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Gan C, Rodrigues M. An Update on New and Existing Treatments for the Management of Melasma. Am J Clin Dermatol 2024; 25:717-733. [PMID: 38896402 PMCID: PMC11358250 DOI: 10.1007/s40257-024-00863-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 06/21/2024]
Abstract
Melasma is a chronic, acquired disorder of focal hypermelanosis that carries significant psychosocial impact and is challenging for both the patient and the treating practitioner to manage in the medium to long term. Multiple treatments have been explored, often in combination given the many aetiological factors involved in its pathogenesis. Therapeutic discoveries to treat melasma are a focal topic in the literature and include a range of modalities, with recent developments including updates on visible light photoprotection, non-hydroquinone depigmenting agents, oral tranexamic acid, chemical peels, and laser and energy-based device therapy for melasma. It is increasingly important yet challenging to remain up-to-date on the arsenal of treatments available for melasma to find an efficacious and well-tolerated option for our patients.
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Affiliation(s)
- Christian Gan
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Michelle Rodrigues
- Department of Dermatology, The Royal Children's Hospital, Melbourne, VIC, Australia.
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
- Chroma Dermatology, Pigment and Skin of Colour Centre, Melbourne, VIC, Australia.
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2
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Jo JY, Chae SJ, Ryu HJ. Update on Melasma Treatments. Ann Dermatol 2024; 36:125-134. [PMID: 38816973 PMCID: PMC11148313 DOI: 10.5021/ad.23.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/12/2024] [Accepted: 03/04/2024] [Indexed: 06/01/2024] Open
Abstract
Melasma is a prevalent hyperpigmentation condition known for its challenging treatment due to its resemblance to photoaged skin disorders. Numerous studies have shed light on the intricate nature of melasma, which often bears similarity to photoaging disorders. Various therapeutic approaches, encompassing topical and systemic treatments, chemical peeling, and laser therapy, have exhibited efficacy in managing melasma in previous research. However, melasma often reoccurs despite successful treatment, primarily due to its inherent photoaged properties. Given that melasma shares features with photoaging disorders, including disruptions in the basement membrane, solar elastosis, angiogenesis, and mast cell infiltration in the dermal layer, a comprehensive treatment strategy is imperative. Such an approach might involve addressing epidermal hyperpigmentation while concurrently restoring dermal components. In this article, we provide a comprehensive review of conventional treatment methods frequently employed in clinical practice, as well as innovative treatments currently under development for melasma management. Additionally, we offer an extensive overview of the pathogenesis of melasma.
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Affiliation(s)
- Ju Young Jo
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Su Ji Chae
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea.
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3
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Philipp-Dormston WG. Melasma: A Step-by-Step Approach Towards a Multimodal Combination Therapy. Clin Cosmet Investig Dermatol 2024; 17:1203-1216. [PMID: 38800358 PMCID: PMC11128260 DOI: 10.2147/ccid.s372456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
Melasma is a common challenge in the field of pigmentary skin disorders, exerting a significant emotional and psychosocial burden on patients. The persistent and recurring nature of melasma complicates its management in routine clinical practice. This comprehensive review outlines a stepwise, practical approach encompassing diagnostic, preventive and therapeutic strategies for the management of melasma. A thorough exploration of aggravating and exacerbating factors, including sun exposure, hormonal imbalances, photosensitizing medication and cosmetics, is essential for a holistic assessment of the disease. With an emphasis on consistent and effective photoprotection, initial topical treatment modalities target the melanin production and/or the transfer of melanosomes to keratinocytes. Topical tyrosine inhibitors emerge as the first choice for reducing and preventing hyperpigmentation, with compounds such as thiamidol or tranexamic acid (TXA) being preferred for their safety profile over hydroquinone (HQ), kojic acid and arbutin. Combination with chemical peels can further enhance the therapeutic efficacy, even in cases with resistant melasma. In more severe cases, laser- and light-based interventions may be considered, but with the caveat of the likelihood of recurrence within 3-6 months. Assisted TXA delivery, via either fractional non-ablative laser or microneedling techniques, can further improve clinical outcomes. In conclusion, an optimal melasma management strategy is a multimodal approach, which includes effective photoprotection and a mix of different topical treatments targeting melanin synthesis, the anti-inflammatory environment, senescence and vascularity. Complementary procedures, such as chemical peels, and laser, light-based or microneedling procedures, with or without TXA, can further expedite melanin clearance in more severely affected instances. Individual discussions with patients regarding treatment expectations, recurrence likelihood and potential side effects are paramount to a comprehensive and successful therapeutic journey.
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Affiliation(s)
- Wolfgang G Philipp-Dormston
- Hautzentrum Köln/Cologne Dermatology, Cologne, Germany
- Faculty of Health, University of Witten/Herdecke, Witten, Germany
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4
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Speeckaert R, Bulat V, Speeckaert MM, van Geel N. The Impact of Antioxidants on Vitiligo and Melasma: A Scoping Review and Meta-Analysis. Antioxidants (Basel) 2023; 12:2082. [PMID: 38136202 PMCID: PMC10740621 DOI: 10.3390/antiox12122082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Reactive oxygen species (ROS) generated during melanogenesis make melanocytes particularly vulnerable to oxidative stress, influencing their survival and melanin synthesis. Oxidative stress, significantly present in vitiligo and recently also detected in melasma, triggers inflammatory cascades and melanogenesis, making antioxidants a promising therapeutic avenue. A systematic search was conducted on Embase and Pubmed to study the efficacy of antioxidants for treating vitiligo and/or melasma. Meta-analysis was performed to assess the difference in Melasma Severity Index (MASI) scores between baseline and follow-up. Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo. For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis. Different antioxidants improve both vitiligo and melasma, with an increased minimal erythema dose (MED) following UV exposure being significant for vitiligo and tyrosinase inhibition being crucial for melasma. However, the efficacy of individual antioxidants varies, and their exact mechanisms, especially in stimulating melanocyte proliferation and anti-inflammatory pathways, require further investigation to understand better and optimize their use.
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Affiliation(s)
- Reinhart Speeckaert
- Department of Dermatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Vedrana Bulat
- Department of Dermatology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | | | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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Häsler Gunnarsdottir S, Sommerauer L, Schnabel T, Oostingh GJ, Schuster A. Antioxidative and Antimicrobial Evaluation of Bark Extracts from Common European Trees in Light of Dermal Applications. Antibiotics (Basel) 2023; 12:antibiotics12010130. [PMID: 36671331 PMCID: PMC9854852 DOI: 10.3390/antibiotics12010130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Plant species have developed effective defense strategies for colonizing diverse habitats and protecting themselves from numerous attacks from a wide range of organisms, including insects, vertebrates, fungi, and bacteria. The bark of trees in particular constitutes a number of components that protect against unwanted intruders. This review focuses on the antioxidative, dermal immunomodulatory, and antimicrobial properties of bark extracts from European common temperate trees in light of various skin pathogens, wound healing, and the maintenance of skin health. The sustainability aspect, achieved by utilizing the bark, which is considered a byproduct in the forest industry, is addressed, as are various extraction methods applied to retrieve extracts from bark.
