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Clinical neurocosmetics: Adaptogenic pharmacology of ashwagandha

The skin is not a passive barrier, but a highly active peripheral neuroendocrine organ that acts as a bridge between the brain and the environment.

As the body’s largest organ, the skin is highly sensitive to environmental stressors, including UV radiation and pollution, and internal fluctuations in stress and hormones. When exposed for prolonged periods of time, chronic stress increases cortisol, and inflammatory mediators in the body.

This disrupts the skin barrier, increasing transepidermal water loss (TEWL) and activating enzymes that break down collagen, making the skin more reactive and prone to premature aging. Over time, this can cause fine lines, wrinkles, and sagging skin.

While stress and environmental stressors are impossible to eliminate entirely, there are ways to mitigate effects on skin health. Protecting the skin involves a combination of topical skincare, lifestyle adjustments, and an understanding of the skin-brain axis. Because of this, there has been growing industry focus on the skin-brain axis.

The brain and skin are deeply connected – representing a bidirectional communication network. This has emerged as a promising scientific paradigm in dermatology and cosmetics. Neurocosmetics – the intersection of neuroscience, dermatology, and psychodermatology – aims to target the skin-brain axis to enhance skin health and emotional wellbeing.1

Evidence-based topical solutions

Due to growing scientific understanding of the skin-brain axis, the industry is moving away from emotional, impulsive skincare and towards evidence-based topical solutions. This rise of stress-responsive skincare aims to provide symptom-based treatment by incorporating clinically-backed adaptogens into ingredients.

Over the last century, the prominence of adaptogens has grown in performance-enhancing nutraceuticals. As non-toxic substances derived from plants, roots, and mushrooms, adaptogens can provide a wide range of health benefits, including increasing the body’s resistance to stress.

In fact, adaptogens are metabolic regulators that improve the body’s resistance to the stress. They have gained increasing recognition in functional medicine, topical formulations, and nutraceutical research.

Ashwagandha (Withania somnifera) is a time-honoured Ayurvedic adaptogen gaining traction as a botanical ingredient, increasingly used in neurocosmetics thanks to its stress-reducing properties.

Acting through the skin-brain axis, ashwagandha can help to close the bridge between internal stress management and external skin concerns. There are several key ways that ashwagandha helps to protect the skin against stressors, including:

  • GABAergic receptor interaction: Ashwagandha acts as a GABA-mimetic to activate GABA receptors and promote sleep.2
  • Glucocorticoid pathway modulation: By interacting with glucocorticoid receptors in the brain, ashwagandha can reduce cortisol and stress levels.3
  • Cytokine and NF-κB regulation: Ashwagandha modulates cytokine expression and protects against skin inflammation.4
  • Antioxidant defence support: Ashwagandha can help to reduce oxidative stress and protect cellular integrity by neutralizing harmful free radicals.5
  • Positioning as an adaptogenic neuro-immune modulator: Ashwagandha offers potent immunomodulatory, neuroprotective, and adaptogenic properties.6 

Clinically-backed results

Standardized ashwagandha extracts are being evaluated in relation to its effect on stress-associated skin parameters, particularly root-derived forms such as KSM-66 Ashwagandha – a clinically backed ingredient in neurocosmetics, targeting the skin-brain axis to reduce stress related skin aging.

A randomized, double-blind, placebo-controlled study published in 2023 assessed the efficacy and safety of topical application lotion containing a standardized ashwagandha root extract on improvement of skin parameters in the photoaged facial skin of healthy subjects.7

The study included 56 health men and women between ages 18 to 60 with Fitzpatrick phototype III-VI skin grade. Participants were randomized to receive the topical application lotion or an identical placebo for 60 days.

Results showed a greater reduction in total physician assessment scores from baseline to day 60 with ashwagandha (-74.69%), compared to placebo (-48.68%). Outcomes showed changes from baseline in the TEWL, melanin index, hydration, and skin elasticity.

Percentage reduction in TEWL from baseline to day 60 was -15.12% with ashwagandha, in comparison to -8.34% with placebo. Similarly, greater percentage improvements were seen with ashwagandha as compared to placebo for skin hydration (20.66% with ashwagandha and 9.5% with placebo). Skin elasticity was also assessed by the R2 ratio, showing 16.34% increase with ashwagandha in comparison to 3.73% with placebo.

Results showed that topical application of a lotion containing ashwagandha standardized root extract can improve skin condition and quality of life in photoaged healthy individuals.

A soon-to-be published clinical study evaluating a topical KSM-66 Ashwagandha lotion in photoaged adults demonstrated a significant reduction in perceived stress along with improvements in several markers of skin health, including hydration, elasticity, and other symptoms associated with skin stress.8

Another clinical study evaluating the efficacy and safety of a topical Ashwagandha lotion on skin health, stress-related biomarkers, and perceived calmness has recently been completed.9 While the clinical results are currently pending analysis, emerging evidence continues to support ashwagandha’s potential as a credible active ingredient in the evolving field of neurocosmetics.

With clinical results pending, the emerging evidence is supporting ashwagandha’s position as a credible solution in the neurocosmetics space.

References

  1. Haykal, D.; et al. Beyond beauty: Neurocosmetics, the skin-brain axis, and the future of emotionally intelligent skincare. Clin Dermatol. 2025 Jul-Aug;43(4):523-527.
  2. Candelario, M.; et al. Direct evidence for GABAergic activity of Withania somnifera on mammalian ionotropic GABAA and GABAρ receptors. Journal of Ethnopharmacology. 2015; 171: 264-272.
  3. Sprengel, M.; et al. Withania somnifera (Ashwagandha) supplementation: a review of its mechanisms, health benefits, and role in sports performance. Nutr Metab (Lond). 2025; 22, 9.
  4. Sikandan, A.; et al. Ashwagandha root extract exerts anti‑inflammatory effects in HaCaT cells by inhibiting the MAPK/NF‑κB pathways and by regulating cytokines. Int J Mol Med. 2018 Jul;42(1):425-434.
  5. Guo, S.; et al. The benefits of ashwagandha (Withania somnifera) supplements on brain function and sports performance. Front Nutr. 2024 Aug 2;11:1439294.
  6. Dipankar, SP.; et al. Pharmacological Insights Into Ashwagandha (Withania somnifera): A Review of Its Immunomodulatory and Neuroprotective Properties. Cureus. 2025 Aug 12;17(8):e89856.
  7. Narra, K.; et al. A Study of Efficacy and Safety of Ashwagandha (Withania somnifera) Lotion on Facial Skin in Photoaged Healthy Adults. Cureus. 2023; 15(3): e36168.
  8. Efficacy and Safety of Ashwagandha Lotion for Skin Stress and Health in Photoaged Healthy Adults. (Under peer review).
  9. Efficacy and safety of topical ashwagandha lotion on skin health, stress biomarkers, and calmness. A 4-week randomized, double blind, placebo-controlled trial. (Ongoing).

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