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Vitamin E is an important fat‑soluble antioxidant and has been in use for more than 50 years in dermatology. It is an important ingredient in many cosmetic products. It protects the skin from various deleterious effects due to solar radiation by acting as a free‑radical scavenger. Experimental studies suggest that vitamin E has antitumorigenic and photoprotective properties. There is a paucity of controlled clinical studies providing a rationale for well‑defined dosages and clinical indications of vitamin E usage in dermatological practice. The aim of this article is to review the cosmetic as well as clinical implications of vitamin E in dermatology. Key words: Cosmetic, dermatology, vitamin E
© 2016 Indian Dermatology Online Journal | Published by Wolters Kluwer - Medknow 311
Drug Prole
Department of
Dermatology, STD and
Leprosy, Government
Medical College and
Associated SMHS
Hospital, Srinagar,
Jammu and Kashmir,
Itisanimportantingredientinmany cosmeticproducts.Itprotectstheskinfromvarious deleteriouseffects
dueto solarradiationby actingasa free‑radicalscavenger.Experimentalstudiessuggest thatvitaminE has
antitumorigenicandphotoprotective properties. Thereisapaucityofcontrolled clinical studies providinga
Key words:Cosmetic,dermatology,vitaminE
Vitamin E was rst described in 1922 by Herbert
M Evans and Katherine Bishop. In 1936, it
was biochemically characterized and named
tocopherol (Greek: “tocos” meaning offspring and
“phero” meaning to bring forth).[1,2]
Vitamin E is synthesized by plants and must
be obtained through dietary sources. Richest
sources are nuts, spinach, whole grains, olive
oil, and sunower oil.[3]
There are eight types of vitamin E (α-,β-,γ-, and
σ-tocopherols and their related corresponding
tocotrienols), γ-tocopherol being the most
abundant tocopherol in diet, whereas
α-tocopherol (α-Toc) is the most abundant
vitamin E derivative in human tissues and sera.
γ-Tocopherol levels exceeding those of α-Toc
in human skin,[4] inhibits the production of PGE2
and nitric oxide, and also prevents sunburn
cell formation, ultraviolet (UV) B-induced lipid
peroxidation and edema,[5,6] wherefore it has
a role in epidermal protection from oxidative
stress. Vitamin E also has a role in photoadduct
formation and immunosuppression.[7]
Stability of vitamin E depends on its form,
dl-α-Toc acetate being the most stable.
Vitamin E, occurring naturally in food in the form
of α-Toc oxidizes slowly when exposed to air. The
stability of topical vitamin E may be increased by
the use of vitamin E conjugates, which are esters
of tocopherol, resistant to oxidation but can still
penetrate skin layers.[8]
Although many cosmeceuticals contain vitamins
C and E, very few are actually effective in topical
application because the stability is compromised
as soon as the product is opened and exposed
to air and light.
However when a stable formulation delivers
a high concentration of nonesteried, optimal
isomer of the antioxidant, vitamins C and E
inhibit the acute UV damage as well as chronic
UV photoaging and skin cancer.[9]
Ferulic acid is a ubiquitous plant antioxidant
and its incorporation into a topical solution of
Vitamin E in dermatology
Mohammad Abid Keen, Iffat Hassan
Address for
Dr. Mohammad Abid
Iqbal Abad, KP Road,
Anantnag ‑ 192 101,
Jammu and
Kashmir, India.
E‑mail: keenabid31@
Access this article online
DOI: 10.4103/2229-5178.185494
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Cite this article as: Keen MA, Hassan I. Vitamin E in
dermatology. Indian Dermatol Online J 2016;7:311-5.