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Affiliation(s)
| | - Lukas Sommerauer
- Department of Forest Products Technology & Timber Constructions, Salzburg University of Applied Sciences, Markt 136a, 5431 Kuchl, Austria
- Salzburg Center for Smart Materials, c/o Department of Chemistry and Physics of Materials, Paris Lodron University of Salzburg, Jakob-Haringer-Straße 2a, 5020 Salzburg, Austria
- Department of Material Sciences and Process Engineering, Institute of Physics and Materials Science, University of Natural Resources and Life Sciences, Peter-Jordan-Straße 82, 1190 Vienna, Austria
| | - Thomas Schnabel
- Department of Forest Products Technology & Timber Constructions, Salzburg University of Applied Sciences, Markt 136a, 5431 Kuchl, Austria
- Faculty of Furniture Design and Wood Engineering, Transilvania University of Brasov, B-dul. Eroilor nr. 29, 500036 Brasov, Romania
| | - Gertie Janneke Oostingh
- Biomedical Sciences, Salzburg University of Applied Sciences, Urstein Sued 1, 5412 Puch, Austria
| | - Anja Schuster
- Biomedical Sciences, Salzburg University of Applied Sciences, Urstein Sued 1, 5412 Puch, Austria
- Correspondence:
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Commentary: Facial Aesthetic Dermatological Procedures and Photoprotection in Chinese Populations. Dermatol Ther (Heidelb) 2022; 13:13-27. [PMID: 36417087 PMCID: PMC9823167 DOI: 10.1007/s13555-022-00862-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
The medical literature on aesthetic dermatology has primarily focused on a light-skinned patient population, yet patients of darker skin types have different needs and priorities. In Chinese individuals, key concerns include altered pigmentation, which is perceived to age the individual, and also relates to the Chinese cultural standard of beauty of fair skin; many seek aesthetic treatment for this. Non-invasive cosmetic procedures such as lasers and injections are also gaining in popularity in the Chinese market, but this population is prone to hyperpigmentation as an adverse effect of such procedures. Considered and tailored approaches, both to primary concerns of photoaging and the side effects of cosmetic treatments, are warranted.
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Piętowska Z, Nowicka D, Szepietowski JC. Understanding Melasma-How Can Pharmacology and Cosmetology Procedures and Prevention Help to Achieve Optimal Treatment Results? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912084. [PMID: 36231404 PMCID: PMC9564742 DOI: 10.3390/ijerph191912084] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 05/06/2023]
Abstract
Melasma is a chronic skin condition that involves the overproduction of melanin in areas exposed to ultraviolet radiation. Melasma treatment is long-term and complicated with recurrence and resistance to treatment. The pathogenesis of melasma is highly complex with multiple pathologies occurring outside of the skin pigment cells. It includes photoaging, excessive melanogenesis, an increased number of mast cells, increased vascularization, and basement membrane damage. In addition, skin lesions related to melasma and their surrounding skin have nearly 300 genes differentially expressed from healthy skin. Traditionally, melasma was treated with topical agents, including hydroquinone, tretinoin, glucocorticosteroids and various formulations; however, the current approach includes the topical application of a variety of substances, chemical peels, laser and light treatments, mesotherapy, microneedling and/or the use of systemic therapy. The treatment plan for patients with melasma begins with the elimination of risk factors, strict protection against ultraviolet radiation, and the topical use of lightening agents. Hyperpigmentation treatment alone can be ineffective unless combined with regenerative methods and photoprotection. In this review, we show that in-depth knowledge associated with proper communication and the establishment of a relationship with the patient help to achieve good adherence and compliance in this long-term, time-consuming and difficult procedure.
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Affiliation(s)
- Zuzanna Piętowska
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
- Correspondence:
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
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Cassiano DP, Espósito ACC, da Silva CN, Lima PB, Dias JAF, Hassun K, Miot LDB, Miot HA, Bagatin E. Update on Melasma-Part II: Treatment. Dermatol Ther (Heidelb) 2022; 12:1989-2012. [PMID: 35906506 PMCID: PMC9464276 DOI: 10.1007/s13555-022-00780-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/13/2022] [Indexed: 01/10/2023] Open
Abstract
Melasma is a prevalent chronic relapsing pigmentary disorder that affects photoexposed areas, especially in women of childbearing age. Although there is currently no curative treatment available for melasma, this manuscript critically reviews the knowledge regarding photoprotection, topical and oral therapies, and procedures such as peelings, laser, and microneedling that represent the main strategies for control and prevention of this disease. As the pathogenesis of melasma is not entirely understood, there are prospects for the development of new therapeutic strategies that might act on the pathways that promote sustained pigmentation rather than merely decreasing melanin synthesis and removing melanin from the epidermis.
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Affiliation(s)
| | - Ana Cláudia C. Espósito
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
| | - Carolina N. da Silva
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
| | - Paula B. Lima
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
| | - Joana A. F. Dias
- Departamento de Dermatologia, UNIFESP, São Paulo, SP Brazil
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
| | - Karime Hassun
- Departamento de Dermatologia, UNIFESP, São Paulo, SP Brazil
| | - Luciane D. B. Miot
- Departamento de Dermatologia, UNIFESP, São Paulo, SP Brazil
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
| | - Hélio A. Miot
- Departamento de Dermatologia e Radioterapia, FMB-Unesp, Campus de Rubião Jr., Botucatu, SP Brazil
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Dietary Supplements and the Skin: Focus on Photoprotection and Antioxidant Activity—A Review. Nutrients 2022; 14:nu14061248. [PMID: 35334905 PMCID: PMC8953599 DOI: 10.3390/nu14061248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 12/22/2022] Open
Abstract
Skin health is not only significantly affected by ageing, but also by other lifestyle-related factors, such as sun exposure, exercise and eating habits, smoking or alcohol intake. It is known that the cutaneous tissue can exhibit visible signs of senescence, in the form of, for example, dull complexion, loss of firmness, or changes in pigmentation. Consumers attempt to improve skin health and appearance not only by cosmetic products, but also with the consumption of food supplements. Recently, there has been an increase in the amount of food supplements with claims that are related to skin and hair health. Nevertheless, the literature is still scarce in evidence of the efficacy of this type of products. Considering this scenario, we aim in this review to assemble studies and methodologies that are directed at the substantiation of the cutaneous health claims of food supplements. For example, we reviewed those that were indicative of antioxidant properties, improvement in pigmentation disorders, increased hydration or protection against the damages caused by ultraviolet radiation.
