Increased skin radiance was another benefit seen in the 12-week, double-blind, vehicle-controlled Draelos study of Re-Q. Participants using the RLX-201-containing serum showed improvement in skin radiance compared with vehicle.

One of the most interesting findings I learned about RLX-201 involves elastin. Rahul Mehta, PhD, told me that biopsies of RLX-201-treated skin showed an increase in mature elastin, not simply tropoelastin, the soluble precursor used to make elastin fibers. This is particularly interesting because restoring functional mature elastin in aged skin has been extremely difficult to achieve with topical skincare ingredients. These biopsy findings have not yet been published. It is too early to know how reproducible this effect will be and how long the new elastin will last.
There are also early anecdotal observations of skin tightening and decreased sagging on the arms and legs. Dr. Mehta showed me before-and-after photographs sent to him by dermatologists using Re-Q on their patients, including photographs from dermatologist Doris Day, MD. Dr. Day is also an author of the published RLX-201 research and has a financial relationship with Rapalogix. These early results are intriguing, but controlled studies are needed to determine whether RLX-201 truly increases mature elastin and whether that translates into meaningful improvement in skin laxity.

Another potential benefit of RLX-201 is decreased skin redness and inflammation. Many patients using Re-Q have reported less redness and improvement in rosacea. According to my discussions with Rahul Mehta, PhD, decreased redness was also seen when Canfield photographs from the Draelos study were compared, although this finding has not yet been published. This effect is biologically plausible because mTORC1 is involved in inflammatory and immune signaling in the skin. However, more clinical research is needed before we can say that RLX-201 treats rosacea or other inflammatory skin conditions. It certainly seems to be safe to use in rosacea patients. (I have rosacea and it has not caused me to get a rosacea flare).

Dry skin was reported in the unpublished Draelos study of Re-Q Pro-Longevity Face Serum There may be a biological explanation; mTORC1 helps regulate lipid synthesis through PPAR and SREBP, and epidermal lipids are essential for a healthy skin barrier. Because RLX-201 inhibits mTORC1, it could theoretically alter epidermal lipid production and contribute to dryness, although this has not been proven.

The dryness seen in the study may simply have occurred because ReQ is a serum and not a moisturizer. However, because mTOR signaling also plays a role in PPAR and epidermal and barrier function, I recommend using ReQ with a barrier repair moisturizer if you experience dryness form Re-Q Pro-Longevity Face Serum.

Because mTORC1 plays a role in epidermal differentiation and adhesion, I recommend avoiding exfoliants when first starting Re-Q. This includes hydroxy acids, retinoids, facial scrubs, peels, and other strong exfoliating products. Overexfoliation can damage the skin barrier and contribute to sensitivity, inflammation, acne breakouts, and hyperpigmentation. These problems were not seen in the Re-Q study, but Re-Q was studied alone, without acids or retinoids, so we do not yet know how these combinations affect the skin.

Dioxothiazetidinyl Demethoxyrapamycin is good for 8 of the Baumann Skin Types.  This is because it works best in skin at risk for aging. o if you are one of the eight "W" skin types, you can add this to your routine.

As fibroblasts age and are repeatedly exposed to stress, some become senescent, meaning they are still alive but no longer function like healthy younger cells. They become less effective at making collagen and maintaining the extracellular matrix that keeps skin firm and resilient.

 One theory of aging is that persistently elevated mTORC1 signaling keeps telling these already stressed cells to grow, make proteins, and remain metabolically active when what they really need is time for cellular maintenance and repair. Turning down mTORC1 is thought to give the cells a metabolic “rest,” allowing them to repair damage and potentially “reset” toward healthier cellular behavior. This idea of a cellular “reset” is one reason mTOR inhibition has become so interesting in longevity research.

RLX-201 is designed to turn down mTORC1 without turning down mTORC2. 

This distinction is important. mTORC2 supports cell survival, normal metabolism, and cellular structure, functions that we want to preserve. So the goal is not to shut down an aging fibroblast or stop it from working. The goal is to quiet excessive mTORC1 signaling long enough to allow the cell to devote more resources to maintenance and repair, while preserving mTORC2 signaling needed for healthy cell function. In simple terms, researchers are trying to give an overworked aging cell a rest so it has an opportunity to “reset,” rather than turning the cell off altogether.

mTORC1 is like a cellular signal that tells a cell when it has enough nutrients and energy to grow and make things. When mTORC1 is activated, it stimulates protein production, cell growth, and other energy-intensive activities. In a young, healthy fibroblast, this is necessary for normal function, including producing collagen and other components of the skin's extracellular matrix.

The problem may occur when mTORC1 remains chronically activated as cells age. Older fibroblasts accumulate damage and can become stressed, dysfunctional, or senescent, yet mTORC1 may continue signaling them to grow and produce proteins. At the same time, high mTORC1 activity suppresses autophagy, one of the cell's important systems for breaking down and recycling damaged cellular components.

This is why researchers are interested in temporarily turning down mTORC1. It may give an overworked aging cell a chance to stop focusing so heavily on growth and production and instead devote more resources to cleanup, maintenance, and repair. You can think of it as giving the cell a rest and an opportunity to “reset.”

mTORC2 helps regulate cell survival, metabolism, and the cytoskeleton, the internal structural framework that helps a cell maintain its shape and function.