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15% l-ascorbic acid and 1% of α-Toc improves chemical
stability of the vitamins (C + E) and doubles photoprotection to
solar-stimulated irradiation of skin from fourfold to eightfold.[10]
Yellow nail syndrome: (Level of evidence IV)
The yellow nail syndrome includes slow growing, opaque
yellow nails with exaggerated yellow curvature, lymphedema,
and chronic respiratory disorders such as chronic bronchitis,
pleural effusions, and chronic sinusitis.[11] Vitamin E is one of
the treatment modalities for yellow nail syndrome,[12] in a dosage
of 1000 IU once a day for a period of 6 months.[13]
Dapsone‑induced hemolysis and headache: (Level of
evidence IV)
In various studies to ascertain the protective effect of Vitamin
E on the hemolysis associated with dapsone treatment, it was
seen that (dl-α-tocopheryl acetate) in a dose of 800 IU/day
confers a partial protective effect against dapsone-induced
hemolysis in patients with dermatitis herpetiformis.[14,15] Vitamin
E has also been used in dapsone-induced headache.[16]
Headache is a recognized effect of methemoglobinemia, and
reduction of previously elevated methemoglobin concentration
is presumably the mechanism by which vitamin E improves this
symptom, as improved methemoglobin concentration seems
to be the most consistent laboratory parameter in studies of
vitamin E for protection against dapsone side effects.[14]
Subcorneal pustular dermatoses: (Level of evidence IV)
Vitamin E (d-α-tocopheryl acetate) 100 IU/day, gradually
increasing to 400 IU/day for 4 weeks is one of the therapeutic
modalities in subcorneal pustular dermatoses, particularly
those showing unsatisfactory response to conventional
Cutaneous amyloidosis: (Level of evidence IV)
Tocoretinate is a hybrid compound of retinoic acid and
tocopherol. In a study designed to evaluate the effects of topical
tocoretinate on lichen amyloidosis and macular amyloidosis,
it was concluded that topical tocoretinate reduces the clinical
symptoms of lichen and macular amyloidosis.[18]
Other dermatological indications for which there is
little utility for the use of Vitamin E
Atopic dermatitis
A single-blind, placebo-controlled study was performed by
Tsoureli-Nikita et al. in which 96 atopic dermatitis patients were
treated with either placebo or oral vitamin E (400 IE/day) for
8 months. They found an improvement and near remission of
atopic dermatitis and a 62% decrease in serum IgE levels in
the vitamin E-treated group. Vitamin E decreases serum levels
of IgE in atopic subjects.[19] The correlation between vitamin E
intake, IgE levels, and the clinical manifestations of atopy indicate
that vitamin E could be a therapeutic tool for atopic dermatitis.
Hailey–Hailey disease
In 1975, Ayres and Mihan reported control of the condition of
three patients with Hailey–Hailey disease by oral administration
of vitamin E in the form of d-α-tocopheryl acetate in doses of
800–1200 IU/L.[20] The exact mechanism by which Vitamin E
controls this disease is unknown, but its antioxidant action in
protecting cell membrane from lipid peroxidation, thus perhaps
preventing the formation of autoimmune antibodies, may be an
important factor.[21]
Epidermolysis bullosa
Several case reports suggest efcacy of vitamin E (300–600 IU/day)
for the management of epidermolysis bullosa.[22,23] Vitamin E
acts as an antioxidant, thus protecting the cell membranes and
intracellular organelles from lipid peroxidation.[24] It is possible
that in case of epidermolysis bullosa, there is a genetic defect
that effects the storage of Vitamin E in the tissues or in the ability
of tissues to use it, which necessitates an additional supply.[24]
A natural product, called “Mirak,” for the treatment of psoriasis
has recently become available in many European countries.
Mirak consists of natural spring water, valconic earth, and
vitamin E cream. It induces a modest therapeutic effect
compared with placebo, without any signicant side effects, but
may not be able to compete with the already existing treatment
options for psoriasis.[25]
Cutaneous ulcers
Vitamin E has been seen to be useful in the treatment of
pressure sores in doses of 800 IU/L gradually increasing to
1600 IU/L in four patients.[26]
Skin cancer prevention
Mouse studies reported inhibition of UV-induced tumors in mice
fed with α-tocopherol acetate.[27] Multiple human studies have
shown no effects of vitamin E on the prevention or development
of skin cancers.[28,29]
Wound healing
Vitamin E along with zinc and vitamin C, is included in oral
therapies for pressure ulcers and burns.[30] The antioxidant
supplementation through vitamins E and C and the mineral
zinc has been seen to apparently enhance the antioxidant
protection against oxidative stress and allow less time for
wound healing.[31]
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Vitamin E alone has shown minimal efcacy in the treatment
of melasma.[32] It has been shown to cause depigmentation by
interference with lipid peroxidation of melanocyte membranes,
increase in intracellular glutathione content, and inhibition of
In a randomized, double-bind, placebo-controlled trial, a
combination of oral proanthocyanidin plus vitamin A, C, and E
was assessed in 60 Phillipino females with bilateral epidermal
melasma. The antioxidants were taken twice a day for 8 weeks
and were compared with placebo intake by mexametric and
Melasma Area and Severity (MASI) score analysis.[34] There
was a signicant reduction in MASI scores and pigmentation
by mexametry in malar regions.
