INSIDE-OUT AESTHETICS

As aesthetic medicine evolves beyond surface-level treatments, in-clinic wellness testing is redefining how practitioners approach skin health – with deeper insights, more personalised care and longer-lasting results from the inside out.

Medical aesthetics has quietly but steadily broadened its scope in recent years. Today’s clinics are incorporating wellness diagnostics, from metabolic blood panels to microbiome mapping to deliver not just visible results, but healthier, more resilient skin from the inside out. The shift reflects a wider trend: patients increasingly expect holistic, personalised care that connects skin health with systemic wellbeing.

THE RISE OF IN-CLINIC WELLNESS

Covid-19 has played it’s part in spurring on what many call a ‘self-testing revolution.’ The pandemic made us more familiar with self-diagnostics and health biomarkers helping to usher in an age of more predictive, personalised and self-managed medicine, which has spilled over into the aesthetics space.

A recent industry report found that around one in three medical aesthetic clinics in the UK now offer services focused on medical wellness and longevity, meaning that aesthetic medicine is becoming a crucial gateway, not just to beauty, but to better health.

“Testing offers objective, personalised health data that cuts through the noise and empowers patients to make informed choices,” Nurse Nicola Liberos explains. “Ultimately, it builds confidence and trust in our recommendations, allowing patients to see long-term results rather than just a quick fix.”

Functional medicine and aesthetic practitioner Dr Mayoni Gooneratne describes her motivation to provide testing to her patients as a clinical responsibility: “I was increasingly uncomfortable treating the ‘external’ while ignoring obvious ‘internal’ red flags.”

“I’d see patients whose skin, healing, mood and energy just didn’t fit the surface story. It became clear that if I wanted better, longer-lasting aesthetic results, fewer complications and thriving patients, then I had to address gut, hormones, neurological stress and mitochondria. Testing gives me an objective map to work from.”

WHAT TESTS ARE CLINICS OFFERING?

Clinics are now providing a spectrum of diagnostic services such as:

• Blood tests for assessing vitamin/mineral levels, hormone balance, markers of inflammation or oxidative stress. This data that can inform skin health and overall wellness planning.

• Gut and microbiome testing involving stool or gut-microbiota analysis to investigate the gut-skin axis dysbiosis and inflammation.

• Skin-surface microbiome testing mapping the microorganisms (bacteria, fungi, even viruses/mites) living on the skin, to help tailor treatments for skin barrier health, acne, rosacea, eczema or other dermal conditions.

• Food intolerance and allergy testing for identifying inflammatory food triggers that can activate conditions such as acne, eczema and rosacea.

• Genetic testing for guiding personalised longevity and skin-ageing strategies merging aesthetics with “biohacking” and preventative health. Liberos notes that these tests frequently reveal hidden drivers behind skin issues… “what happens inside the body eventually shows up on the outside.”

BEHIND THE DEMAND

Dr Gooneratne says she is experiencing the rise in demand for testing within her aesthetic practice.

“Patients are increasingly coming in saying, ‘I’ve had bloods done with my GP but I still don’t feel right’ or ‘I want to know what’s going on under the surface before I invest in my skin.’”

The main drivers for testing she is seeing in her clinic are:

• Frustration with short, symptom-focused medical encounters.

• The rise in influencerers and podcasters raising awareness of hormones, gut health, metabolic health.

• The cost of aesthetic treatments – people want reassurance that their internal health won’t undermine their results.

• For women specifically, peri/menopause and long Covid-style fatigue have made them much more attuned to their biology. Dr Gooneratne says that the client profile for these tests tends to be women between the ages of 35 and 65, those experiencing hormonal transitions like peri and post menopause, those concerned about their weight, ageing skin, hair loss, energy levels and lack of sleep.

“These are often the ‘doorway’ complaints that prompt patients to investigate. Underneath these, we often find metabolic dysregulation, chronic stress, nutrient deficiencies, and hormonal imbalances, so testing becomes a bridge between their aesthetic goal and their health reality.”

“They are often high-achieving, time-poor, and very motivated once they understand the ‘why’ behind the symptoms they are experiencing,” she continues. “I also see a growing number of younger women with acne, PCOS-type symptoms or cycle issues who are very receptive to testing, especially if they’ve tried topical or pill-based solutions without lasting success.”

CONNECTING THE DOTS...HOW TESTING ELEVATES AESTHETIC RESULTS

Liberos believes that most aesthetic treatments benefit from pre-treatment wellness insights, “particularly in skin treatments such as micro-needling, chemical peels, and lasers,” she says.