The mTOR pathway is active in many types of skin cells, so RLX-201 could potentially affect more than fibroblasts. We know the most about its effects on dermal fibroblasts, but according to Dr. Mehta, effects have also been seen in keratinocytes. RLX-201 could potentially affect melanocytes and immune cells in the skin as well, but at this time there is not enough data to know what these effects are. Because topical Re-Q appears to remain within the skin rather than entering the bloodstream, its effects should primarily involve cells in the skin.

One of the most interesting potential uses for RLX-201 is preparing aging fibroblasts before procedures that stimulate collagen production. RLX-201 has been shown to shift older fibroblasts toward a younger, more elongated shape and functional phenotype. The hypothesis is that giving aging fibroblasts a period of “rest” before stimulating them may help them respond better to procedures. This strategy is still experimental, and clinical studies are beginning to investigate it.

I recommend using Re-Q for 2–4 weeks before a chemical peel, but stopping it 2 days before the peel. Preparing fibroblasts beforehand may potentially improve their response to the wound-healing signals generated by the peel, although this has not yet been proven. I would not restart Re-Q until the skin is completely healed, because of the theoretical possibility of delayed epidermal healing or overexfoliation.

The same approach makes sense with laser treatments. Using Re-Q for 2–4 weeks beforehand may help prepare aging fibroblasts to respond to the collagen-stimulating signals produced by laser treatment. I recommend stopping Re-Q 2 days before the laser procedure. RLX-201 could delay healing so wait until the skin is completely healed before restarting it.

Hyaluronic acid fillers and collagen biostimulators such as Sculptra and Radiesse stimulate fibroblasts and increase collagen production. With HA fillers, human studies show that the filler adds structural support to the extracellular matrix, creating mechanical forces that stimulate fibroblasts to produce more collagen. How well a fibroblast responds to these forces depends in part on its shape and its connections to the surrounding extracellular matrix.
RLX-201 has been shown to shift older, collapsed fibroblasts toward the elongated, spindle-shaped form seen in younger fibroblasts. This shape may allow fibroblasts to better sense and respond to the mechanical forces that stimulate collagen production. For this reason, using Re-Q before filler or biostimulator injections may help prepare fibroblasts to respond better to treatment. Re-Q can be used up until the time of injections. After treatment, I would switch to collagen-stimulating skincare such as vitamin C, retinoids, and exosomes to support the collagen response. This strategy is biologically plausible, but still hypothetical and needs to be tested in clinical studies.

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) stimulate fibroblasts with growth factors released by platelets, including PDGF and TGF-β, which can increase fibroblast activity and collagen production. But an exhausted fibroblast that is functioning poorly or approaching senescence may not respond as strongly to these signals.

RLX-201 has been shown in cell studies to shift aging fibroblasts toward a younger shape and activity level. This raises the possibility that pretreating with Re-Q could help “rest” exhausted fibroblasts and make them more responsive to the growth factors released by PRP or PRF, potentially improving the response to treatment. I recommend using Re-Q for several weeks before the procedure and stopping it 2 days before treatment, allowing time for its mTORC1-suppressing effects to wear off before fibroblasts are stimulated. Collagen-stimulating skincare can then be introduced after the skin has healed. This strategy is scientifically plausible but has not yet been tested in clinical studies.

The science behind RLX-201 is credible and based on an important area of aging research. Aging fibroblasts can become exhausted, misshapen, and less responsive to the signals that normally stimulate collagen production. By selectively reducing mTORC1 while preserving mTORC2, RLX-201 appears to give these cells an opportunity to rest and perform cellular housekeeping. In laboratory studies, treated fibroblasts regained the elongated, spindle shape associated with younger fibroblasts, which may make them better able to sense mechanical forces and respond to collagen-stimulating signals. Other early findings are also intriguing, including reduced p21, increased autophagy, and changes in DNA methylation toward a more youthful epigenetic pattern. These findings suggest reduced cellular senescence, although I would not yet call RLX-201 a proven senolytic.
This raises an especially interesting possibility: Re-Q Pro-Longevity Face Serum may eventually prove useful for helping other anti-aging skincare products and cosmetic procedures work better. A healthier, more responsive fibroblast may respond more effectively to retinoids, vitamin C, growth factors, exosomes, fillers, biostimulators, PRP/PRF, lasers, and other treatments that stimulate collagen production. For procedures, I currently recommend using Re-Q for 2–4 weeks beforehand and stopping it 2 days before treatment, allowing its mTORC1-suppressing effect to wear off before the collagen-stimulating phase begins.
However, RLX-201 and Re-Q are still very new. There are few published studies, and several of the most interesting findings have not yet been published in peer-reviewed medical journals. While early clinical findings, laboratory data, and anecdotal reports are promising, we need controlled studies to determine whether these cellular changes translate into meaningful long-term improvements in skin aging and whether pretreatment truly improves the response to other therapies. I am trying the serum myself and will update this article as more data and clinical experience become available.