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Antioxidants in dermatology

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The skin cells continuously produce, through cellular respiration, metabolic processes or under external aggressions, highly reactive molecules oxidation products, generally called free radicals. These molecules are immediately neutralized by enzymatic and non-enzymatic systems in a physiological and dynamic balance. In situations where this balance is broken, various cellular structures, such as the cell membrane, nuclear or mitochondrial DNA may suffer structural modifications, triggering or worsening skin diseases. several substances with alleged antioxidant effects has been offered for topical or oral use, but little is known about their safety, possible associations and especially their mechanism of action. The management of topical and oral antioxidants can help dermatologist to intervene in the oxidative processes safely and effectively, since they know the mechanisms, limitations and potential risks of using these molecules as well as the potential benefits of available associations.
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356
An Bras Dermatol. 2017;92(3):356-62.
review
Antioxidants in dermatology*
FlaviaAlvimSant´annaAddor1
s
Received on 15.02.2016
ApprovedbytheAdvisoryBoardandacceptedforpublicationon03.05.2016
* Studyconductedatprivateclinic–SãoPaulo(SP),Brazil.
Financial support: none.
 Conictofinterest:none.
1 Privateclinic–SãoPaulo(SP),Brazil.
 ©2017byAnaisBrasileirosdeDermatologia
INTRODUCTION
Skin and mucous membranes have a contact and defense
barrier role against chemical, physical and biological aggressions
continuously.1
Maintenanceof cellularintegrity,aswellasofallimmune
mechanisms,whetherinborn (cutaneous lipidsandplasma mem-
branes,forexample)orspecic(cytokinesynthesis,enzymesorcell
proliferation),involvesaseriesofchemicalreactionsthatgenerate
reactive oxygen species - highly reactive molecules that can rapidly
altermoleculesfundamentaltocutaneoushomeostasis,suchaspro-
teins,lipids,orDNA.2 Endogenous or exogenous antioxidant mech-
anismsactbyneutralizingthesereactivemolecules.Theimbalance
ofthisneutralization has multiple consequences:freeradicals are
implicatedintheetiopathogenesis of variousdermatoses,as well
as in the aging process and in the onset of cutaneous neoplasias.3
Proper use of antioxidants should be considered in these sit-
uationswhereevidencesoftheirbenetshavebeenaccumulatingin
the last decades.
OXIDATIVE MECHANISMS AND SKIN PHYSIOLOGY
Themainreactiveoxygen species (ROS)arethe hydroxyl
radicals(HO•)andsuperoxide(O2•-),peroxylandalkoxylradicals
(RO2•andRO•),thesingletoxygen(1O2)3-5,aswellashydrogenper-
oxide (H2O2)and organicperoxides(ROOH).4 In addition to direct
damagetomoleculessuch as lipids, aminoacidsand DNA, ROS
canactivateenzymaticandnon-enzymaticcellularresponses,with
the potential to modify other processes that end up interfering with
gene expression. 5
Antioxidantsare substancesthat combineto neutralizere-
active oxygen species preventing oxidative damage to cells and tis-
sues.6 Thecutaneousantioxidantsystemconsistsofenzymatic and
non-enzymaticsubstances.Among enzymatic antioxidants, gluta-
thioneperoxidase(GPx),catalase(CAT)andsuperoxidedismutase
(SOD)canbehighlighted. 7
Non-enzymaticor lowmolecular weightantioxidantsalso
contribute to the maintenance of cellular redox balance. Here some
hormonesaregroupedsuchasestradioland,melatonin,aswellas
somevitamins,suchasEandC.8
Figure1 summarizesthe mainoxidative sourcesandtheir
antioxidant systems; participating.9
THE PARADOX OF ANTIOXIDANTS EXCESS
GenerationofROSinphysiologicalconditions,suchasres-
pirationorevenphysicalexercise,isimportantinthemaintenance
of cellular functional integrity. These molecules generally induce
intracellular enzymatic processes via transcription factors (FoxO)
thatinducethe expressionof antioxidant enzymes,suchas SOD.9
Increased levels of FoxO reduce cell proliferation and induce apop-
tosis.Thesefactorsareinvolvedincellgrowth,proliferation,differ-
entiation and longevity.10
Balance of antioxidant systems and the endogenous genera-
tion of ROS is dynamic and tenuous.
