Cytotoxic, genotoxic, and toxicogenomic effects of dihydroxyacetone in human primary keratinocytes.

PURPOSE: Dihydroxyacetone (DHA) is the only ingredient approved by the U.S. FDA as a colour additive in sunless tanning (self-tanning) products. Consumer sunless tanning products available for retail purchase contain 1-15% DHA. Although originally thought to only interact with the stratum corneum, more recent research has shown that DHA penetrates beyond the stratum corneum to living keratinocytes indicating a possible route of exposure in the epidermis. MATERIALS AND METHODS: Normal Human Epidermal Keratinocytes (NHEK) were used to determine any potential in vitro toxicological effects of DHA in the epidermis. NHEK cells exposed to DHA concentrations up to 0.90% (100 mM) in dosing media were evaluated for viability, genotoxicity (Comet Assay), and gene expression changes by microarray analysis. RESULTS: Cell viability significantly decreased ∼50% after 3-h exposure to 50 and 100 mM DHA. DNA damage was only found to be significantly increased in cells exposed to cytotoxic DHA concentrations. A subtoxic dose of DHA induced significant gene expression changes. Particularly, expression of cyclin B1, CDK1, and six other genes associated with the G2/M cell cycle checkpoint was significantly decreased which correlates well with a G2/M block reported in the existing literature. Advanced Glycation End Product (AGE) formation significantly increased after 24 h of DHA exposure at and above 10 mM. In summary, these data show that DHA is cytotoxic above 25 mM in primary keratinocytes. Genotoxicity was detected only at cytotoxic concentrations, likely indicative of non-biologically relevant DNA damage, while subtoxic doses induce gene expression changes and glycation. CONCLUSION: DHA treatment had a significant and negative effect on primary keratinocytes consistent with in vitro cultured cell outcomes; however, more information is needed to draw conclusions about the biological effect of DHA in human skin.

Camouflaging vitiligo using a spray tan.

Vitiligo is a depigmenting skin disorder that can cause significant patient distress. Treatment of vitiligo is challenging and should address patient's concern for cosmetic treatment. Herein, we report the case of a 60-year-old patient who achieved temporary improvement in pigmentation using a spray tan. Camouflaging vitiligo using a spray-tan is a reasonable, safe, and effective mechanism for management of vitiligo.

Successful treatment of aluminium phosphide poisoning by dihydroxyacetone: A two-case report study.

WHAT IS KNOWN AND OBJECTIVE: Aluminium phosphide (AlP) is an agricultural fumigant which produces phosphine gas in the presence of moisture. Phosphine inhibits oxidative phosphorylation and causes cell death by inhibiting cytochrome C oxidase. Clinical manifestations of AlP poisoning are refractory hypotension, tachycardia, low oxygen saturation and severe metabolic acidosis. CASE SUMMARY: Two cases received dihydroxyacetone (DHA) in addition to routine management of AlP poisoning. Administration of DHA (7 gr in 50 mL sodium bicarbonate, gavage) 2 times at a 1-hour interval improved the clinical signs. WHAT IS NEW AND CONCLUSION: This is the first case report to highlight the safe and successful treatment of AlP poisoning with DHA. However, more clinical studies are recommended to determine the precise mechanism of DHA action.

Dihydroxyacetone: A Review.

The sunless tanning industry has experienced rapid growth due to public education on the dangers of ultraviolet radiation on skin and improvements in products. Dihydroxyacetone (DHA) is a 3-carbon sugar allowed by the Food and Drug Administration (FDA) as a color additive in sunless tanning products. Bronzers, a product removed with soap and water, may also contain DHA. We aim to review the literature on DHA. DHA is intended for external application, not including the mucous membranes or in or around the eye area. DHA has been used in spray-tan booths and by airbrushing it onto consumers, although these are unapproved uses, as contact with the color additive is not restricted to the external part of the body. Consequently, the FDA recommends customers shield their eyes, lips, and mucous membranes, as well as refrain from ingestion or inhalation of DHA. Unlike sunscreens, products that protect against ultraviolet radiation and are regulated by the FDA as non-prescription drugs, sunless tanning products are regulated as cosmetics and cannot provide any protection from exposure to ultraviolet radiation. There are reports of non-cosmetic uses of DHA that are not FDA approved. With the wide-spread use of DHA, additional studies on its safety are warranted.

J Drugs Dermatol. 2018;17(4):387-391.

Defining the Absorption Spectrum of the Skin After Application of a Popular Sunless Tanner, Dihydroxyacetone, Using Re ectance Photospectrometry.

