking NMN/NR can increase some NAD-related metabolites.

The problem lies in the second half:

After NAD is elevated, do people really become healthier, younger, and live longer?

So far, there is no reliable answer.

A 2026 systematic review found that oral NR and NMN can raise NAD-related biomarkers and are generally well tolerated in the short term. Results for metabolism, vascular function, physical function, and healthspan, however, were inconsistent and often not statistically significant. Clinical effectiveness remains uncertain.

Another meta-analysis of randomized NMN trials included:

8 RCTs, 342 people, 250~2,000 mg/day.

It found no clear, consistent improvement in:

Fasting blood glucose

Insulin

HbA1c

HOMA-IR

Blood lipids

None showed a clear, consistent improvement.

How to Assess NMN

The right conclusion is not that NMN has been proven useless.

It is that:

Currently, there is no evidence that it can slow human aging or extend lifespan.

Spending hundreds of RMB per month on NMN should therefore come only after the basics are covered:

Sunscreen

Training

Protein

Creatine

Weight management

Resveratrol was the previous generation's anti-aging star.

It was once known for:

SIRT1

Antioxidant

Red wine

Calorie-restriction mimicry

That combination made it wildly popular.

But human experiments are far less impressive than animal studies.

Existing systematic evidence does not prove:

Resveratrol can extend human lifespan.

The 2024 systematic review even pointed out that after extensive clinical studies, there is still insufficient clear clinical evidence to recommend it for medical use.

Overall Rating

C-/D.

If your budget is limited:

You can simply skip buying it.

Metformin is more scientifically interesting than NMN because it is a well-established medication with decades of clinical use.

For patients with type 2 diabetes:

It is certainly an important medication.

In recent years, researchers have explored this hypothesis:

Metformin

→ AMPK

→ Lowers insulin signaling

→ Alters metabolism

→ May affect aging

This led to widespread discussion of the idea that:

"Metformin may extend life in healthy people."

The problem is that:

Currently, there are no large randomized studies proving that taking Metformin in healthy individuals can extend lifespan.

Moreover, some trials in non-diabetic populations have not demonstrated the anti-aging benefits that people expect.

People with Diabetes

Using metformin when a clinician prescribes it for diabetes is well established.

Healthy People

Long-term self-medication for anti-aging purposes is not currently recommended.

There is also no scientifically recognized "anti-aging dose."

If you only look at animal studies:

Rapamycin is indeed one of the most exciting geroscience drugs available today.

It acts on:

mTOR pathway.

There is evidence of extended lifespan in various animal models.

Therefore, many so-called "longevity medicine" clinics promote low-dose intermittent Rapamycin.

But what about humans?

The 2024 systematic review included 19 human studies, finding that some immune, cardiovascular, and skin-related indicators may improve, but many systems show no significant effect, and some patients may experience infections and dyslipidemia. The authors still believe that long-term research is needed.

Therefore, a more appropriate positioning is:

It's very worth studying, but it's not yet an anti-aging medicine that healthy people can take casually.

Especially since it itself has immunosuppressive effects.

If Vitamin D is deficient:

Of course, supplements make sense.

Especially:

Bones

Calcium metabolism

Osteoporosis risk

But:

"A healthy person takes 2000 IU of Vitamin D per day = life extension"

The evidence does not support it.

Notable VITAL trials include:

25,871 people, Vitamin D3 2,000 IU/day, average follow-up about 5.3 years.

No significant reduction was found:

Major cardiovascular events

Aggressive cancer occurs overall

All caused by death.

Therefore, Vitamin D should be understood as:

Correcting shortcomings.

Instead of:

An elixir for anti-aging.

This one is quite special.

Semaglutide (Wegovy) is not an anti-aging drug.

But for the following:

Obesity/overweight

Cardiovascular disease is present at the same time

For humans, the evidence that it lowers the true clinical endpoint is very strong.

SELECT Test:

17,604 people

Age≥ 45

BMI≥27

Already has cardiovascular disease

No diabetes

Semaglutide 2.4mg/week:

Major cardiovascular events:

6.5% vs 8.0%

HR approximates:

0.80

This means a relative risk reduction of about 20%.

This is more like:

"NAD indicator increased by 30%"

It makes much sense.

Because it is:

Myocardial infarction, stroke, cardiovascular death

This is the true human ending.

But it is very important:

People with a normal weight should not think because of this:

"Wegovy can be used to fight aging."

This is a misunderstanding.

It is a therapeutic drug for specific high-risk groups.

Suppose a person:

LDL is very high

Atherosclerosis is already present

Or the cardiovascular risk is very high

He and Qi Hua:

About 460 RMB per month to buy NMN,

What truly supports a large amount of long-term human research is often the following:

Control LDL.

The 2026 ACC/AHA guidelines will still list statins as one of the core drugs for reducing the risk of atherosclerotic cardiovascular disease.

So a major misconception about anti-aging is:

People like to buy "anti-aging health supplements" but overlook the diseases that truly cause premature loss of healthy lifespan.

Where Your Money Goes Furthest

Actual investment can be arranged in the following order:

1. Protect yourself from the sun every day.
2. Maintain vitamin A at night for extended periods; For the strongest results, consider Tretinoin under a doctor's guidance; for milder treatment, use Retinal/Retinol.
3. Proper moisturizing allows vitamin A to be maintained long-term.
4. Strength training should be done at least 2~3 times a week, combined with sufficient aerobics.
5. As you age, protein and muscle are especially important; People who regularly train can seriously consider 3~5g/day of Creatine.
6. If there are issues with blood pressure, LDL, blood sugar, or obesity, prioritize addressing these issues.
7. Vitamin C and niacinamide can be added as skincare benefits.
8. NMN, collagen, resveratrol, and other products are saved for last, and it's okay not to buy them at all.
9. Do not self-medicate Metformin or Rapamycin for so-called longevity.

So, the real question is:

As of 2026, which anti-aging tools have we actually mastered?

The answer is not some magical capsule.

Currently, the most mature practices are:

Preventing skin damage—sunscreen.

Partly reversing photoaging—tretinoin and other retinoids.

Slowing age-related functional decline—exercise, muscle maintenance, and good nutrition.

Reducing the diseases that shorten healthspan—by managing obesity, blood pressure, LDL cholesterol, and blood sugar, and by not smoking.

By contrast, pathways such as:

NMN → NAD+ → Sirtuin → Rejuvenation

Or:

Rapamycin → mTOR → Longevity

Currently, most research remains at the very promising stage of aging biology and has not yet reached the stage where "healthy people can reliably add years to their lives by taking a pill."

Based solely on the existing human scientific evidence—sunscreen + retinoids + strength training + cardio + adequate protein, with creatine when appropriate—this seemingly ordinary combination is actually much more reliable than most expensive "anti-aging kits."