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Pan J, Zhao JH, Lv YW, Zeng SW, Zhao JY, Gao FL. Clinical Study of a Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser with Different Parameters in the Treatment of Chloasma: A Randomized-Controlled Trial. Photobiomodul Photomed Laser Surg 2022; 40:183-188. [PMID: 35298285 DOI: 10.1089/photob.2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the clinical efficacy of a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser with different parameters in the treatment of chloasma. Methods: In this study, 30 patients with chloasma, symmetrically distributed on the left and right sides of the face and who were treated with a Fayton Q-switched 1064 nm Nd:YAG laser, were recruited. The patients were randomly selected for the treatment of facial lesions on the left and right sides of the face using a spot diameter of 9 mm and an energy density of 0.8 J/cm2 on one side, and, on the opposite side, a spot diameter of 6 mm with an energy density of 1.2 J/cm2. The laser frequency was 5 Hz and treatment was conducted once every 7-10 days and repeated eight times as a course of treatment. At the end of the course of treatment, as well as 1, 3, and 6 months after treatment, front-facing images and 45° left- and right-side images were taken, respectively. The curative effect of the treatment was evaluated using the Melasma Area Severity Index (MASI) score. Results: The results of this study showed that the total effective rate of a Fayton Q-switched 1064 nm Nd:YAG laser in the treatment of chloasma was 60%. Conclusions: Using a Q-switched 1064 nm Nd:YAG laser represents a safe and effective approach for the treatment of chloasma. The therapeutic effects of the parameter sets, that is, a spot diameter of 9 mm and an energy density of 0.8 J/cm2, and a spot diameter of 6 mm with an energy density of 1.2 J/cm2, were similar. The treatment time and average effective times of the latter were relatively shortened. Clinical Trial Registration number researchregistry6799.
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Affiliation(s)
- Jing Pan
- Department of Dermatology and Venereology and Beijing Jishuitan Hospital, Beijing, China
| | - Jing-Hui Zhao
- Department of Dermatology and Venereology and Beijing Jishuitan Hospital, Beijing, China
| | - Yan-Wei Lv
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, China
| | - Shu-Wen Zeng
- Department of Dermatology, Beijing Xiuzhong Medical Center, Beijing, China
| | - Jun-Ying Zhao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Feng-Lin Gao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Neves JR, Grether-Beck S, Krutmann J, Correia P, Gonçalves Junior JE, Sant'Anna B, Kerob D. Efficacy of a topical serum containing l-ascorbic acid, neohesperidin, pycnogenol, tocopherol and hyaluronic acid in relation to skin aging signs. J Cosmet Dermatol 2022; 21:4462-4469. [PMID: 35150043 DOI: 10.1111/jocd.14837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/19/2021] [Accepted: 01/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Skin aging is a process regulated by chronological aging and amplified by exposome factors including chronic UV exposure and pollution, which both induce reactive oxygen species. Topical antioxidants have the potential to counteract this process and to improve skin aging signs, including wrinkles and hyperpigmentation. OBJECTIVE To evaluate the efficacy of a topical antioxidant serum containing 15% L-ascorbic acid, neohesperidin, Pinus pinaster bark, tocopherol and hyaluronic acid (HA) ex vivo on air pollution-induced pigmentation and gene expression, as well as in vivo on skin aging signs in Brazilian volunteers, after 90 days of use. METHODS Ex vivo human skin samples were repetitively exposed to Diesel Exhaust Particles (DEP) and subsequently analyzed for changes in pigmentation and gene expression. Clinical efficacy was evaluated in 40 healthy adult females with phototype II to IV and visible photoaging signs, including facial hyperpigmentation, through dermatological evaluation and instrumental analysis including Reflectance Confocal Microscopy. RESULTS Ex vivo, the topical anti-oxidant serum significantly reduced DEP-induced skin pigmentation and expression of proinflammatory genes. A significant improvement of skin aging signs was observed after 90 days. Local tolerance was good. CONCLUSION The tested serum is effective in protecting human skin ex vivo against air pollution-induced skin pigmentation/aging and reduced in vivo skin aging signs, with a good safety profile after 90 days of daily use.
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Affiliation(s)
| | | | - Jean Krutmann
- IUF - Leibniz Research Institute of Environmental Medicine, Düsseldorf, Germany
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Abstract
Nutrition and dietary supplements have been used to promote a youthful appearance for millennia. Despite high public demand for these products, evidence supporting their efficacy is limited and often inconsistent. We discuss the structural and functional changes that occur in the skin during the aging process. We also review evidence supporting the use of nutritional supplements commonly used to promote a youthful appearance, including essential fatty acids, coenzyme Q, collagen peptides, curcumin, polyphenols, flavonoids, probiotics, silymarin, and vitamins A, C, D, and E. We also consider the role of advanced glycosylated end products, antiinflammatory diets, and caloric restriction in delaying premature skin aging. Although evidence supporting the use of some dietary interventions is promising, further long-term studies in humans are required to fully understand their effects on the promotion of a youthful appearance.
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Affiliation(s)
- Sonal Muzumdar
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Katalin Ferenczi
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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13
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Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol 2021; 20:3759-3781. [PMID: 34741573 PMCID: PMC9298335 DOI: 10.1111/jocd.14537] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023]
Abstract
Background Androgenetic alopecia (AGA) is the most common form of hair loss consisting of a characteristic receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention, and can impact an individual's quality of life. The condition is primarily mediated by 5‐alpha‐reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles. Although a variety of medical, surgical, light‐based and nutraceutical treatment options are available to slow or reverse the progression of AGA, it can be challenging to select appropriate therapies for this chronic condition. Aims To highlight treatment options for androgenetic alopecia taking into consideration the efficacy, side effect profiles, practicality of treatment (compliance), and costs to help clinicians offer ethically appropriate treatment regimens to their patients. Materials and Methods A literature search was conducted using electronic databases (Medline, PubMed, Embase, CINAHL, EBSCO) and textbooks, in addition to the authors' and other practitioners' clinical experiences in treating androgenetic alopecia, and the findings are presented here. Results Although topical minoxidil, oral finasteride, and low‐level light therapy are the only FDA‐approved therapies to treat AGA, they are just a fraction of the treatment options available, including other oral and topical modalities, hormonal therapies, nutraceuticals, PRP and exosome treatments, and hair transplantation. Discussion Androgenetic alopecia therapy remains challenging as treatment selection involves ethical, evidence‐based decision‐making and consideration of each individual patient's needs, compliance, budget, extent of hair loss, and aesthetic goals, independent of potential financial benefits to the practitioners.