Thereisevidencethatsituationsofmildstress,suchasca-
loricrestrictionorphysicalactivity,canmodulatetheagingprocess,
DOI: http://dx.doi.org/10.1590/abd1806-4841.20175697
Abstract: Theskincellscontinuouslyproduce,throughcellularrespiration,metabolicprocessesorunderexternalaggres-
sions,highlyreactivemoleculesoxidationproducts,generallycalledfreeradicals.Thesemoleculesareimmediatelyneu-
tralizedbyenzymaticandnon-enzymaticsystemsinaphysiologicalanddynamicbalance.Insituationswherethisbalance
isbroken,variouscellularstructures,such as the cell membrane, nuclear or mitochondrialDNAmay suffer structural
modications,triggeringorworseningskindiseases.severalsubstanceswithallegedantioxidanteffectshasbeenoffered
fortopicalororaluse,butlittleisknownabouttheirsafety,possibleassociationsandespeciallytheirmechanismofaction.
The management of topical and oral antioxidants can help dermatologist to intervene in the oxidative processes safely and
effectively,sincetheyknowthemechanisms,limitationsandpotentialrisksofusingthesemoleculesaswellasthepotential
benetsofavailableassociations.
Keywords: Antioxidants;Carotenoids;Dermatitis;DNAdamage;Freeradicals;Polypodium;Skinaging
Antioxidants in dermatology 357
An Bras Dermatol. 2017;92(3):356-62.
sincetheyincreasemitochondrialactivity,alsoincreasingthegener-
ationofROS–whichwouldprovokeanadaptiveresponse,withim-
provementofdefensemechanismsandconsequentbetterresponse
and resistance to stress.11
Althoughthisquestionisnotyetstudiedforskinphysiolo-
gyandpathology,itmaybevalid,especiallyforchronologicalaging
in healthy individuals.
Therefore,theingestionorapplicationofantioxidantmole-
cules is indicated in situations in which there is an inability to neu-
tralize,bothbytheROS excessandby thedeclineofendogenous
systems,asoccursinagingandinsomediseases.
However,not all moleculesofantioxidantpotential, from
thephysiologicalpointofview,actlinearlyincutaneousoxidative
stress; an important example of this is the oral use of beta-carotene.
A randomized, controlled trial to determine whether the
impactofthe useofbeta-carotene supplementation,associatedor
notto sunscreens,coulddelaythesignsofphotoagingwas devel-
opedbetween1992and 1996; no signicanteffectof 30 mg daily
supplementationofbeta-carotenewasidentied.12 Likewise,anoth-
ercarotenoid,lycopene, does not presentaphotoprotective effect
wheningestedorally,bothinnaturaandinsupplementation.13
However,there is evidence that these molecules can also
lead to deleterious effects when used indiscriminately. The risk of
hypervitaminosisin olderpatients,inwhomrenalexcretoryfunc-
tionisreduced,isanexample.14
Most emblematic, however, is the issue of vitamin E: to-
copherol and its esters are some of the most documented antiox-
idants and they are commonly used for their proven action on
induced ultraviolet damage. Its indiscriminate use, however, can
inhibitglutathione-S-transferase,responsiblefortheremovalofcy-
totoxic compounds related to tumorigenesis in the skin.15,16
Resveratrolitself,with its recognizedantioxidantandan-
ti-inammatoryactivities, hasconictingdataregardingitsdoses:
recent data demonstrate its bioactivity in nanometric doses when
derived from phytochemicals in food – and this demonstrates how
itcanbedifculttoevaluatethesynergy,orevenantagonism,ofthe
association between dietary components.17
Theadministrationofantioxidantsinsmaller doses,butin
combination,hasbeenassertingasthesafestalternativeforitsuse.