“These address superficial stubborn skin concerns, which can often stem from internal causes and therefore require internal intervention. Hair loss also often stems from internal issues such as vitamin deficiency, hormonal imbalance or genetic predisposition.”

“Diagnostics can delve into the reasons behind skin concerns or sudden hair shedding, and guide on the most suitable supplements, foods, lifestyle changes, and medications to complement aesthetic treatments and skincare.”

Dr Gooneratne operates a layered health model starting with gut health before looking at the endocrine system, the brain and nervous system, stress and the mitochondria.

“Aesthetic treatments should sit on top of that foundation, not instead of it,” she says. Liberos reports measurable success, including an acne patient whose stubborn breakouts resolved once dietary triggers (such as egg intolerance) were identified.

“While aesthetic treatments can certainly enhance a patient’s skin and confidence, there’s also a need for wellness treatments and testing to optimise results further”, she notes.

Dr Gooneratne is seeing the positive impact of pre-treatment wellness insights for anything that relies heavily on collagen, healing and tissue quality.’

Key improvements she has observed include faster, healthier healing after energy-based treatments, better collagen response in regenerative procedures and longer-lasting results.

BRINGING TESTING INTO YOUR CLINIC

To add pre-treatment diagnostics and testing into your treatment offering, Dr Gooneratne says as well as finding the right partner labs, a solid medical or prescribing background is a minimum essential requirement for anyone ordering and interpreting more complex tests.

“I would also suggest additional training in functional or lifestyle medicine concepts if you’re going beyond basic bloods and importantly you myst have an honest awareness of your limits… know when to refer and when something is outside your lane.”

Far from being purely aesthetic add-ons, tests sometimes reveal issues requiring medical intervention.

Dr Gooneratne shares that she has declined or delayed treatment where results show severe anaemia, uncontrolled metabolic markers, or possible autoimmune disease, co-managing with GPs or specialists when needed.

“For more complex findings, I collaborate with other doctors, nutritionists, and sometimes endocrinologists or other specialists.”

Liberos recommeds selecting accredited laboratories that adhere to rigorous quality control procedures such as ISO or UKAS standards. “ Clinics should regularly review lab methodologies, validation data and turnaround times”, she says.

KNOWING YOUR LIMITS

As wellness diagnostics become more accessible, it’s easy for the boundaries of aesthetic practice to blur. But both experts are clear: not every test belongs in an aesthetic clinic.

Dr Mayoni Gooneratne stresses that diagnostics requiring complex or ongoing clinical management such as cancer screening or significant genetic risk testing, must remain firmly within secondary care. If a test could unveil something with serious medical implications, she believes it demands the infrastructure of specialist services. Put simply, if a clinic “doesn’t have the expertise or pathway to manage what they]might uncover,” they should not be offering that test.

Instead, aesthetic wellness testing should remain focused on areas where practitioners can meaningfully intervene – metabolic health, hormones, nutritional status, the gut–skin connection and stress resilience – while maintaining clear and timely referral routes.

Liberos emphasises that ethical practice, begins with strong clinical consultation: choosing tests based on genuine need, not curiosity or commercial pressure. Clear communication, informed consent, data security and honest acknowledgment of professional limitations are essential.

THE FUTURE OF AESTHETIC CLINIC TESTING

Looking ahead, both practitioners believe that wellness diagnostics will become standard of care in advanced aesthetics.

“The clinics that thrive will be those that treat the patient as a whole human, not a face or a body part”, Dr Gooneratne predicts.

She also expects epigenetic testing, continuous metabolic monitoring and AI-supported interpretation to become part of personalised care while warning that “the risk is data overload; the opportunity is truly personalised, adaptive care. AI must support, not replace, clinical judgment.” Liberos sees the same trajectory: “Wellness testing and holistic health are increasingly becoming cornerstones of standard health in aesthetics and wellness.”

Emerging precision diagnostics, she notes, will increasingly support aesthetic planning. From nutrigenomics to deeper inflammatory and metabolic biomarker profiling.

Both experts believe the biggest long-term impact may be in improving women’s health, particularly around peri/ menopause, a stage where patients often say they “don’t feel like themselves” but feel unheard elsewhere.

The message is clear: Wellness testing isn’t a trend, it’s a natural evolution for the aesthetics sector that is going in the direction of precision medicine.

As clinics lean into testing and whole-person care, aesthetics is moving to helping patients truly feel better, function better and age better from the inside out.

“In other words, the “vanity door” becomes an entry or launch pad into longevity, vitality and prevention,” as Gooneratne puts it. “And that, to me, is a beautiful evolution of aesthetic medicine.”