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Affiliation(s)
- Mark S Nestor
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, Florida, USA.,Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Glynis Ablon
- Ablon Skin Institute & Research Center, Manhattan Beach, California, USA.,Department of Dermatology, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Anita Gade
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Haowei Han
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
| | - Daniel L Fischer
- Center for Clinical and Cosmetic Research, Aventura, Florida, USA
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Xian D, Guo M, Xu J, Yang Y, Zhao Y, Zhong J. Current evidence to support the therapeutic potential of flavonoids in oxidative stress-related dermatoses. Redox Rep 2021; 26:134-146. [PMID: 34355664 PMCID: PMC8354022 DOI: 10.1080/13510002.2021.1962094] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Skin, as a crucial external defense organ, is more vulnerable to oxidative stress (OS) insult, reactive oxygen species (ROS)-mediated OS in particular. OS results from a redox imbalance caused by various extrinsic stimuli and occurs once the oxidants production overwhelming the antioxidants capacity, through mediating in DNA damage, lipid peroxidation (LPO), protein oxidation and a serial of signaling pathways activation/inactivation, thereby offering favorable conditions for the occurrence and development of numerous diseases especially some dermatoses, e.g. psoriasis, vitiligo, skin photodamage, skin cancer, systemic sclerosis (SSc), chloasma, atopic dermatitis (AD), pemphigus, etc. Targeting OS molecular mechanism, a variety of anti-OS agents emerge, in which flavonoids, natural plant extracts, stand out. OBJECTIVES To discuss the possible mechanisms of OS mediating in dermatoses and summarize the properties of flavonoids as well as their applications in OS-related skin disorders. METHODS Published papers on flavonoids and OS-related skin diseases were collected and reviewed via database searching on PubMed, MEDLINE and Embase, etc. RESULTS It has been confirmed that flavonoids, belonging to polyphenols, are a class of plant secondary metabolites widely distributed in various plants and possess diverse bioactivities especially their potent antioxidant capacity. Moreover, flavonoids benefit to suppress OS via eliminating free radicals and mediating the corresponding signals, further excellently working in the prevention and management of OS-related skin diseases. CONCLUSION Flavonoids have the potential therapeutic effects on oxidative stress-related dermatoses. However, more studies on specific mechanism as well as the dosage of flavonoids are needed in future.
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Affiliation(s)
- Dehai Xian
- Department of Anatomy, Southwest Medical University, Luzhou, People's Republic of China
| | - Menglu Guo
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Jixiang Xu
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yang Yang
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Yangmeng Zhao
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
| | - Jianqiao Zhong
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, People's Republic of China
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Leis Ayres E, Dos Santos Silva J, Eberlin S, Facchini G, Vasconcellos C, Da Costa A. Invitro effect of pine bark extract on melanin synthesis, tyrosinase activity, production of endothelin-1, and PPAR in cultured melanocytes exposed to Ultraviolet, Infrared, and Visible light radiation. J Cosmet Dermatol 2021; 21:1234-1242. [PMID: 33960120 DOI: 10.1111/jocd.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND French maritime pine bark (Pinus pinaster) extract (PBE), the registered trade name of which is Pycnogenol® , has been studied for its depigmenting action due to its antioxidant, anti-inflammatory, and anti-melanogenic activity. However, the mechanisms through which PBE are still not fully clear. OBJECTIVE Evaluate the impact of PBE on four in vitro parameters closely associated with cutaneous pigmentation, including melanin synthesis, tyrosinase activity, endothelin-1 (ED1), and production of peroxisome proliferator-activated receptor α, δ, and γ (PPAR α, δ, and γ), by studying the modulation of action of ultraviolet radiation A (UVA)/ultraviolet radiation B (UVB), infrared-A (IR-A), visible light (VL), and association of UVA/UVB, IR-A, and VL (ASS). METHODS Human melanocytes were incubated in a dry extract solution of PBE, exposed to UVA/UVB, IR-A, VL, and ASS for subsequent quantification of melanin, ED1, and PPAR α, δ, and γ. The effects of PBE on inhibition of tyrosinase activity were also performed by monophenolase activity assay. RESULTS UVA/UVB, IR-A, VL, and ASS radiation caused significant increases in the synthesis of melanin, ED1, and PPAR α, δ, and γ when compared to baseline control. However, PBE significantly reduced the production of melanin, ED1, and PPAR α, δ, and γ, as well as reducing about 66.5% of the tyrosinase activity. CONCLUSIONS PBE reduces in vitro melanin production by downregulating tyrosinase and reducing pigmentation-related mediators, such as ED1 and PPAR α, δ, and γ, therefore contributing to the inhibition of pathways associated with skin hyperpigmentation.