VitaminE acts in synergy withvitaminC,which regenerates the
radicaltocopheryl,aproductofalpha-tocopheroloxidation. 18
Supplementation with beta-carotene, this time associated
with lycopene and a probiotic, promoted the preventionof poly-
morphiclighteruptioninastudyalsorandomized.19Similarly,an-
otherrandomizedstudy,conductedwithanassociationofvitamins
A,C,E,selenium,pomegranateextract,quercetin,greentea, coen-
zymeq10andcarotenoids,suchaslutein,lycopeneandzeaxanthin,
led to an improvement in the erythematous dose and absorption
levels of free radicals after 4 weeks of use.20
Thesendingssuggestthattheuseofcombinationsofmul-
tiple antioxidant molecules allows not only to amplify the antioxi-
dantactionin severalsitesbut alsotoobtain anampliedaction,
comparableto amonotherapy inhigh doses.For thisreason, each
association should be ideally evaluated for its clinical effects.21
MAIN INDICATIONS IN DERMATOLOGY
Photodamage
Currently,there isenough evidencetoassert thatallsolar
spectrum favors the generation of free radicals; this generation pos-
siblyfavors,toagreaterorlesserextent,photoaging,photoimunio-
suppression and photocarcinogenesis. 22
Ultraviolet (UV) radiation, in its UVB range (290-320 nm),
isresponsiblefor theimmediatedamages of solarradiation,acting
mainlyonkeratinocytes;UVAband(320-400nm),whichinducescel-
lularchanges,particularlycompromisesmelanocytesandbroblasts.
Inadditiontoconsumingantioxidantsystems,UVdamage
leadstoinammation,andneutrophilinltrateactivatesNAD(P)H
oxidase,generatingROSthatalter theproductionofkeratinocytic
cytokines.23,24
Use of antioxidants in the prevention and repair of ultravio-
letphotodamageiswidelystudied,beingthemostknownandused
indication.Association ofantioxidant molecules,fromvitamins to
phytoextracts, in photoprotectors and moisturizers with appeal
againstaging,isfrequent. 25-27
Astudywiththeobjectiveofprovingtheefcacyofanas-
sociation of antioxidants with trace elements and glycosaminogly-
cansinarandomizedcontrolstudyshowedclinicalimprovementof
signs of photoaging after 3 months of use. 28
Oral use of antioxidants does not dispense the use of sun-
screensandisthereforeasecondlineofprotectionagainstUVpho-
todamageevenwhentheyreducetheappearanceofsolarerythema,
such as Polypodium leucotomos. 29
Antioxidantaction ofthisphytoextractnotonlyoccursby
theneutralizingeffectofROS,blockinglipidperoxidation,butalso
by activating natural antioxidant systems.
AlthoughtheindicationofPolypodium leucotomos in our sce-
narioisforpolymorphiclighteruption,thereisconsistentevidence
of its use in other dermatoses as well as in photoaging.30
The combination of oral antioxidants at physiological doses
recommendeddailyintake(RDI)isalsoableto increaseminimum
erythemaldoselevels(MED).31
Regardingvisiblelight(400-720nm),itproducesabout50%
Cell damage
Cell death
Change in proliferative response
Change in immune response
Mitochondria
Peroxisomes
Cycle/ lipoxygenases
NAPDHoxidase
Nitric oxide synthase
Etc.
Sunlight(UV,Visible,IR)
Ionizingradiation
Pollutants
Xenobiotics
Etc.
Enzymaticsystems:SOD,CAT,etc.
Non-enzymaticsystems:glutathione,
vitamins,elatonin,etc.
Source: Pastore et al, 2010.9
ROS:reactiveoxygenspecies(oxygen-freespecies);RNS:reactivenitrogenspecies(nitro-
gen-freespecies);SOD:superoxidedismutase;CAT:catalase
ROS
RNS
FIgure 1: Diagram of the redox balance in the skin
358 Addor FAS
An Bras Dermatol. 2017;92(3):356-62.