Pycnogenol is a standardized extract of the bark of the
French maritime pine (Pinus pinaster), a well-known, potent
antioxidant, several times more powerful than vitamin E
and in addition, regenerates vitamin E and increases the
endogenous antioxidant enzyme system. Therefore its efcacy
in the treatment of melasma was investigated in a clinical
study in which 30 women with melasma took one 25 mg tablet
of pycnogenol with meals three times daily, that is, 75 mg
pycnogenol per day for a period of 30 days. These patients
were evaluated clinically by parameters such as the melasma
area index, pigmentary intensity index, and by routine blood and
urine tests. After a 30-day treatment, the average melasma area
of the patients decreased by 25.86 ± 20.39 mm (2) (P < 0.001)
and the average pigmentary intensity decreased by 0.47 ± 0.51
unit (P < 0.001).[35]
α-Toc derivatives inhibit tyrosinase in vitro[36] and melanogenesis
in epidermal melanocytes.[37] The antioxidant properties of
α-Toc, which interferes with lipid peroxidation of melanocyte
membranes and increases the intracellular glutathione content,
could explain its depigmenting effect.[38]
Acne vulgaris
In one of the studies conducted in a series of 98 patients,
the emphasis was based on the correction of the defective
keratinization of sebaceous follicles with a combination of
vitamin E and vitamin C.[39] This was seen to prevent the
formation of comedones, thus depriving the Propionibacterium
acnes of a culture medium. Vitamin E prevents lipid peroxidation
of serum from bacterial-induced leakage through follicles
and sebaceous glands, thus preventing inammation due to
peroxide irritation.
Vitamin E has also been used with high doses of isotretinoin
to ameliorate isotretinoin-induced side effects. However,
studies have demonstrated that vitamin E does not signicantly
ameliorate retinoid side effects when combined with isotretinoin
in the treatment of acne.[40,41]
Oxidative stress is signicantly increased in patients with
scleroderma when compared with the healthy controls,
suggesting that free radical induced oxidative injury occurs
in scleroderma.[42] Antioxidants such as vitamin E might,
therefore, be benecial. Vitamin E is also believed to stabilize
lysosomal membranes, potentially inhibiting events involved in
the autoimmune process.[21]
Vitamin E supplementation has resulted in improvement in
the skin of scleroderma patients, although nondermatological
aspects of scleroderma did not improve.[43]
Various components of scleroderma, including morphea,
calcinosis cutis, and Raynaud’s phenomenon respond to
vitamin E.[44] The dose of vitamin E in these reports ranged
from 200 to 1200 IU per day.
One patient successfully treated was a 45-year-old man with
Raynaud’s phenomenon, probable early scleroderma, and
ulceration and gangrene of the ngertips. He received 800 IU
oral vitamin E daily and applied the vitamin (50 IU per mL) to the
ulcerated ngers twice daily. The ulcerations became less painful
after two weeks and healed almost completely within one month.[45]
Dermatological indications for which there are
anecdotal reports of beneficial effects of vitamin E
Chronic cutaneous lupus erythematosus[46]
Keratosis follicularis[47]
Postherpetic neuralgia[48]
Pseudoxanthoma elasticum[49]
Porphyria cutanea tarda.[50]
Recommended dose of vitamin E
In case of vitamin E, the recommended intake (6–10 mg of
α-tocopherol or the equivalent) is based solely on an estimate
of how much tocopherol the average person consumes.[51] In a
healthy adult who had been on a normal diet it would take an
estimated 4 years to fully deplete body stores of vitamin E.[52]
Topical vitamin E has emerged as a popular treatment for a
number of skin disorders owing to its antioxidant properties. It
has been seen that reactive oxygen species have the ability to
alter the biosynthesis of collagen and glycosaminoglycans in
skin.[53] Most of the over-the-counter antiaging creams contain
0.5%–1% of vitamin E.
One of the most popular applications of vitamin E is the
treatment of burns, surgical scars, and wounds. However,
studies looking at the efcacy of vitamin E in the treatment of
burns and scars have been disappointing.[54,55]
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Topical vitamin E has also been found to be effective in
granuloma annulare.[56] Vitamin E is one of the ingredients in
over-the-counter treatments of skin aging.[57] Topical application
of the gel containing 2% phytonadione, 0.1% retinol, 0.1%
vitamin C, and 0.1% vitamin E has been seen to be fairly
or moderately effective in reducing dark under-eye circles,
especially in cases of hemostasis.[58]
Vitamin E supplements in pregnancy usually contain only small
doses of vitamin E, although adverse effects have not been
observed even at higher doses.[59] Theoretically, however,
due to the involvement of cytochrome P450 system in the
metabolism of orally supplemented RRR-α-tocopherol, drug
interactions have to be taken into account when supranutritional
doses of Vitamin E are provided. There is no published report
documenting adverse fetal effects due to use of topical vitamin
Most of the people do not experience any side effects when
taking the recommended daily dose. High dose can cause
nausea, diarrhea, stomach cramps, fatigue, weakness,
headache, blurred vision, rash, bruising, and bleeding.
