The concept of aging has evolved from being primarily attributed to genetic factors to recognizing the critical role of epigenetic mechanisms. Recent advancements, such as epigenetic clocks, have provided tools to assess biological age and offer insights into aging processes at the molecular level. In aesthetic dermatology, understanding these processes allows for more personalized, effective interventions targeting the root causes of skin aging. This review explores the interplay of epigenetic changes, aging, and the potential of personalized care to enhance longevity and skin rejuvenation. This review is based on an extensive literature search conducted across PubMed and other scientific databases. Studies focused on epigenetic mechanisms such as DNA methylation, histone modifications, and their relationship to skin aging. Particular attention was given to recent advancements in biological clocks, including Horvath's Clock and GrimAge, and their implications for personalized dermatological treatments. Epigenetic clocks, such as Horvath's Clock, have demonstrated utility in assessing biological age through methylation markers, revealing actionable insights into aging processes. Energy-based devices like fractional lasers and radiofrequency have shown promise in reversing age-related epigenetic changes, promoting collagen synthesis, and reducing biological skin age. Additionally, lifestyle factors such as diet, sleep, and circadian rhythm alignment significantly influence epigenetic aging and skin health. Integrating epigenetic insights into aesthetic dermatology represents a paradigm shift in skin rejuvenation, allowing for personalized treatments that address visible signs of aging and underlying molecular mechanisms. Using biological clocks provides a framework for tailoring interventions to individual patient needs, optimizing outcomes, and extending the longevity of aesthetic results. Future research should focus on longitudinal studies, accessibility, and ethical considerations to fully harness the potential of epigenetics in promoting skin health and overall well-being.