of the total oxidative stress caused by sunlight. Reactive species
such as O2- * and * * OH CHR are generated by visible light.32
Althoughthereisevidenceofcutaneouscarotenedepletion
inducedbyvisiblelight,useoftopicalororalantioxidants,toreduce
freeradicalsgeneratedbythisrange,hasnotyetbeenelucidated. 33
Lutein,acarotenoidalreadyusedinophthalmologyin the
treatmentofmaculardegeneration,hasbeenassociatedwithapro-
tectiveeffectofoxidativedamagefromsunlight,particularlybyvis-
iblelight,byabsorbingbluelight.34
A double blind, placebo-controlled study compared the
efcacyoforal supplementationwithtopical applicationof lutein
combinedwithzeaxanthintoveparameters:epidermallipids,hy-
dration,photoprotectiveactivity,skinelasticityandlipidperoxida-
tionunderUVradiation.After12weeks,bothtreatmentsimproved
thesemeasures,andoraladministrationwassuperior,butthecom-
bination(oralandtopical)providedthegreatestprotection.35
Morerecently,studieshaveshownthatthermogenicinfra-
red radiation is also capable of generating free radicals in human
skin;its ambiguouseffect,sinceitisalsoused therapeutically,de-
pends on two distinct mechanisms: the NF-kB signaling pathway is
responsibleforthetherapeuticeffects,whereastheAP-1pathwayis
responsible for the pathological effects.29AP-1isresponsibleforthe
productionofmetalloproteinases thatpromotecollagen breakage,
clinically inducing wrinkles.36,37
The ability of infrared radiation to deeply penetrate favors
thegenerationoffreeradicals,asitcancausemutationinmitochon-
drialDNA.38
Some studies have been conducted with the objective of
investigatingwhichantioxidants would bethemost adequate for
inhibitingtheeffectofthisradiation,usingcombinationsoftopical
use of known molecules; a topical combination of vitamins C, E,
ubiquinoneandgrapeextractshowedpositiveresultsinacompar-
ative study. 39
Aging
Concomitant with solar radiation and other environmental
factorsresponsibleforoxidativephenomena,skinaging,aswellas
ofallorgans,isaccompaniedbythedeclineoftheendogenousan-
tioxidant mechanisms.
Clinically,thendingsofphotoagingarethepredominant,
anditisdifcult–andoftenunnecessaryinpractice–todistinguish
theimpactofexogenousfactorsonthechronologicalprocess,butit
isknownthatthemainndingofintrinsicagingiscutaneousatro-
phy,bythereductionofepidermis,but,mainly,bythe decreasein
the collagen content and other dermal elements.40
Intheintrinsicagingprocess,progressivedamagetomito-
chondrialDNAoccurs,withincreasedROSproduction,whichcaus-
es cell aging and impairs protein proliferation.41
The theory of aging from free radicals was developed in the
1950s;later,it wasobserved thatthe cellularorganelleresponsible
forthecellularmetabolism,themitochondria,wasthemaingener-
ator of free radicals due to the cellular respiration that occurs in it.42
Initsreducedform,ubiquinol(coenzymeQ10)preventsthis
oxidativeactivityandalsoregeneratesalpha-tocopherol.Coenzyme
Q10 is the only soluble lipid antioxidant that animal cells can syn-
thesizeandforwhichthereisanappropriateenzymaticmechanism
to regenerate it – which also declines over time.43 Finally,coenzyme
Q10hasbeenshowntoinuence(bymechanismofgeneinduction)
the synthesis of key cutaneous proteins and to inhibit the expression
ofsomemetalloproteinases,suchascollagenase,bypreservingthe
collagen content of the skin.44
Inskinaging,there isaprogressiveaccumulation ofpro-
teins,DNAandmodiedlipids,reinforcingtheassociationbetween
ROS and intrinsic aging.45
Amongthemultipleantioxidantmechanisms,SODplaysa
centralrolein the variety ofreactivemolecules it neutralizes.Al-
though there is still no direct correlation, animal models suggest
that the lack of SOD leads to degenerative changes with reduced
collagen.Possibly,vitaminCwouldhaveapositiveimpactonSOD
reduction states preventing atrophy due to collagen degradation.46
The most physiological protective effect against oxidative
stress seems to be the support to the endogenous system, using
antioxidantsnormallypresent intheskin. This strategy,however,
should not be confused with the permanent use of high non-physio-