Vitamin E being a fat-soluble vitamin, administration of a dose
higher than daily requirement results in accumulation inside
the body, resulting in hypervitaminosis E. Healthy adults
taking vitamin E daily at a dose of 100 mg for more than 1 year
are likely to get hypervitaminosis E, manifesting as reduced
platelet aggregation and interference with vitamin K metabolism
resulting in bleeding tendencies.[60]
Topical application of vitamin E can rarely cause contact
dermatitis,[61] erythema multiforme,[62] and xanthomatous
There are no contraindications to the use of vitamin E. Patients
with coagulation disorders or taking anticoagulant medications
should be monitored for increased bleeding tendencies.
Despite development of new formulations for use in cosmetics
and skin care products, there is a lack of controlled clinical
trials providing a rationale for well-dened dosages and clinical
indications for oral and topical vitamin E. After so many years
of research on vitamin E, it is still unclear as to whether millions
of dollars worth of vitamin E products paid for by patients and
consumers have been of any benet. A better understanding of
this vitamin may help in evaluating the indications and dosage
regimens for the prevention and treatment of acute and chronic
skin disorders.
Financial support and sponsorship
Conflicts of interest
There are no conicts of interest.
1. EvansHM,EmersonOH,EmersonGA.Theisolationfromwheatgerm
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Topicalapplication of a novel, hydrophilicgamma‑tocopherol
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15. KellyJW,ScottJ,SandlandM,VanderWeydenMB,MarksR.Vitamin
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... Additionally, some cosmetics are used to improve the appearance of aged skin and may benefit from the addition of seaweed and its bioactive compounds. Some algal products as vitamin E and pigments can rejuvenate and act towards skin ageing (Keen and Hassan 2016). Nonetheless, the final concentration of extracts in the product must comply with regulatory and safety requirements, especially due to the presence of heavy metals, and allergens (e.g. ...
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Seaweeds have been identified as a valuable source of natural ingredients and their use in cosmetics is being studied increasingly. This work sought to understand the possible uses of three species of brown algae present along the Portuguese coast: Bifurcaria bifurcata, Saccorhiza polyschides and Fucus spiralis. Considering the idea of more sustainable use of resources, two extracts (water (W) and ethanol (E)) and two fractions (polysaccharides (P) and residues (R)) were obtained employing a biorefinery process. The extracts and fractions were evaluated in terms of antioxidant capacity (ABTS•+, DPPH•, •NO, O2•− and FRAP assays), anti-hyperpigmentation capacity (tyrosinase inhibition), and evaluated in terms of biocompounds (phenolic compounds and pigment content). The biochemical analysis revealed that F. spiralis contain more lipids and carbohydrates than the other species, while S. polyschides has more proteins and ashes. Fucus spiralis showed the most promising results, regarding the antioxidant assays, tyrosinase inhibition, highest phenolic compound concentration, total chlorophylls and total carotenoids. In a biorefinery concept, F. spiralis from the autumn season would be the most promising candidate as all extracts and fractions have potential commercial value. Bifurcaria bifurcata also has its merits in antioxidant activities and the content of phenolic compounds.
... One approach to improve the stability of topical vitamin E solutions involves the use of vitamin E conjugates, commercially produced esters of tocopherol that exhibit resistance to oxidation while retaining the ability to penetrate the layers of the skin. However, it is important to note that vitamin E conjugates do not possess antioxidant functions, and the efficacy of these formulations can vary considerably depending on the specific compound and the model system utilized [153]. ...