Dihydroxyacetone (DHA) is a popular ingredient in sunless tanner and lotions. We sought to measure the absorption spectrum of hu- man skin after application of DHA. A male in his 30's applied DHA to one underarm once daily for seven days. Re ectance spectropho- tometry was performed on the treated and untreated side. The area treated with DHA revealed increased absorption in the 400-700 nm range. Compared to normal skin, the absorption spectrum of human skin after application of DHA is altered from 400-700 nm. Care should be taking with using lasers in these wavelengths on skin treated with DHA. J Drugs Dermatol. 2016;15(11):1459-1460..

Effect of Simultaneous Administration of Dihydroxyacetone on the Diffusion of Lawsone Through Various In Vitro Skin Models.

Unprotected sunlight exposure is a risk factor for a variety of cutaneous cancers. Topically used dihydroxyacetone (DHA) creates, via Maillard reaction, chemically fixed keratin sunscreen in the stratum corneum with significant protection against UVA/Soret radiation. When used in conjunction with naphthoquinones a naphthoquinone-modified DHA Maillard reaction is produced that provides protection across the UVB/UVA/Soret spectra lasting up to 1 week, resisting sweating and contact removal. The aim of this study was to examine a simplified version of this formulation for effect on UV transmission and to determine if penetration levels merit toxicity concerns. Permeability was demonstrated for freshly prepared DHA (30 mg/mL) and lawsone (0.035 mg/mL) alone and in combination using a side-by-side diffusion apparatus at 37°C over 48 h across shed snake skin and dermatomed pig skin. These samples were then examined for effectiveness and safety. Concentrations were determined by HPLC and UPLC monitored from 250-500 nm. Lawsone flux significantly decreased across pig skin (20.8 (± 4.8) and 0.09 (± 0.1) mg/cm(2) h without and with DHA, respectively) but did not change across shed snake skin in the presence of DHA. Significantly reduced lawsone concentration was noted in donor chambers of combined solutions. Damage was not observed in any skins. Darker coloration with greater UV absorbance was observed in skins exposed to the combined solution versus individual solutions. This study confirmed that combined DHA and lawsone provided effective blocking of ultraviolet light through products bound in keratinized tissue. DHA permeation levels in pig skin suggest further in vitro and in vivo study is required to determine the safety of this system.

Do melanoidins induced by topical 9% dihydroxyacetone sunless tanning spray inhibit vitamin d production? A pilot study.

We report here preliminary pilot study data of the effect of sunless tanning spray with 9% [Correction added after online publication (August 24th, 2009): The concentration of Dihydroxyacetone used in the study was 9% and not 3% as previously stated] dihydroxyacetone (DHA) on 25-hydroxyvitamin D [25(OH)D] serum levels in subjects exposed to controlled amounts of UV-B radiation during April/May in Omaha, NE, 41 degrees N latitude. We found that DHA-induced melanoidins in skin act as a topical sunscreen attenuating the formation of 25(OH)D.

Camouflaging vitiligo with dihydroxyacetone.

Dihydroxyacetone (DHA), the active ingredient in sunless tanning agents, can provide cosmetically acceptable camouflage for some vitiligo patients.

Dihydroxyacetone: a safe camouflaging option in vitiligo.

BACKGROUND: Most treatment protocols for vitiligo usually do not result in complete repigmentation. Therefore, cosmetically acceptable camouflage, low cost and easy to handle alternatives are warranted. OBJECTIVE: To evaluate the efficacy of low-cost self-tanner available in the Thai market in normal subjects with skin types III, IV, and V, and the efficacy for camouflage of 6% dihydroxyacetone (DHA) cream in the treatment of vitiligo on exposed areas of Asian skin. METHODS: The study was divided into two parts. Part 1 is a prospective study of 15 healthy volunteers using three different DHA creams which were available in the Thai market with concentrations of 3.5%, 4.2%, and 5%. Part 2 was a retrospective study of 20 patients suffering from vitiligo affecting the face and/or hands and feet who were treated with 6% DHA. The data were collected through direct examination, telephone interview, face-to-face interview, and photographs. RESULTS: In healthy volunteers, we found that color matching was achieved by using a higher concentration of DHA in darker-skin subjects. Most of the vitiligo patients (88.9%) reported moderate to marked satisfaction with the cosmetic results of 6% DHA cream. CONCLUSION: Dihydroxyacetone offers a safe and effective therapeutic option for recalcitrant vitiligo. Dark-skin subjects need a higher concentration of DHA cream than lighter-skin subjects.

The effect of glutamine and dihydroxyacetone supplementation on food intake, weight gain, and postprandial glycogen synthesis in female Zucker rats.