logicaldosesofisolatedantioxidants,norconsideredasasubstitute
foradequatefood.47
Melasma
InducedUV melanogenesisthatoccursinmelasmaisam-
plied by increasing the oxidation of dopaquinone; antioxidants
suchasvitaminC,whichreducedopaquinone(DOPA),preventthe
formation of free radicals.48
TheinducedUV inammatory processalsofavors thein-
crease of melanogenesis.49
AclinicalAclinicaltrialtostudytheendogenoustheendog-
enous antioxidant systems in patients with melasma demonstrat-
inga signicantconsumption ofsuperoxidedismutase(SOD)and
glutathione peroxidase. This result demonstrates the rupture of the
redoxequilibrium.50
Oxidationisaprocessthatmayfavormelasma,buttheex-
clusive use of antioxidants in its treatment does not seem to have a
relevanteffect.Antioxidant moleculesemployedthathaveproven
utility also have whitening action by inhibition of tyrosinase (for
example,ascorbicacid and ellagicacid)or anti-inammatory (for
example,pycnogenol).51-53
Non-melanoma skin cancer
GenerationofUVinducedfreeradicalsintheskindevelops
oxidative stress when it exceeds the ability of natural defense: the
onlyskinprotectionsystemsareantioxidantenzymesandmelanin,
therstlineofdefenseagainstDNAdamage.54
DNAabsorbsultravioletlight,whoseenergycanbreakits
molecular bonds; most of these breaks are repaired by enzymes
presentinthenucleusitself,howevertheremainingdamagesgen-
erate mutations that lead to neoplasia.55
The two main actions of defenses that antioxidants can pro-
vide are in relation to preventing the formation of free radicals or
neutralizingtheradicalsalreadygenerated.56
Epidermal antioxidant capacity is much higher than the
dermal:catalase,glutathioneperoxidaseandglutathionereductase
systems were higher in the epidermis than in the dermis – both the
lipophilicantioxidants(tocopherol,ubiquinol9,etc.)andthehydro-
philicones(ascorbicacid and glutathione). Thestratumcorneum
Antioxidants in dermatology 359
An Bras Dermatol. 2017;92(3):356-62.
containsbothhydrophilic andlipophilicantioxidants. VitaminsC
andE,aswellasglutathione(GSH)anduricacid,werefound.Sur-
prisingly,theyarenotevenlydistributed,butingradientform,with
lower concentrations in the outer layers and higher concentrations
toward the deeper layers of the stratum corneum. 57
Itisalsoconrmedthattheacute exposureofhumanskin
to solar radiation leading to oxidation can be prevented by previous
treatmentswithantioxidants,reducingtheriskofcarcinogenesis.58
In contrast, there is evidence that treatment with topical
antioxidantsafterUVdamage can interfere with thecellcycleor
apoptosisofdamagedcells,notbringingbenetorevenpotentiat-
ing the damage.59
Therefore, endogenous photoprotection with antioxidants
iscomplementaryto photoprotectionwith sunscreens,andis cur-
rentlythe mostadequateformofphotocarcinogenesisprevention,
in addition to, of course, the photoprotection behavior (seeking
shadows,avoidinghoursofgreatersunshine,etc.). 60
Psoriasis
There are consistent systemic signs of oxidative stress in
patients with active psoriasis: plasma levels of malonyldialdehyde
(MDA)aresignicantlyelevated,suggestingthedepletionofnatu-
ralenzymaticandnon-enzymatic antioxidant systemsandconse-
quentlytheprevalenceofperoxidationprocessesincellmembranes
and plasma lipid processes of circulating cells.61Similarly,SOD is
reduced in erythrocytes of psoriatic patients.62
Theinammatoryprocessitselfinthelesionareasinduces
the formation of reactive oxygen and nitrogen species.63
Ontheotherhand,classictreatmentssuchasphototherapy
or methotrexate are also capable of generating ROS and RNS.
However,the eventual use of antioxidants should aim to
recovertheredox balance,leadingtoan anti-inammatory effect,
possibly by the activation of antiproliferative and proapoptotic
pathways,bothinthelocalandintheinammatorycells.9
Alopecia
Thepossiblebenetoftheuseofantioxidantsintelogenef-
uviumwillbeaccordingtotheunderlyingcause,especiallywhen
linked to systemic inammatory processes, but there is no direct
evidence of any oxidative mechanism directly linked to this tricose.
