COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE in VS .NET

Generate QR Code JIS X 0510 in VS .NET COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE

COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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Dehydroepiandrosterone believed to be a powerful antioxidant However, its abilities remain unproven (DHEA) is endogenous antioxidant DHEA pur-
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Melatonin is a hormone secreted by the pineal gland Less than 10 years ago, it was discovered to be a direct free radical scavenger Besides its ability to directly neutralize a number of free radicals and reactive oxygen and nitrogen species, it stimulates several antioxidative enzymes including superoxide dismutase, GPX, and glutathione reductase This increases its efficiency as an antioxidant254 Melatonin has been shown to markedly protect both membrane lipids and nuclear DNA from oxidative damage,255 and has been shown to reduce skin cancer formation in mice256 This may be because of its protective UV absorption effects257 Further, various studies in humans have demonstrated that topical melatonin reduces UV-induced erythema (sunburn)258,259 However, controversial results have been obtained in another study260 With regard to photoprotection, melatonin was shown to modulate the expression of apoptosisrelated genes in UVB-irradiated HaCaT cells, resulting in increasing cell survival This suggests that melatonin may be used as a sunscreen substance to reduce cell death of keratinocytes after excessive UVB irradiation261 Melatonin is also used as a medication for sleep disturbance in depression and in people complaining of jet lag It is currently available in an oral form and has also been added as an ingredient to various topical products, such as facial cleansers and moisturizers, eye creams, and skin lighteners
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studies263 Selenium supplementation has been shown to prevent UVB-induced skin tumors in hairless mice264,265 In addition to its antioxidant properties, the protective effects of selenium against skin cancer are enhanced because it prevents the production of inflammatory and immunosuppressive cytokines, which impair immune responses following UV exposure In fact, selenium has been shown to inhibit the UVB-induction of IL-6, IL-8, IL-10, and TNF- in a dosedependent manner266 Selenium has also been shown to boost both cellular and humoral immunity267 All these actions work synergistically to give selenium its anticancer properties The anticancer activity was recently demonstrated in a large double-blind, placebo-controlled intervention trial that evaluated whether selenium supplementation could reduce the risk of cancer268 In this study, 1312 individuals with a history of nonmelanoma skin cancer were randomized to placebo or 200 g selenium per day Although there was no effect on the primary endpoint of nonmelanoma skin cancer, those receiving selenium showed secondary endpoint effects of 50% lower total cancer mortality and 37% lower total cancer incidence with 63% fewer cancers of the prostate, 58% fewer cancers of the colon, and 46% fewer cancers of the lung SIDE EFFECTS The Institute of Medicine has set a tolerable upper intake level for selenium at 400 g/d269 Selenium toxicity, or selenosis, is associated with gastrointestinal upset, hair loss, white blotchy nails, and mild nerve damage270 Selenium and other antioxidants should always be taken as part of a balanced diet271 Otherwise, selenium can act as a pro-oxidant and cause DNA damage272 SUMMARY Although there is much interest and enthusiasm regarding the use of antioxidants, there is a paucity of clinical trials examining the capacity of antioxidants to prevent or decelerate the aging of skin One should remember that the theory behind the efficacy of these products is that they function by neutralizing free radicals, thus sparing the organs from the damage caused by these reactive oxygen species There is no reason to believe that antioxidants treat already formed wrinkles unless it can occur by a different mechanism such as through increased collagen synthesis as seen with vitamin C Current research suggests that combinations of various antioxidants might have synergistic effects and conse-
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quently more efficacy, as each antioxidant is endowed with various properties that distinguish it from other antioxidants16,273 Also, some data suggest a cumulative or additive bene t derived from using oral and topical antioxidant products in combination274,275 This has resulted in the entry of many antioxidant-containing beverages onto the market It is unknown if these beverages help prevent aging and inflammation; however, they are harmless and may be beneficial Further longterm studies in humans are needed to determine the efficacy of both the topical and oral products
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