Evaluation of a kojic acid, emblica extract, and glycolic acid formulation compared with hydroquinone 4% for skin lightening.

Hydroquinone has been the standard prescription agent for skin lightening; however, its use recently has become controversial. Hydroquinone is banned in Europe and parts of Asia because of potential long-term consequences, including carcinogenesis when orally consumed. These concerns have stimulated research to develop alternative skin lightening agents with efficacy comparable to hydroquinone but with a better safety profile. This double-blind study examined the skin lightening ability of a topical formulation containing kojic acid, emblica extract, and glycolic acid compared with prescription generic hydroquinone cream 4%. Eighty multiethnic participants with mild to moderate facial dyschromia were randomly assigned to use the study product or hydroquinone 4% twice daily for 12 weeks to evaluate product efficacy, tolerability, and safety using investigator assessment, participant assessment, and dermospectrophotometry. Study results demonstrated efficacy parity between the study product and hydroquinone 4%. Thus this novel skin lightening preparation is an alternative to hydroquinone 4% for participants with mild to moderate facial dyschromia.

Complementary effects of antioxidants and sunscreens in reducing UV-induced skin damage as demonstrated by skin biomarker expression.

BACKGROUND: UV-exposure of the skin causes oxidative stress, leading to inflammatory reactions and premature skin aging. Sunscreens protect by absorbing or reflecting UV on the skin surface. Antioxidants provide protection by quenching UV-induced reactive oxygen species inside skin. OBJECTIVE: To evaluate the complementary photoprotective benefits of formulas containing either an antioxidant complex of Cassia alata leaf extract or a combination of the antioxidant complex and sunscreens on normal healthy volunteers using biomarkers of skin damage. METHODS: Each formula and a placebo control were applied separately to selected areas on the lower back of 10 individuals for 4 consecutive days. On Day 4, the control and three test sites were exposed to 5 x MED (minimal erythemal dose) of solar-simulated UV-irradiation (UVR). On Day 5, 4-mm punch biopsies were collected from the four exposed sites and a control site (untreated, unexposed) for immunohistochemistry. RESULTS: Exposure to 5 x MED demonstrated significant damage as assessed by thymine dimer formation, MMP-9 and p53 protein expression on untreated exposed skin. The formula containing sunscreens + the antioxidant complex was the most protective, followed by the formula with the antioxidant alone. CONCLUSION: The study demonstrated that a combination of antioxidants and sunscreens complement each other, resulting in superior photoprotection.

An evaluation of the effect of a topical product containing C-xyloside and blueberry extract on the appearance of type II diabetic skin.

BACKGROUND: Diabetes is a multisystem disease caused by the presence of chronic hyperglycemia, which leads to increased oxidative stress. Many of the changes observed in type II diabetic patients can be traced to the increased production of advanced glycation end products, also known as AGEs. AGEs are produced as a result of a nonenzymatic reaction with glucose interacting with proteins, lipids, and nucleic acids. AGEs are also present in normal skin with advancing age and contribute to the senescence of many body organs, including the skin. AIMS: This research evaluated the effect of a topical product formulation containing blueberry extract, an AGE inhibitor, and C-xyloside, a GAG synthesis stimulator, applied twice daily on the hand, arm, and facial skin of 20 type II diabetic females. Diabetic skin was chosen for evaluation because AGEs are found in increased concentration in diabetic skin, representing a model for accelerated aging. MATERIALS AND METHODS: This single-center study enrolled 20 female type II diabetics aged 55+ years with mild to moderate fine lines, wrinkles, and hyperpigmentation on the face and hands. Subjects used the study product on their face, hand, and inner forearm twice daily for 12 weeks. Ordinal grading on a 4-point scale (0 = none, 1 = mild, 2 =moderate, 3 = severe) of facial fine lines, wrinkles, firmness, radiance, skin tone, skin smoothness, hyperpigmentation, creping, density, sagging, and overall appearance was performed by the investigator at baseline, week 4, week 8, and week 12. Tolerability, subject assessments, digital photography, AGE measurements, skin caliper measurements, and corneometry were also performed at each time point. RESULTS: 19/20 subjects successfully completed the study. The presence of AGEs was documented by skin autofluorescence. The 12-week duration of the study was insufficient to measure a change in skin AGEs, but longer application of the study product might produce different results. No tolerability issues were noted. There was a statistically significant increase in skin caliper measurements on the face (P = 0.004) and arm (P = 0.014) as well as corneometry measurements (P < 0.001) consistent with enhanced moisturization at week 12. The dermatologist investigator also found statistically significant improvement in fine lines (P = 0.01), firmness (P = 0.011), radiance (P < 0.001), skin tone (P = 0.014), skin smoothness (P < 0.001), creping (P < 0.004), and overall appearance (P < 0.001). CONCLUSION: This study examined a topical product containing an AGE inhibitor and a GAG synthesis stimulator designed for the unique needs of diabetic skin.