OBJECTIVE: We sought to test the hypothesis that increasing postprandial hepatic glycogen synthesis rate would decrease food intake and growth rate in obese Zucker rats. DESIGN: Supplements of glutamine, with and without dihydroxyacetone (DHA), which have previously been shown to stimulate hepatic glycogen synthesis, were administered in the diet of obese Zucker rats for periods of 1 and 3 wk. MEASUREMENTS: Food intake and body weight were monitored throughout the experiments. At the end of the feeding period the rats were fed a test meal and injected with (3)H(2)O to measure in vivo rates of glycogen and lipid synthesis. Final plasma glucose and triacylglycerol and hepatic glycogen content were also determined. Carcass fat and water contents were also measured in the 3-wk study. RESULTS: Dietary glutamine had no effect on food intake, weight gain, or body composition. Addition of DHA caused a reduction in food intake and weight gain and a stimulation of in vivo hepatic glycogen synthesis after 1 wk, but these changes were abolished by the end of 3 wk. Hepatic lipogenesis in vivo was increased by DHA treatment for 1 and 3 wk. CONCLUSIONS: Stimulation of hepatic glycogen synthesis by DHA treatment was associated with a reduction in food intake. However, the effect of DHA on glycogen synthesis and food intake disappeared after 3 wk of supplementation.

The maillard reaction for sunlight protection.

During seven months of a clinical trial in spring, summer, and fall, 30 UVA/B/Soret band-photosensitive patients used sequential topical applications of dihydroxyacetone (DHA) followed by naphthoquinone only at bedtime and received excellent photoprotection without a single therapeutic failure or loss of any patient to follow-up. Eighteen of the 30 patients extended the limits of their photoprotection repeatedly over a seven-month period to tolerate without sunburns six to eight hours of midday sunlight under all kinds of occupational and recreational environmental conditions. Previously, the use of 3% DHA topically in earlier studies gave only a sun protection factor (SPF) of 3. In this reanalysis of the original notes of a previous clinical study of the melanoidins produced by DHA followed by naphthoquinone in the keratin layers of the epidermis of minimally pigmented Caucasian photosensitive patients, it is determined that these patients received a minimal UVB photoprotection of SPF 18 or more. This represents at least a sixfold amplification of the UVB photoprotective effect over the use of only dihydroxyacetone in the Maillard reaction.

Effect of diet supplementation with glutamine, dihydroxyacetone, and leucine on food intake, weight gain, and postprandial glycogen metabolism of rats.

OBJECTIVE: We tested the hypothesis that increasing the rate of postprandial hepatic glycogen synthesis would decrease food intake and growth rate in normal rats. METHODS: Diets supplemented with glutamine, glutamine plus dihydroxyacetone, and glutamine plus dihydroxyacetone plus leucine were administered to male Sprague-Dawley rats for 1 wk. These are combinations that have been shown to stimulate hepatic glycogen synthesis in vitro. Food intake and body weight were monitored throughout the experiment. At the end of the feeding period, rats were fed a test meal and injected with 3H2O to measure in vivo rates of glycogen and lipid synthesis. Positional analysis of the 3H incorporated into glycogen was used to determine the proportion of glycogen synthesized via pyruvate. Final levels of plasma glucose and triacylglycerol and hepatic glycogen were also measured. RESULTS: Dietary glutamine increased hepatic glycogen synthesis. Addition of dihydroxyacetone, with or without additional leucine, caused an additional increase in hepatic glycogen synthesis and increased the proportion of glycogen synthesized via pyruvate. Lipogenesis was not altered in the liver or adipose tissue. None of the dietary treatments had any effect on food intake, but the diets that contained dihydroxyacetone decreased the rate of weight gain. CONCLUSIONS: Increasing glycogen synthesis had no effect on food intake. Increasing the proportion of glycogen synthesized by the indirect pathway through pyruvate was associated with a decrease in weight gain.

Durability of the sun protection factor provided by dihydroxyacetone.

BACKGROUND/PURPOSE: The sunless tanning agent dihydroxyacetone (DHA) is known to protect against longwave ultraviolet radiation (UVA) and visible light. Recently, our laboratory has shown that DHA in addition offers a modest sun protection factor (SPF) in humans. We conducted this study in order to investigate the durability of the SPF provided by DHA. METHODS: Ten healthy volunteers were treated with 20% DHA cream twice in three areas on the volar forearm. One, 5 and 7 days after the second application the participants were phototested with simulated sunlight in each area. Blue reflectance was used to measure the skin coloration by DHA in the test sites. RESULTS: DHA generated a significant SPF of 3.0 at day 1, 2.0 at day 5 and 1.7 at day 7 (P<0.0001). The SPF was positively correlated to the change in blue reflectance (r=0.39, P=0.034). The loss of SPF unit/day was not significantly different between the subjects (P<0.122). However, the intercepts were significantly different (P<0.0001) indicating differences in the initial SPF obtained among the subjects. CONCLUSIONS: The SPF of DHA decreases with the same loss of SPF unit/day between humans and the durability of the SPF thus depends on the initial SPF provided.