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Disruption of the skin barrier and immunity has been associated with several skin diseases, namely atopic dermatitis (AD), psoriasis, and acne. Resident and non-resident immune cells and the barrier system of the skin are integral to innate immunity. Recent advances in understanding skin microbiota have opened the scope of further understanding the various communications between these microbiota and skin immune cells. Vitamins, being one of the important micronutrients, have been reported to exert antioxidant, anti-inflammatory, and anti-microbial effects. The immunomodulatory action of vitamins can halt the progression of skin diseases, and thus, understanding the immuno-pharmacology of these vitamins, especially for skin diseases can pave the way for their therapeutic potential. At the same time, molecular and cellular markers modulated with these vitamins and their derivatives need to be explored. The present review is focused on significant vitamins (vitamins A, B3, C, D, and E) consumed as nutritional supplements to discuss the outcomes and scope of studies related to skin immunity, health, and diseases. Graphical abstract
... Studies indicate that orally administered antioxidants can reach detectable levels in the skin. For instance, Keen and Hassan demonstrated increased vitamin E levels in the skin following oral administration of vitamin E [10]. Similarly, Pullar et al. showed increased vitamin C levels in the skin after oral supplementation with vitamin C [11]. ...
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... Persiapan dilakukan 3 bulan menjelang acara dilaksanakan meliputi: Pendataan peserta: Pendataan peserta dilakukan dengan menghubungi ketua RW serta ketua PKK pada RW 06 Cempaka Baru untuk mendata jumlah peserta yang akan mengikuti pelatihan. Penyiapan bahan yang akan digunakan dalam pelatihan (Keen and Hassan, 2016). Beberapa bahan yang akan digunakan dibeli pada toko bahan baku kosmetik. ...
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Setiap perempuan menginginkan penampilan yang menarik dengankulit wajah yang putih, cerah dan berseri. Untuk mendapatkan kulityang sehat dan menarik diperlukan perawatan yang rutin. Salahsatunya dengan menggunakan skincare berupa gel pencerah kulit.Salah satu penyebab yang membuat kulit wajah menjadi kusam danmuncul permasalahan seperti flek hitam adalah radikal bebas yangmerupakan dampak polusi lingkungan. Radikal bebas adalah suatusenyawa atau molekul yang berdiri sendiri yang mengandung satuatau lebih elektron yang tidak berpasangan pada orbit luar. Efek dariradikal bebas ini dapat menyebabkan kulit terlihat kusam danmempercepat timbulnya flek hitam serta penuaan dini. Air cucianberas terbukti berpotensi sebagai antioksidan dan antiaging karenamemiliki starch atau pati halus. Pati dapat mengangkat sel kulit matidan meregenerasi sel kulit. Selain itu Air cucian beras mengandungtotal polifenol 390.98 mg/100 g. Berdasarkan hal tersebut maka perludikembangkan potensi antioksidan air cucian beras pada sediaankosmetik menjadi suatu sediaan perawatan kulit. Salah satu bentuksediaan kosmetika yang banyak diminati adalah gel. Hal ini karena gelmudah mengering, membentuk lapisan film yang mudah dicuci danmemberikan rasa dingin di kulit. Berdasarkan latar belakang danmanfaat dari air cucian beras maka perlu diadakan pelatihanpembuatan skincare gel yang mengandung air cucian beras untukdapat membantu ibu-ibu PKK dalam merawat kulit wajah. Selain itupelatihan ini juga memberikan peluang wirausaha rumah tangga.
The biological process of aging is intricate and progressive, and it is influenced by both environmental and hereditary variables. These days, eating a diet that is unbalanced and weak in many vital nutrients is also connected to aging. Nutraceuticals are now valued and regarded as a vital component in enhancing life and supplying antioxidant-containing compounds. Numerous fruits and vegetables include antioxidant molecules that have advantageous qualities that can slow down the aging process. Additionally, these nutraceuticals have a positive effect on the digestive system and do not manifest any undesirable effects. Therefore, the use of nutraceuticals as food supplements holds great promise for slowing down and preventing the aging process. The advantages of nutraceuticals encourage their inclusion in the diet for better health and longevity. The anti-aging effects of plant-based supplements and plant-derived metabolites are systematically summarized.KeywordsAgingNutraceuticalsAntioxidantsFree radical scavengersDNA damage
Parkinson's disease (PD) is designated as a convoluted nerve cell devastating disorder that encompasses the profound declination of dopaminergic (DArgic) nerve cells of the mesencephalon region. The condition is sketched by four eminent motor manifestations, namely, slow movement, muscle tension, shaking, and disrupted balance, but the pathology behind these manifestations is still vague. Modern-day medicinal treatment emphasizes curbing the manifestations via introducing a gold standard (levodopa) instead of forestalling the DArgic nerve cell destruction. Therefore, the invention and utilization of novel neuroprotective candidates are of paramount importance in overcoming PD. Vitamins are organic molecules engaged in the modulation of evolution, procreation, biotransformation, and other operations of the body. Numerous studies employing varying experimental models have promulgated a prominent linkage between vitamins and PD. Vitamins, owing to their antioxidant and gene expression modulation abilities, might be efficacious in PD therapy. Recent corroborations depict that adequate augmentation of vitamins might de-escalate the manifestations and emergence of PD; however, the safety of daily vitamin intake must be considered. By assembling the comprehensive information obtained from existing publications via searching various renowned medical portals, the investigators render in-depth insights into the physiological association amongst vitamins (D, E, B3, and C) and PD and concerned pathological processes and their safeguarding actions in varied PD models. Furthermore, the manuscript delineates the remedial aptitude of vitamins in PD therapy. Conclusively, augmentation of vitamins (owing to their antioxidant and gene expression regulation capabilities) might appear as a novel and terribly efficacious ancillary therapeutic approach for PD.