In alopecia areata, there is evidence of increased plasma
SODactivityandintheaffectedtissue,howeverthestudiesarestill
controversial. 64
Other dermatoses
Many inammation conditions demonstrate redox imbal-
ance and signicant consumption of their antioxidant systems in
localcells,such as atopicdermatitisor burned skin,aswell as in
thescarringprocess,inwhichtheexcessofROShindersdermaland
epidermalrepair,especiallyinthemomentofacuteinammation.65
Observational studies of melanoma patients demonstrate a
correlation between the lower incidence of the disease and the daily
consumptionof carotenoidandvitaminC-richtea andvegetables,
aswellasthehigh consumption(atleast threeportions/week) of
darkgreenvegetablesrichinlutein;however,thereisnoelucidation
whether the antitumor mechanism involved would be antioxidant.66
Polypodium leucotomos extract has demonstrated a com-
plementaryeffecton the limitation of melanomacellgrowth,but
the impact of the antioxidant mechanism on this effect is unclear.67
There is also evidence of oxidative stress in dermatoses such as vit-
iligo,lichen planus,acne vulgaris,seborrheicdermatitisand pem-
phigusfoliaceus,buttherearenoclinicalstudiesdemonstratingthe
impactoftheuse of antioxidantsinthecontrol of thesediseases,
both oral and topically.68-72
PRACTICAL ASPECTS ON THE USE OF ANTIOXIDANTS
Use of oral or topical antioxidants in the treatment of derma-
tosesbasically seekstoneutralizeexcessfreeradicals,reducingor
preventingtheattackoncellularstructures.Asthepreservationor
reestablishmentoftheredoxbalanceisthegoalinthesesituations,
the use of antioxidants should always be in line with treatments or
otherpreventivemeasures,asinthecaseofphotoprotection.73
Inthiscontext,theuseofconcentrationsclosetothephysi-
ologicalonesispreferential,sincetheyadjustmoreeasilytothecel-
lularphysiology,inadditiontoreducingrisksoftoxicityorevenof
drug interaction with any drugs that the patient uses. Effects of an-
tioxidants can vary considerably depending on the concentrations.74
It is important to note that the use of oral or topical antioxi-
dantsdoesnotreplaceadietwithfruitandvegetableconsumption,
inwhichthecombinationoftheactiveelementsexpandsitseffects,
anddoesnotinvolveanyrisk.Lycopene,forexample,readilyfound
intomatopaste,ingested on theorderof 55 g/dayfor12weeks,
ledtoasignicantreductionofMMP-1expressioninarandomized
controlled study.75
Rich and varied diet should be encouraged in normal in-
dividuals;however,groupssuchaspatientsafterbariatricsurgery,
elderly,andpeoplewithdietary restrictionsmayhave vitaminde-
ciencies,in whichrepositioninphysiological doseswouldbein-
dicated.
Use of antioxidants in long-term pharmacological concen-
trations should only be considered in situations where there is a di-
agnosed need under strict medical supervision.76,77
Association of antioxidants with complementary mecha-
nisms allows a broader neutralizing action, with adequate safety
of use during the period of oxidative stress – which can be from a
simple sun exposure to extensive and acute phase dermatosis.78,79
Useofsupplementswithoutindication,oringestedinhigh
doses, or even for a prolonged time can, in thesis, cause adverse
events precisely in the physiological antioxidative balance. Hence
the importance of medical monitoring.11
Itisimportanttohighlightthat,amongtheexogenousanti-
oxidantsavailableonthemarket,thescienticevidenceregarding
the actual effect on skin cell lines is varied.
Likewise, the proposed associations may have varied re-
sponses according to the concentrations and molecules involved.
The evaluation of clinical response should be made in order to better
understand the effects in relation to the proposed indication.
Anotherimportantpointisthattheinvitroeffectdoesnot
necessarilycorrespondtotheclinicaleffect,inuencedbyrouteof
administration,level ofconcentrationinadministrationandtarget
cell, level of degradation etc. Chart 1 lists the major antioxidants
with action on the skin by oral or topical administration and their
mechanisms of action.