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Affiliation(s)
- Eloisa Leis Ayres
- Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, Brazil
| | | | - Samara Eberlin
- Kosmoscience Ciência e Tecnologia Cosmética Ltda, Campinas, Brazil
| | - Gustavo Facchini
- Kosmoscience Ciência e Tecnologia Cosmética Ltda, Campinas, Brazil
| | - Cidia Vasconcellos
- Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, Brazil
| | - Adilson Da Costa
- Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, Brazil
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Hussain I. The Safety of Medicinal Plants Used in the Treatment of Vitiligo and Hypermelanosis: A Systematic Review of Use and Reports of Harm. Clin Cosmet Investig Dermatol 2021; 14:261-284. [PMID: 33790609 PMCID: PMC8001124 DOI: 10.2147/ccid.s298342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/24/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Vitiligo is disfiguring and devastating condition that can humans feel stigmatic and devalued. Melasma is a general condition of hyperpigmentation particularly involving the face. The pigmentation disorders of vitiligo (hypopigmentation or de-pigmentation) and melasma (Hypermelanosis) are common among the world's population (around 1% for vitiligo). OBJECTIVE The identification of medicinal plants used in the treatment of vitiligo and hypermelanosis. A systematic literature review on harms associated with the medicinal plants used in the treatment of vitiligo and hypermelanosis. To review and summarize information on reported adverse drug reactions (ADRs) associated with these medicinal plants contained in (where access is available) national and global individual case safety report databases. METHODS A systematic review of the literature with special reference to all types of clinical trial and case reports using biomedical databases including Medline, EMBASE, Scopus, International Pharmaceutical Abstracts and so forth to identify medicinal plants alone or as an adjuvant with other treatments and their safety/tolerability in the treatment of vitiligo and Hypermelanosis. Other sources of this search were medicinal plants text books, pharmacopoeias and authentic websites discussing possible treatments for vitiligo/hypermelanosis. It also included databases such as VigiAccess containing data from spontaneous reporting schemes for ADRs. RESULTS A total of 55 articles (47 clinical trials and 8 case reports) met the inclusion criteria. Some trials did not reported safety information, some did report, but not very well. Reports of blistering, erythema, acute hepatitis and mutagenesis with Psoralea corylifolia. Adverse effects of erythema (mild to severe), phototoxic reactions, mild raise in liver transaminases, gastrointestinal disturbances, burns, itching, scaling, depigmented macules, pruritis, and giddiness with the use of psoralens. Khellin-related erythema, perilesional hyperpigmentation, gastrointestinal disturbances, mild raise in liver transaminases and orthostatic complaints. Infrequent side effects with Ginkgo biloba. Lower grade of erythema and edema reported with the use of Polypodium leucotomos. CONCLUSION Primarily the retrieved clinical studies were efficacy oriented and safety parameters were secondary in priority whilst the general protocol of clinical trials requires the screening of drugs/medicinal plants on the basis of safety studies before testing the clinical aspects of efficacy. Thereby it is recommended that efficacy studies may be followed once the safety has been established for a particular medicinal plant in treating vitiligo and hypermelanosis.
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Affiliation(s)
- Irshad Hussain
- Institute of Pharmacy, Shaheed Mohtarma Benazir Bhutto (SMBB) Medical University, Larkana, Pakistan
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Development and Characterization of Xanthan Gum and Alginate Based Bioadhesive Film for Pycnogenol Topical Use in Wound Treatment. Pharmaceutics 2021; 13:pharmaceutics13030324. [PMID: 33802607 PMCID: PMC8002000 DOI: 10.3390/pharmaceutics13030324] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
Pycnogenol (PYC) is a concentrate of phenolic compounds derived from French maritime pine; its biological activity as antioxidant, anti-inflammatory and antibacterial suggests its use in the treatment of open wounds. A bioadhesive film, loaded with PYC, was prepared by casting, starting with a combination of two biopolymer acqueous solutions: xanthan gum (1% wt/wt) and sodium alginate (1.5% wt/wt), in a 2.5/7.5 (wt/wt) ratio. In both solutions, glycerol (10% wt/wt) was added as plasticizing agent. The film resulted in an adhesive capable to absorb a simulated wound fluid (~ 65% wt/wt within 1 h), therefore suitable for exuding wounds. The mechanical characterization showed that the film is deformable (elastic modulus E = 3.070 ± 0.044 MPa), suggesting adaptability to any type of surface and resistance to mechanical solicitations. PYC is released within 24 h by a sustained mechanism, achieving a maximum concentration of ~0.2 mg/mL, that is safe for keratinocytes, as shown by cytotoxicity studies. A concentration of 0.015 mg/mL is reached in the first 5 min after application, at which point PYC stimulates keratinocyte growth. These preliminary results suggest the use of PYC in formulations designed for topical use.
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Robertson NU, Schoonees A, Brand A, Visser J. Pine bark (Pinus spp.) extract for treating chronic disorders. Cochrane Database Syst Rev 2020; 9:CD008294. [PMID: 32990945 PMCID: PMC8094515 DOI: 10.1002/14651858.cd008294.pub5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pine bark (Pinus spp.) extract is rich in bioflavonoids, predominantly proanthocyanidins, which are antioxidants. Commercially-available extract supplements are marketed for preventing or treating various chronic conditions associated with oxidative stress. This is an update of a previously published review. OBJECTIVES To assess the efficacy and safety of pine bark extract supplements for treating chronic disorders. SEARCH METHODS We searched three databases and three trial registries; latest search: 30 September 2019. We contacted the manufacturers of pine bark extracts to identify additional studies and hand-searched bibliographies of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) evaluating pine bark extract supplements in adults or children with any chronic disorder. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted data and assessed risk of bias. Where possible, we pooled data in meta-analyses. We used GRADE to evaluate the certainty of evidence. Primary outcomes were participant- and investigator-reported clinical outcomes directly related to each disorder and all-cause mortality. We also assessed adverse events and biomarkers of oxidative stress. MAIN RESULTS This review included 27 RCTs (22 parallel and five cross-over designs; 1641 participants) evaluating pine bark extract supplements across 10 chronic disorders: asthma (two studies; 86 participants); attention deficit hyperactivity disorder (ADHD) (one study; 61 participants), cardiovascular disease (CVD) and risk factors (seven studies; 338 participants), chronic venous insufficiency (CVI) (two studies; 60 participants), diabetes mellitus (DM) (six studies; 339 participants), erectile dysfunction (three studies; 277 participants), female sexual dysfunction (one study; 83 participants), osteoarthritis (three studies; 293 participants), osteopenia (one study; 44 participants) and traumatic brain injury (one study; 60 participants). Two studies exclusively recruited children; the remainder recruited adults. Trials lasted between four weeks and six months. Placebo was the control in 24 studies. Overall risk of bias was low for four, high for one and unclear for 22 studies. In adults with asthma, we do not know whether pine bark extract increases change in forced expiratory volume in one second (FEV1) % predicted/forced vital capacity (FVC) (mean difference (MD) 7.70, 95% confidence interval (CI) 3.19 to 12.21; one study; 44 participants; very low-certainty evidence), increases change in FEV1 % predicted (MD 7.00, 95% CI 0.10 to 13.90; one study; 44 participants; very low-certainty evidence), improves asthma symptoms (risk ratio (RR) 1.85, 95% CI 1.32 to 2.58; one study; 60 participants; very low-certainty evidence) or increases the number of people able to stop using albuterol inhalers (RR 6.00, 95% CI 1.97 to 18.25; one study; 60 participants; very low-certainty evidence). In children with ADHD, we do not know whether pine bark extract decreases inattention and hyperactivity assessed by parent- and teacher-rating scales (narrative synthesis; one study; 57 participants; very low-certainty evidence) or increases the change in visual-motoric coordination and concentration (MD 3.37, 95% CI 2.41 to 4.33; one study; 57 participants; very low-certainty evidence). In participants with CVD, we do not know whether pine bark extract decreases diastolic blood pressure (MD -3.00 mm Hg, 95% CI -4.51 to -1.49; one study; 61 participants; very low-certainty evidence); increases HDL cholesterol (MD 0.05 mmol/L, 95% CI -0.01 to 0.11; one study; 61 participants; very low-certainty evidence) or decreases LDL cholesterol (MD -0.03 mmol/L, 95% CI -0.05 to 0.00; one study; 61 participants; very low-certainty evidence). In participants with CVI, we do not know whether pine bark extract decreases pain scores (MD -0.59, 95% CI -1.02 to -0.16; one study; 40 participants; very low-certainty evidence), increases the disappearance of pain (RR 25.0, 95% CI 1.58 to 395.48; one study; 40 participants; very low-certainty evidence) or increases physician-judged treatment efficacy (RR 4.75, 95% CI 1.97 to 11.48; 1 study; 40 participants; very low-certainty evidence). In type 2 DM, we do not know whether pine bark extract leads to a greater reduction in fasting blood glucose (MD 1.0 mmol/L, 95% CI 0.91 to 1.09; one study; 48 participants;very low-certainty evidence) or decreases HbA1c (MD -0.90 %, 95% CI -1.78 to -0.02; 1 study; 48 participants; very low-certainty evidence). In a mixed group of participants with type 1 and type 2 DM we do not know whether pine bark extract decreases HbA1c (MD -0.20 %, 95% CI -1.83 to 1.43; one study; 67 participants; very low-certainty evidence). In men with erectile dysfunction, we do not know whether pine bark extract supplements increase International Index of Erectile Function-5 scores (not pooled; two studies; 147 participants; very low-certainty evidence). In women with sexual dysfunction, we do not know whether pine bark extract increases satisfaction as measured by the Female Sexual Function Index (MD 5.10, 95% CI 3.49 to 6.71; one study; 75 participants; very low-certainty evidence) or leads to a greater reduction of pain scores (MD 4.30, 95% CI 2.69 to 5.91; one study; 75 participants; very low-certainty evidence). In adults with osteoarthritis of the knee, we do not know whether pine bark extract decreases composite Western Ontario and McMaster Universities Osteoarthritis Index scores (MD -730.00, 95% CI -1011.95 to -448.05; one study; 37 participants; very low-certainty evidence) or the use of non-steroidal anti-inflammatory medication (MD -18.30, 95% CI -25.14 to -11.46; one study; 35 participants; very low-certainty evidence). We do not know whether pine bark extract increases bone alkaline phosphatase in post-menopausal women with osteopenia (MD 1.16 ug/L, 95% CI -2.37 to 4.69; one study; 40 participants; very low-certainty evidence). In individuals with traumatic brain injury, we do not know whether pine bark extract decreases cognitive failure scores (MD -2.24, 95% CI -11.17 to 6.69; one study; 56 participants; very low-certainty evidence) or post-concussion symptoms (MD -0.76, 95% CI -5.39 to 3.87; one study; 56 participants; very low-certainty evidence). For most comparisons, studies did not report outcomes of hospital admissions or serious adverse events. AUTHORS' CONCLUSIONS Small sample sizes, limited numbers of RCTs per condition, variation in outcome measures, and poor reporting of the included RCTs mean no definitive conclusions regarding the efficacy or safety of pine bark extract supplements are possible.
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Affiliation(s)
- Nina U Robertson
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
| | - Anel Schoonees
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Amanda Brand
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janicke Visser
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
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Lima P, Dias J, Esposito A, Miot L, Miot H. French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double‐blind, randomized, placebo‐controlled trial. J Eur Acad Dermatol Venereol 2020; 35:502-508. [DOI: 10.1111/jdv.16896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022]
Affiliation(s)
- P.B. Lima
- Departamento de Dermatologia e Radioterapia FMB‐Unesp Botucatu Brazil
| | - J.A.F. Dias
- Departamento de Dermatologia e Radioterapia FMB‐Unesp Botucatu Brazil
| | - A.C.C. Esposito
- Departamento de Dermatologia e Radioterapia FMB‐Unesp Botucatu Brazil
| | - L.D.B. Miot
- Departamento de Dermatologia e Radioterapia FMB‐Unesp Botucatu Brazil
| | - H.A. Miot
- Departamento de Dermatologia e Radioterapia FMB‐Unesp Botucatu Brazil
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Babbush KM, Babbush RA, Khachemoune A. Treatment of melasma: a review of less commonly used antioxidants. Int J Dermatol 2020; 60:166-173. [PMID: 32815582 DOI: 10.1111/ijd.15133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/28/2020] [Accepted: 07/20/2020] [Indexed: 12/27/2022]
Abstract
Melasma, a common cause for seeking dermatologic care, is a chronic condition of skin hyperpigmentation. With a poorly understood pathogenesis, and no universal cure, melasma is a challenge for many dermatologists. For decades, there has been investigation into the role of oxidative stress in melasma. In this literature review, we introduce the role of oxidative stress in melasma and discuss the function of various topical and oral antioxidant therapies for patients suffering from melasma. Numerous studies have shown efficacy of various antioxidant therapies for treatment of hyperpigmentation, and in this review, we focus primarily on those with less widespread use. Vitamin E, niacinamide, polypodium leucotomos, pycnogenol, grape seed extract, amino fruit acids, phytic acid, zinc, silymarin, Korean red ginseng powder, plant extracts, and parsley all have well-demonstrated evidence of antioxidant properties, and these substances have been studied in the context of skin hyperpigmentation. Although there is conflicting evidence of their therapeutic efficacy, the use of these naturally occurring substances is promising for patients and medical providers seeking alternative therapeutic options.