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Environmental stressors such as air pollutants, ozone, and UV radiation are among the most noxious outdoor stressors affecting human skin and leading to premature skin aging. To prevent the extrinsic aging, the skin is equipped with an effective defensive system. However, cutaneous defense mechanisms can be overwhelmed through chronic exposure to environmental pollutants. Recent studies have suggested that the topical usage of natural compounds, such as blueberries, could be a good strategy to prevent skin damage from the environment. Indeed, blueberries contain bioactive compounds found to induce an active skin response against the environmental noxious effects. In this review, results from recent studies on this topic are discussed in order to build the argument for blueberries to possibly be an effective agent for skin health. In addition, we hope to highlight the need for further research to elucidate the mechanisms behind the use of both topical application and dietary supplementation with blueberries to bolster cutaneous systems and defensive mechanisms.
Objective: To explore the volatile chemical constituents present in different crude extracts of Huberantha senjiana (H. senjiana) leaves. Method: The coarsely powdered foliar parts of the leaves were extracted sequentially with solvents of increasing polarity like n-hexane, chloroform, ethyl acetate, isopropyl alcohol, and methanol. The extracts obtained were subjected to GC-MS analysis. Results: The analysis revealed the presence of different non-polar compounds in all five extracts in different concentrations. The bioactive Phyto compounds were recognized and characterized based on their retention and elution order in an analytical column. The mass spectra are matched with the inbuilt database of the NIST 8 library to identify the compound present. Conclusion: The present study is considered to be the preliminary study that reveals the presence of volatile components in different leaf extracts of H. senjiana which will serve as a reference for future studies.
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Glaucoma is a chronic optic neuropathy that can lead to irreversible functional and morphological damage if left untreated. The gold standard therapeutic approaches in managing patients with glaucoma and limiting progression include local drops, laser, and/or surgery, which are all geared at reducing intraocular pressure (IOP). Nutrients, antioxidants, vitamins, organic compounds, and micronutrients have been gaining increasing interest in the past decade as integrative IOP-independent strategies to delay or halt glaucomatous retinal ganglion cell degeneration. In our minireview, we examine the various nutrients and compounds proposed in the current literature for the management of ophthalmology diseases, especially for glaucoma. With respect to each substance considered, this minireview reports the molecular and biological characteristics, neuroprotective activities, antioxidant properties, beneficial mechanisms, and clinical studies published in the past decade in the field of general medicine. This study highlights the potential benefits of these substances in glaucoma and other ophthalmologic pathologies. Nutritional supplementation can thus be useful as integrative IOP-independent strategies in the management of glaucoma and in other ophthalmologic pathologies. Large multicenter clinical trials based on functional and morphologic data collected over long follow-up periods in patients with IOP-independent treatments can pave the way for alternative and/or coadjutant therapeutic options in the management of glaucoma and other ocular pathologies.
