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COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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based on the ranking of all four antioxidant assays (free radical scavenging capacity by 2,2-diphenyl1-picrylhydrazyl, DPPH; total oxygen radical absorbance capacity, ORAC; ferric reducing antioxidant power, FRAP; Trolox equivalent antioxidant capacity, TEAC) an overall antioxidant potency composite index was calculated by assigning each test equal weight Antioxidant index score (sample score/best score) 100, averaged for all tests for all beverages b Seeram NP, Aviram M, Zhang Y, Henning SM, Feng L, Dreher M, Heber D Comparison of Antioxidant Potency of Commonly Consumed Polyphenol-Rich Beverages in the United States J Agric Food Chem 2008;56(4):1415-1422 Epub 2008 Jan 26 PHOTOPROTECTION There have been numerous reports on the in vitro and in vivo anticancer properties of pomegranates205,206 Pomegranate fruit extract has been demonstrated to exert photochemopreventive properties, ameliorating UVAmediated damages by modulating cellular pathways207 The seed oil of the pomegranate fruit has been shown to possess chemopreventive activity against skin cancer208 In a recent study, Afaq et al showed that topically applied pomegranate fruit extract (PFE) possesses antiskin tumor-promoting effects in a CD-1 mouse model of chemical carcinogenesis201 They further studied the effect of PFE on UVB-induced adverse effects in NHEK and showed that PFE protects against the adverse effects of UVB radiation by inhibiting UVB-induced modulations of NF- B and MAPK pathways209 The same group then investigated the effect of polyphenol-rich PFE on UVBinduced oxidative stress and photoaging in human immortalized HaCaT keratinocytes, showing that pretreatment of HaCaT cells with PFE inhibited UVBmediated reduction in cell viability and
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intracellular glutathione content as well as an increase in lipid peroxidation It also inhibited the upregulation of various MMPs, and phosphorylation of MAPKs These results suggest that PFE protects HaCaT cells against UVB-induced oxidative stress and markers of photoaging and could be a useful supplement in skin care products210 This is buttressed by further in vitro studies that suggest that pomegranate peel fractions may promote dermal regeneration while pomegranate seed oil fractions may foster epidermal regeneration, presenting potential additional dermatologic applications211 Pomegranate extract is already available OTC in various skin care products
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antioxidative effect than does ALA DHLA is very unstable, however, and would get oxidized in a matter of minutes after application to the skin ALA has become popular because it is absorbed in a stable form and after it enters the cells, it is immediately converted to DHLA216 Podda et al studied the capacity of ALA to penetrate the skin in anesthetized hairless mice after application of a 5% solution in propylene glycol for 05 to 4 hours They showed the rate of ALA absorption into the skin to be constant by 30 minutes after application, reaching the maximum concentration by the 2-hour mark217 TOPICAL APPLICATION Topical application of 3% ALA in a lecithin base to human skin has been shown to decrease UVBinduced erythema in one-half the time of lesions treated with lecithin base alone217 This model indicated that topical application of ALA could prevent free radical damage to skin, and thus prevent photoaging and carcinogenesis218 Although ALA is available in topical cosmetic products and in formulations used for office peels, there are no published peer-reviewed clinical trials examining the efficacy of these products SYSTEMIC ADMINISTRATION ALA can be used either topically or systemically When systemically administered, it has been used to influence glucose control and prevent chronic hyperglycemiaassociated complications such as diabetes mellitus, Alzheimer s disease, cataracts, HIV activation, and radiation injury212,219 ALA has also been used as adjuvant therapy for glaucoma, ischemia-reperfusion injury, amanita mushroom poisoning, cellular oxidative damage,220 and Chagas disease221 There is no currently established RDA but most proponents of ALA supplementation suggest 25 to 500 mg daily ANTIOXIDATIVE BENEFITS There are four principal antioxidative properties of ALA: metal chelating capacity, ability to scavenge ROS, ability to regenerate endogenous antioxidants,222,223 and the ability to repair oxidative damage224 ALA is available in different forms and vehicles and currently marketed in cleansers, moisturizers, and oral supplements When starting patients on ALAcontaining products, they should be warned that they may feel a slight tingling sensation, which decreases after a few seconds and disappears within minutes of application Topical application of ALA is recommended every
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other day for the first week, increasing to twice a day for the third week if no side effects occur ALA can cause a significant amount of inflammation so these patients should be followed closely Fine skin lines may improve after a few weeks; however, this may be caused by the resultant inflammation Contact dermatitis to ALA has been reported225 SUMMARY ALA exhibits antioxidant and exfoliating properties that may render it a good choice for resistant skin types with a tendency to wrinkle (see 9) Please note, though, that the status of ALA as a topical antioxidant has recently been called into question (see 33)
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