CONCLUSION
Theskinisthesiteofmultipleoxidativereactions,neutral-
ized by exogenous or endogenous enzymatic and non-enzymatic
systems,inacomplexbutefcient,equilibrium.Interactionwiththe
environment(characteristicof theintegumentarysystem),as well
asthepeculiarities of itscells,especially epidermal cells(ofgreat
metabolicand proliferativeactivity), islargelyresponsiblefor this
generationof reactivespecies.Anychangeinthisbalancemayin-
duce or aggravate dermatoses and the use of antioxidants may be of
greatvalue,iftheyareadministered,orallyand/ortopically,ratio-
nally. Each molecule with antioxidant action has actions in certain
sitesand,therefore,theassociationof these molecules,insmaller
doses,seemstobemoreefcient.Inaddition,associationsallowad-
ministeringconcentrationsclosertothe physiologicalones,which
reduces toxicological risks and even of aggravation of imbalance of
the antioxidant systems. q
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*Informationonthemechanismofactionisrestrictedonlytotheantioxidanteffect,althoughmanyofthecitedmoleculeshaveothereffectsdescribed.
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Molecule Mechanism of antioxidant action
VitaminE Neutralizationofsingletoxygeninthecellmembrane;involvementwithmembranestabilization,
preventinglipidperoxidation-oxidationofunsaturatedfattyacids,suchasarachidonicacid
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Lycopene Carotenoidofgreaterbiologicalactionintheneutralizationofsingletoxygen84
Lutein CarotenoidthatprotectsthebroblastsfromUVA-inducedoxidativeaction,alsopreventingthe
decreaseoftheantioxidantenzymescatalaseandsuperoxidedismutase(SOD)85,86
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Epigallocatechingallate(greentea) Flavonoidwithbroadscavengingactionoffreeradicals,inhibitingtheproductionofROSand
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Lipoicacid Repairofendogenousantioxidantsystems,freeradicalneutralizer91
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CoenzymeQ10 ReductionoftheproductionoffreeradicalsandregenerationofvitaminE;reductionofkeratino-
cyteDNAdamageandUVA-inducedmetalloproteinaseproductioninthebroblasts;reduction
of mitochondrial oxidative damage43,93
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362 Addor FAS
An Bras Dermatol. 2017;92(3):356-62.
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... 9 Oxidative stress in atopic dermatitis is caused by Administration of antioxidants in small doses and in combination is the safest alternative use. 19 Vitamin E works synergistically with vitamin C to regenerate tocopheryl radicals, the oxidation product of alphatocopherol. 19 The relationship of vitamins A, C, E, selenium, pomegranate extract, quercetin, green tea, coenzyme q10, and carotenoids such as lutein, lycopene, and zeaxanthin gave improved results in erythematous lesions and absorbed free radical levels after 4 weeks of use. ...
... 19 Vitamin E works synergistically with vitamin C to regenerate tocopheryl radicals, the oxidation product of alphatocopherol. 19 The relationship of vitamins A, C, E, selenium, pomegranate extract, quercetin, green tea, coenzyme q10, and carotenoids such as lutein, lycopene, and zeaxanthin gave improved results in erythematous lesions and absorbed free radical levels after 4 weeks of use. 19 ...
... 19 The relationship of vitamins A, C, E, selenium, pomegranate extract, quercetin, green tea, coenzyme q10, and carotenoids such as lutein, lycopene, and zeaxanthin gave improved results in erythematous lesions and absorbed free radical levels after 4 weeks of use. 19 ...
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Atopic dermatitis (AD) is a chronic skin inflammation found in children with a varied course caused by external and internal factors. The incidence of AD in industrialized countries is 10-20% in children and 1-3% in adults. The main etiopathogenesis of AD is genetic and skin barrier disorders, immunologic disorders, and environment. Oxidative stress (SO) is the accumulation of reactive oxygen species (ROS) that exceeds the defense capacity of the body's antioxidant system. Uncontrolled ROS production plays a major role in various skin diseases. Oxidative stress can damage the deoxyribonucleic acid (DNA) of keratinocytes through lipid oxidation, as well as disrupt skin barrier function, increase the production of proinflammatory cytokines and worsen AD lesions. The main objectives of this literature review are to determine the role of oxidative stress in AD and antioxidants as adjunctive therapy.
... In addition, modern times have brought to everyone, women and men, young and old, more information, and therefore, better education in this regard. Another category of causes refers to the increase in the incidence of skin diseases, against the background of increased pollution, urbanism with its effects, lifestyle, work, rest, nutrition and general medication habits [1,2]. ...