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Human skin needs additional protection from damaging ultraviolet radiation (UVR: 280–400 nm). Harmful UVR exposure leads to DNA damage and the development of skin cancer. Available sunscreens offer chemical protection from detrimental sun radiation to a certain extent. However, many synthetic sunscreens do not provide sufficient UVR protection due to the lack of photostability of their UV-absorbing active ingredients and/or the lack of ability to prevent the formation of free radicals, inevitably leading to skin damage. In addition, synthetic sunscreens may negatively affect human skin, causing irritation, accelerating skin aging and even resulting in allergic reactions. Beyond the potential negative effect on human health, some synthetic sunscreens have been shown to have a harmful impact on the environment. Consequently, identifying photostable, biodegradable, non-toxic, and renewable natural UV filters is imperative to address human health needs and provide a sustainable environmental solution. In nature, marine, freshwater, and terrestrial organisms are protected from harmful UVR through several important photoprotective mechanisms, including the synthesis of UV-absorbing compounds such as mycosporine-like amino acids (MAAs). Beyond MAAs, several other promising, natural UV-absorbing products could be considered for the future development of natural sunscreens. This review investigates the damaging impact of UVR on human health and the necessity of using sunscreens for UV protection, specifically UV-absorbing natural products that are more environmentally friendly than synthetic UV filters. Critical challenges and limitations related to using MAAs in sunscreen formulations are also evaluated. Furthermore, we explain how the genetic diversity of MAA biosynthetic pathways may be linked to their bioactivities and assess MAAs’ potential for applications in human health.
A young man with a severe eruption of keratosis follicularis (Darier's disease) of long duration had failed to respond to continuous administration of vitamin A in large doses over a five year period. Seven months after adding vitamin E in a dose of 1,200 international units (IU) daily and continuing vitamin A, the eruption had improved approximately 75%. It is speculated that the striking improvement in this recalcitrant case was due to a synergistic action of vitamin E with vitamin A, previously demonstrated experimentally. If these results can be duplicated, it would suggest the advisability of the combined administration of these vitamins in those conditions where vitamin A is indicated, thus facilitating its utilization and lessening the danger of hypervitaminosis A by reducing the amounts required for a therapeutic effect.
We have prepared from the non-saponifiable matter of wheat germ oil thress aflophanates: 1. M.p. 250°. This is a possibly the allophante of β-amyrin. The alcohol regenrated from the allopohante has no vitamin E potency. 2. M.p. 138°, readily crystallizing in long needles. The analysis agree with values required by monollophantes of an alcohol, C39H50O2. The alcohol from this allophante apparenelly has some vitamin E potency, but less than that from the third allophanate. 3. M.p. 158-160°. From this allophanate, the alcohol—for which we propose the name α-tocopherol—when given in a single dose of 3 mg. always enables vitamin E-deficient rats to bear young. α-Tocopherol shows a characteristic absoption band at 2980 Å., E1 per cent1 cm. = 90 ca. Treatment with methyl alcoholic silver nitrate converts it to a substance which has absorption bands at 2710 and 2620 Å respectively, E1 per centcm. = 480 ca., and possesses and some vitamin E activity. α-Tocopherol yields a crystaline p-nitrophenylurethane melting at 120-131°. Analyses of both the urethane and the allophanate indicate a provisional formula for α-tocopherol of C29H50O2
A novel vitamin E derivative, (6″-hydroxy-2″,5″,7″,8″-tetramethylchroman-2″-yl) methyl 3-(2′,4′-dihydroxyphenyl)propionate (TM4R), which has a chromanoxyl ring and 4-substituted resorcinol moieties, was synthesized; and its inhibitory effects on tyrosinase, antioxidant ability, and lightening effect of ultraviolet B (UVB)-induced hyperpigmentation were estimated. TM4R showed potent inhibitory activity on tyrosinase, which is the rate-limiting enzyme in melanogenesis. The scavenging activities of TM4R on 1,1-diphenyl-2-picrylhydrazyl and hydroxyl radicals were found to be nearly the same as those of α-tocopherol. Furthermore, an efficient lightening effect was observed following topical application of TM4R to UVB-stimulated hyperpigmented dorsal skin of brownish guinea pigs. These results suggest that TM4R may be a candidate for an efficient whitening agent, possibly by inhibiting tyrosinase activity and biological reactions caused by reactive oxygen species.
Yellow nail syndrome is an acquired condition of unknown etiology, rarely seen in children, characterized by a triad of thickened yellow nails, primary lymphedema, and respiratory manifestations. We report an 8-year-old girl with this syndrome who showed improvement with Fluconazole, 200 mg once weekly and vitamin E, 1000 IU once daily.