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Affiliation(s)
- Kayla M Babbush
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Remy A Babbush
- Department of Food Science, Cornell University, Ithaca, NY, USA
| | - Amor Khachemoune
- Department of Dermatology, State University of New York Downstate, Brooklyn, NY, USA.,Department of Dermatology, Veterans Health Administration, Brooklyn, NY, USA
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Sawant O, Khan T. Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches. Dermatol Ther 2020; 33:e13717. [PMID: 32472659 DOI: 10.1111/dth.13717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/17/2020] [Accepted: 05/23/2020] [Indexed: 11/30/2022]
Abstract
Periorbital hyperpigmentation (POH) is a common dermatological condition that presents as dark periorbital area beneath the lower eyelids, and it is commonly found in females belonging to the age group of 16 to 45 years. The data presented in this review include studies conducted on patients with a clinical/histological diagnosis of POH or melasma. Many diverse topical depigmenting agents comprising an array of naturally obtained actives such as arabinoxylans, α-arbutin, asiaticoside, azelaic acid, beta-carotene, boswellic acid, caffeine, chrysin, curcumin, cyanidin-3-glucoside, d-glucoronic acid, dihydrochalcone, dipalmitoyl-hydroxyprolene, fucoxanthin, genistein, glabridin, b-glucogallin, hyaluronic acid, lactic acid, lycopene, niacinamide, pycnogenol, retinol, salidroside, and xymenynic acid demonstrated significant benefits in the management of POH. An exhaustive literature search revealed that other techniques such as blepharoplasty, carboxytherapy, calcium hydroxylapatite fillers, tear trough implant, Q-switched ruby laser, medicated tattoo, fat transfer, micro-needling, chemical peels, nitrogen plasma skin regeneration, intense pulsed light, and radiofrequency have been evaluated and reported to be beneficial in the treatment of POH. The use of topical depigmenting agents is the most widely reported method in the clinical management of POH. Of these, α-arbutin, caffeine, cyanidin-3-glucoside, and dihydrochalcone are reported to exhibit significant benefits. Combination products containing a blend of actives are reported to be better than single active containing products. This review aims to provide a comprehensive perspective on the role of several topical actives in the modulation of melanin and tyrosinase biosynthesis pathway involved in the complex pathophysiology of POH. It also presents the advantages of combination products and other alternative therapies used in the management of POH.
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Affiliation(s)
- Omkar Sawant
- Department of Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Tabassum Khan
- Department of Pharmaceutical Chemistry and Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
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Shoji T, Masumoto S, Moriichi N, Ohtake Y, Kanda T. Administration of Apple Polyphenol Supplements for Skin Conditions in Healthy Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Nutrients 2020; 12:E1071. [PMID: 32294883 PMCID: PMC7231294 DOI: 10.3390/nu12041071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 12/19/2022] Open
Abstract
This clinical study was performed to evaluate the effects of continuous apple polyphenol (AP) administration on facial skin conditions and pigmentation induced by ultraviolet (UV) irradiation in healthy women participants. Participants (n = 65, age 20-39 years) were randomized to receive tablets containing AP (300 or 600 mg/day) or placebo in a double-blinded, placebo-controlled clinical trial. Continuous administration of AP for 12 weeks significantly prevented UV irradiation induced skin pigmentation (erythema value, melanin value, L value), although a dose-dependent relationship was not clearly observed. In contrast, no significant differences were detected between the groups with regard to water content and trans-epidermal water loss. Our study demonstrated that APs and their major active compounds, procyanidins, have several health benefits. Here, we report that continuous administration of AP for 12 weeks alleviated UV irradiation induced skin pigmentation, when compared with placebo, in healthy women.
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Affiliation(s)
- Toshihiko Shoji
- Research Laboratories for Fundamental Technology of Food, Asahi Breweries Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan; (S.M.); (N.M.); (Y.O.); (T.K.)
- Food Research Institute, National Agriculture and Food Research Organization, 2-1-12 Kannondai, Tsukuba-shi, Ibaraki 305–8605, Japan
| | - Saeko Masumoto
- Research Laboratories for Fundamental Technology of Food, Asahi Breweries Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan; (S.M.); (N.M.); (Y.O.); (T.K.)
- Faculty of Food and Agricultural Sciences, Fukushima University, 1 Kanayagawa, Fukushima-shi, Fukushima 960-1269, Japan
| | - Nina Moriichi
- Research Laboratories for Fundamental Technology of Food, Asahi Breweries Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan; (S.M.); (N.M.); (Y.O.); (T.K.)
| | - Yasuyuki Ohtake
- Research Laboratories for Fundamental Technology of Food, Asahi Breweries Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan; (S.M.); (N.M.); (Y.O.); (T.K.)
- Asahi Group Foods, Ltd., 2-4-1 Ebisuminami, Shibuya-ku, Tokyo 150-0022, Japan
| | - Tomomasa Kanda
- Research Laboratories for Fundamental Technology of Food, Asahi Breweries Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan; (S.M.); (N.M.); (Y.O.); (T.K.)
- Asahi Group Holdings Ltd., 1-21 Midori 1-chome, Moriya-shi, Ibaraki 305-0106, Japan
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New Herbal Biomedicines for the Topical Treatment of Dermatological Disorders. Biomedicines 2020; 8:biomedicines8020027. [PMID: 32046246 PMCID: PMC7168306 DOI: 10.3390/biomedicines8020027] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Herbal extracts and isolated plant compounds play an increasing role in the treatment of skin disorders and wounds. Several new herbal drugs, medicinal products and cosmetic products for the treatment of various skin conditions have been developed in recent years. In this nonsystematic review, we focus on herbal drugs that were tested in controlled clinical studies or in scientifically sound preclinical studies. The herbal biomedicines are intended to treat atopic dermatitis (St. John's wort, licorice, tormentil, bitter substances, evening primrose), psoriasis (araroba tree, lace flower, barberry bark, indigo, turmeric, olibanum, St. John's wort), actinic keratosis (birch bark, petty spurge), herpes simplex (lemon balm, sage and rhubarb), rosacea (green tea, licorice, tormentil) and acne vulgaris (tea tree oil, green tea, hop), or to improve photo protection (green tea, Dyer's weed, cocoa tree, carotinoids, licorice), aesthetic dermatology (licorice, pine bark, gotu kola) and wound healing (birch bark, onion).
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Sarkar R, Bansal A, Ailawadi P. Future therapies in melasma: What lies ahead? Indian J Dermatol Venereol Leprol 2020; 86:8-17. [DOI: 10.4103/ijdvl.ijdvl_633_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Efficacy and Safety of an Oral Nutritional (Dietary) Supplement Containing Pinus pinaster Bark Extract and Grape Seed Extract in Combination with a High SPF Sunscreen in the Treatment of Mild-to-Moderate Melasma: A Prospective Clinical Study. COSMETICS 2019. [DOI: 10.3390/cosmetics6010015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Melasma is a common hyperpigmentation disorder, characterized by light-to-dark brown patches, usually distributed on sun-exposed areas of the body. The objective of this study was to evaluate the efficacy and tolerability of an oral nutritional supplement containing Pinus pinaster and Grape seed extract, vitamins and minerals, used concomitantly with a high SPF sunscreen in 30 women with mild-to-moderate facial melasma. Methods: Efficacy was assessed by measurement of the Melasma Area and Severity Index (MASI), instrumental analysis of the lesions (Mexameter®, VISIA®)) and Patient’s and Physician’s Global Assessment (PGA). Results: The MASI score decreased significantly compared with baseline at days 28, 56, and 84. Mexameter® analysis showed a significant decrease of ∆M (difference in the melanin index between melasma and adjacent area). VISIA® results also showed a reduction in the number and areas of UV pigmented spots and in the areas of melasma overtime. Both the Patient’s and Physician’s Global Assessment showed that the product led to an improvement of the lesions in terms of depigmentation and had positive cosmetic features without adverse events. Conclusion: The oral supplement subject of this study in combination with high SPF sunscreen was effective and well-tolerated for treatment of mild to moderate facial melasma.