... A multitude of factors in the current environment, together with modern lifestyle, with the omnipresence of medication, processed foods, smoking, etc., lead to an excess of free radicals in the body's skin, against which natural regulating mechanisms are overcome. The damage to the skin is due to the deterioration of the membrane lipids and proteins and the cellular genetic material [1,4]. ...
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The increasing incidence of skin diseases, against the background of increased pollution, urbanism, poor habits in lifestyle, work, rest, diet and general medication, led to the development of products with a protective effect. These new types of dermatocosmetic preparations ensure maximum benefits with minimal formulation. Antioxidants are, nowadays, ingredients that stand out with a proven role in skin protection from oxidative stress and its effects. Thus, research has shown that light-textured formulas, quickly absorbed into the skin, with optimum hydration and protection against excessive free radicals, uphold the skin integrity and appearance. This article aims to evaluate essential criteria for a newly marketed product: stability, rheological properties and microbiological characteristics of oil-in-water emulsions based on a mixture of 3% resveratrol 0.5% ferulic acid and 1mL alcoholic extract of Saffron. The tests led to the conclusion that O / W dermatocosmetic emulsions, based on 3% resveratrol and 0.5% ferulic acid, or also 1mL alcoholic extract of Saffron, show resistance to microbiological contamination, good rheological properties (viscoelastic behavior, structural stability, acceptable shearing behavior) that reveal satisfactory texture and high physical stability during storage. These results encourage the transition to dermatological testing as the final stage in considering a new commercial product.
... These effects are mainly caused by an indirect mechanism known as radiolysis. In this process, the water molecule is broken by radiation, forming reactive oxygen species (ROS), which causes damage in a non-selective manner to DNA and other molecules of healthy tissue cells present in the irradiated area (Singh et al., 2016), and thereby triggering an inflammatory process (Vano-Galvan et al., 2013) In addition, exogenous antioxidant systems can be impaired in irradiated cells, and supplementation with exogenous antioxidants, or agents that stimulate endogenous antioxidants within cells, have shown promise in suppressing the harmful effects of radiation (Addor, 2017;Burke, 2019;Chen et al., 2012;Kodiyan and Amber, 2015;Singh et al., 2013;Yirmibesoglu et al., 2012). ...
... Studies regarding its prophylactic application for radiodermatitis are scarce in the literature (Bairati et al., 2005;Guo et al., 2022). However, numerous studies report its application for other skin conditions (Addor, 2017;Dattola et al., 2020;CHI et al., 2011;Pessoa et al., 2016). In this context, we hypothesized that topical administration of vitamin E could be employed for the prophylaxis of radiodermatitis. ...
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... In our body, this action occurs continuously and we need antioxidants to control this process [48,58]. It will not be beneficial for health when our body has to tolerate excess free radicals that are produced by endogenous and exogenous oxidant species such as solar radiation [57,59,60]. The latter is considered as the major source of free radical production that causes inflammation, acceleration of cellular aging, and initiation of skin cancer [61]. ...
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... In the last decade, FF production has become an important biotechnology industry, given growing consumer interest in improving life expectancy and healthy due to raising of awareness about prevention of certain diseases such as diabetes, cancer, and Alzheimer's [1,2]. Antioxidants are commonly compounds added to other nutritional particles to promote synergism: e.g., vitamin C to regenerate the vitamin E tocopheryl radical after its oxidation [3]. Additionally, antioxidants are added to suppress lipid oxidation, increase products' shelf life, and reduce free radical concentrations generated in organisms [4]. ...
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... Efforts to prevent the harmful effects on the skin due to free radicals are with antioxidants. The use of antioxidants topically on the skin is useful to reduce or prevent damage to these cell structures [4]. Antioxidants such as vitamin C, vitamin E are several types of natural antioxidants, both are found in plants or food. ...
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... In addition, P. commune extract was demonstrated to have antioxidation potential that was strongly correlated with total phenolic contents found in the extract (Hanif et al. 2014). The antioxidants present in P. Commune were able to neutralize the reactive oxygen species and prevent oxidative damage to human cells and tissues, which in turn were able to help in the treatment of skin diseases (Addor 2017). There are a few reports on the antibacterial, cytotoxicity, and antimicrobial activities of solvent extract of P. commune grown in different parts of the world including Turkey (Klavina et al. 2015;Nikolajeva et al. 2012;Sevim et al. 2017). ...
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