The level of NAD(P)H in the epidermis is significantly greater in younger vs. older skin in vivo. This likely reflects decreased production and/or increased degradation of NAD(P)H in older skin, possibly as a result of chronological ageing and environmental damage (e.g. photodamage). NAD(P)H levels in epidermal skin may be a useful biomarker of skin ageing in vivo. It is also likely that maintaining NAD(P)H production is a useful approach to maintaining good skin condition and caring for ageing skin.