COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE in .NET framework

Create QR Code in .NET framework COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE

COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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Alpha Lipoic Acid
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Also named thioctic acid, alpha lipoic acid and its reduced form dihydrolipoic acid (DHLA) have both been considered strong antioxidants Alpha lipoic acid (Fig 33-17) has been called the universal antioxidant because it is both water and fat soluble and can thus act in the lipid cell membrane and the aqueous compartment of the cell134 In addition, alpha lipoic acid has been shown to inhibit the activation of NF- B transcription factor, modulating the cellular response to UV radiation and preventing UV-induced oxidative injury It further inhibits tyrosinase by chelating copper and suppressing DOPAquinone-derivative formation132 Dihydrolipoic acid shows slightly stronger antioxidant activity by reacting with superoxide and hydroxyl radicals135 In addition, alpha lipoic acid elevates intracellular GSH levels by increasing its de novo synthesis, 1 3 6 which again reduces UV radiation sensitivity137 Both lipoic and dihydrolipoic acids have been proven to block the expression of MITF (a regulator of melanocyte development and survival),138 consequently inhibiting tyrosinase expression and activity as well as inducing skin lightening20 Sodium zinc dihydrolipoylhistidinate (DHLHZn), a compound of Zn2 /dihydrolipoic acid derivate complex, seems to covalently react with DOPAquinone, resulting in a competitive inhibitory effect of DHLHZn on DOPAchrome formation and thus
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Pycnogenol is a standardized pine bark extract that exhibits potent antioxidant, anti-inflammatory, and anticarcinogenic activity123 125 The efficacy of pycnogenol in protecting against UVinduced pigmentation was evaluated in a 30-day clinical trial of 30 women with melasma Patients were given one 25-mg tablet of pycnogenol at each meal, 3 times daily Investigators found that the average surface area of melasma significantly decreased, revealing pycnogenol to be an effective and safe treatment for this condition124 One study has demonstrated that pycnogenol is active when applied topically In this study, hairless mice exposed to solar-simulated ultraviolet radiation were topically treated, postirradiation, with lotions containing pycnogenol Dose-dependent reductions in the inflammatory sunburn reaction and immunosuppression were observed as a result of pycnogenol treatment Tumor formation was delayed and tumor prevalence was also significantly reduced in mice treated with
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FIGURE 33-17 The chemical structure of alpha lipoic acid
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potentially serving as an effective skinlightening agent139 Lipoic acid is included in multiple topical cosmetic formulations However, there has been a report on contact dermatitis to alpha lipoic acid140 Further in vivo studies are necessary to verify the above-stated findings In addition, a recent report has called into question whether the topical antioxidant designation is accurate for alpha lipoic acid141
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Pyruvic Acid
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Pyruvic acid is an alpha-keto-acid with keratolytic, antimicrobial, and sebostatic properties in addition to the ability to stimulate new collagen production and elastic fiber formation It is successfully used in the treatment of acne156 A treatment with 50% pyruvic acid, employed for four peeling sessions performed every 2 weeks has been shown to effectively reduce the degree of pigmentation in melasma patients and significantly increase skin elasticity as well as decrease skin wrinkling No side effects, such as persistent erythema or postinflammatory hyperpigmentation, were observed157 Comparable results in terms of safety and efficacy were also shown in 20 patients treated for moderately photodamaged facial skin158
FIGURE 33-19 The chemical structure of lactic acid matory hyperpigmentation in individuals with dark complexions147 Patients who receive a chemical peel in addition to a topical treatment demonstrate a greater and more rapid improvement of pigmented lesions compared to topical treatment alone with a slight lightening of their normal facial skin tone148 In a recent study, lactic acid in a concentration of 92% was used to treat melasma Patients treated every 3 weeks for a maximum of 6 times showed significant improvement in their melasma area and severity index (MASI) scores149 Lactic acid was further shown to be as effective in decreasing pigmentation as Jessner s solution150 When treating PIPA with peels, it is initially important to use lower concentrations of AHA and slowly increase the strength to avoid irritating the skin, causing even more hyperpigmentation151 The use of topical HQ preparations pre- and postpeel decreases the chances of aggravating PIPA
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