Lichen amyloidosis and macular amyloidosis are commonly therapy-resistant. Tocoretinate is a hybrid compound of retinoic acid and tocopherol that is commonly used for the treatment of skin ulcers. Although beneficial effect of oral retinoic acid on lichen amyloidosis is reported, tocoretinate has not been reported to be useful for the treatment of lichen amyloidosis or macular amyloidosis. We evaluated the effects of topical tocoretinate on lichen amyloidosis and macular amyloidosis lesions. Tocoretinate was topically applied daily to the lesions and clinical improvement and histological changes were evaluated. The outcome was very good for four, good for two, moderate for two and poor for two of 10 treated patients. Epidermal hypertrophy was reduced and expression of involucrin, keratin 1 and keratin 10 was decreased by tocoretinate treatment, suggesting the normalization of epidermal differentiation. Amyloid deposits remained histologically detectable, even in clinically responsive patients. Together, topical application of tocoretinate reduced the clinical symptoms of lichen amyloidosis and macular amyloidosis, and normalized disturbed epidermal differentiation.
This review evaluates the efficacy of vitamin supplementations for prevention and treatment of pressure ulcer and surgical wounds on the basis of recent clinical intervention studies. Intervention studies show that an energy and protein-rich oral nutritional supplement providing high doses of vitamin C and zinc in combination with arginine may prevent the development of pressure ulcers. This measure seems to improve the healing of pressure ulcer, which is questionable for vitamin C alone. For surgical wounds, data from randomized controlled studies are scarce, but results on the use of vitamin C in combination with pantothenic acid are promising. Considerable evidence suggests that supplementation of vitamin C together with zinc by an oral nutritional supplement rich in energy, protein and arginine may be an efficient tool for pressure ulcer healing in contrast to single vitamin C. The evidence for prevention of pressure ulcer by such an oral nutritional supplement is comparably low. This fits also for single vitamin C supplementation in the healing of surgical wounds. Further, well designed and well powered studies on the benefit of antioxidant vitamins for wound healing within a diet providing adequate energy and protein are necessary.
The aim of this study was to investigate the effect of supplementation of vitamin E, vitamin C, and zinc on the oxidative stress in burned children. In a prospective double-blind placebo controlled pilot study, 32 patients were randomized as no supplementation (n = 15) or antioxidant supplementation (n = 17) groups. Supplementation consisted of the antioxidant mixture of vitamin C (1.5 times upper intake level), vitamin E (1.35 times upper intake level), and zinc (2.0 times recommended dietary allowance) administered during 7 days starting on the second day of admittance into the hospital. Energy requirement was calculated by the Curreri equation, and protein input was 3.0 g/kg of ideal body mass index (percentile 50). Total antioxidant capacity of plasma and malondialdehyde were used to monitor oxidative stress. The time of wound healing was evaluated as the main clinical feature. Patients (age 54.2 +/- 48.9 months, 65.6% males), who exhibited 15.5 +/- 6.7% of total burn area, showed no differences in age and sex, when compared with controls. Intake of the administered antioxidants was obviously higher in treated subjects (P = .005), and serum differences were confirmed for vitamin E and C, but not for zinc (P = .180). There was a decrease in lipid peroxidation (malondialdehyde level) (P = .006) and an increase in vitamin E concentrations in the antioxidant supplementation group (P = .016). The time of wound healing was lower in the supplemented group (P < .001). The antioxidant supplementation through vitamin E and C and the mineral zinc apparently enhanced antioxidant protection against oxidative stress and allowed less time for wound healing.
Melasma is a common, acquired, symmetric hypermelanosis characterized by irregular brown to gray-brown macules on the cheeks, forehead, nasal bridge, cutaneous part of the upper lip, mandible, and the upper arms. Few trials have been conducted regarding the potential benefits of oral procyanidin in melasma. To assess the safety and efficacy of oral procyanidin + vitamins A, C, E among Filipino patients with epidermal melasma. A randomized, double-blind, placebo-controlled trial lasting 8 weeks, involving 60 adult female volunteers with bilateral epidermal melasma, Fitzpatrick skin types III-V, was conducted at the Section of Dermatology, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines. Patients received either the test drug or placebo, twice daily with meals. Changes in pigmentation were measured using a mexameter, the melasma area and severity index (MASI), and a global evaluation by the patient and investigator. Safety evaluations were performed at each follow-up visit. Fifty-six patients completed the trial. Mexameter results demonstrated a significant decrease in the degree of pigmentation in the left malar (165.85 +/- 70.909) and right malar (161.33 +/- 61.824) regions (P < 0.0001). MASI scores showed a significant improvement in the left malar (2.4862 +/- 1.67816) and right malar (1.8889 +/- 1.67110) regions (P = 0.001). Procyanidin + vitamins A, C, E proved to be safe and well tolerated, with minimal adverse events. In this 8-week trial period, oral procyanidin + vitamins A, C, E proved to be safe and effective among Filipino women with epidermal melasma.