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Polyphenols as Natural Antioxidants: Sources, Extraction and Applications in Food, Cosmetics and Drugs. GREEN CHEMISTRY AND SUSTAINABLE TECHNOLOGY 2019. [DOI: 10.1007/978-981-13-3810-6_8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Juhasz MLW, Levin MK. The role of systemic treatments for skin lightening. J Cosmet Dermatol 2018; 17:1144-1157. [PMID: 30133125 DOI: 10.1111/jocd.12747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/03/2018] [Accepted: 07/16/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Pigmentation of the skin occurs as a result of increased melanin production or deposition due to various reasons including age, hormonal imbalances, endocrine disease, inflammation, and/or exposure to damaging radiation, resulting in dermatologic conditions such as lentigines, melasma, or postinflammatory hyperpigmentation. Although numerous topical therapies exist for skin lightening, they are limited by efficacy and pigmentation recurrence after treatment cessation. New research into systemic therapies for hyperpigmentation has been promising. OBJECTIVE To summarize the current literature for systemic skin lightening therapies. METHODS A review of the literature surrounding systemic skin lightening therapies was completed using PubMed (US National Library of Medicine). RESULTS Multiple systemic therapies for skin lightening exist including oral carotenoids, glutathione, melatonin, Polypodium leucotomos hydrophilic extract, procyanidin, and tranexamic acid. Preliminary data for the treatment of hyperpigmentation are promising, and currently, these oral treatments appear safe. It is not suggested to use intravenous glutathione for skin lightening due to the increased risk of adverse events. CONCLUSION With the patient population seeking effective systemic treatments for skin pigmentation, it is important for dermatologists to understand the properties, the efficacy, and the adverse events profile of each compound, thus ensuring proper use by patients, and that patients are appropriately counseled regarding treatment expectation and safety.
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Affiliation(s)
- Margit L W Juhasz
- Department of Dermatology, University of California, Irvine, Irvine, California
| | - Melissa K Levin
- The Ronald O. Perelman Department of Dermatology, New York University Langone Health, New York City, New York.,Department of Dermatology, The Mount Sinai Hospital, New York City, New York
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Pérez-Sánchez A, Barrajón-Catalán E, Herranz-López M, Micol V. Nutraceuticals for Skin Care: A Comprehensive Review of Human Clinical Studies. Nutrients 2018; 10:nu10040403. [PMID: 29587342 PMCID: PMC5946188 DOI: 10.3390/nu10040403] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 12/18/2022] Open
Abstract
The skin is the body’s largest organ, it participates in sensitivity and offers protection against microorganisms, chemicals and ultraviolet (UV) radiation. Consequently, the skin may suffer alterations such as photo-ageing, immune dysfunction and inflammation which may significantly affect human health. Nutraceuticals represent a promising strategy for preventing, delaying, or minimising premature ageing of the skin and also to alleviate certain skin disorders. Among them, bioactive peptides and oligosaccharides, plant polyphenols, carotenoids, vitamins and polyunsaturated fatty acids are the most widely used ingredients. Supplementation with these products has shown evidence of having an effect on the signs of ageing and protection against UV radiation ageing in several human trials. In this review, the most relevant human studies on skin nutraceuticals are evaluated and the statistical resolution, biological relevance of their results, and, the trial protocols are discussed. In conclusion, quality and rigorousness of the trials must be improved to build credible scientific evidence for skin nutraceuticals and to establish a cause-effect relationship between the ingredients the beneficial effects for the skin.
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Affiliation(s)
- Almudena Pérez-Sánchez
- Instituto de Biología Molecular y Celular (IBMC), Universidad Miguel Hernández (UMH), Edificio Torregaitán, 03202 Elche, Spain.
| | - Enrique Barrajón-Catalán
- Instituto de Biología Molecular y Celular (IBMC), Universidad Miguel Hernández (UMH), Edificio Torregaitán, 03202 Elche, Spain.
- Ilice Effitech, UMH Scientific Park, 03202 Elche, Spain.
| | - María Herranz-López
- Instituto de Biología Molecular y Celular (IBMC), Universidad Miguel Hernández (UMH), Edificio Torregaitán, 03202 Elche, Spain.
- Ilice Effitech, UMH Scientific Park, 03202 Elche, Spain.
| | - Vicente Micol
- Instituto de Biología Molecular y Celular (IBMC), Universidad Miguel Hernández (UMH), Edificio Torregaitán, 03202 Elche, Spain.
- Ilice Effitech, UMH Scientific Park, 03202 Elche, Spain.
- CIBER: CB12/03/30038, Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), 07122 Palma Sola, Spain.
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Abstract
A blemish free, even-toned skin is universally associated with healthy skin. This reasoning makes people desire to have a flawless skin. Melanin is a naturally occurring pigment in humans. This pigment is responsible for skin, hair, and eye color, therefore determines our race and phenotypic appearance. On darker skin types, it is common that melanin production processes malfunctions. These malfunctions often lead to overproduction and secretion of melanin. As a result, unwanted pigmentary problems such melasma occur. Due to unknown etiology and its recurrence in nature, melasma is challenging to treat. The current available melasma treatment options often produce undesired side effects and suboptimum results. First-line topical treatments usually involve hydroquinone or topical steroids. Apart from the irritant reactions, this treatment mode is not suitable for all skin types. Skin care specialists are in search of an effective long-term cosmetics and cosmeceuticals to address hypermelanosis problems. Understanding of naturally occurring depigmenting agents provides an opportunity for more effective ways to manage melasma in all skin types. This review considers the benefits of naturally occurring ingredients which could help address skin pigmentation problems and broaden the choice for skin-lightening treatments.
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Affiliation(s)
- Mpofana Nomakhosi
- a Laser Research Centre, Faculty of Health Sciences , University of Johannesburg , Doornfontein , South Africa
| | - Abrahamse Heidi
- a Laser Research Centre, Faculty of Health Sciences , University of Johannesburg , Doornfontein , South Africa
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Qiu B, Jiang W, Qiu W, Mu W, Qin Y, Zhu Y, Zhang J, Wang Q, Liu D, Qu Z. Pine needle oil induces G2/M arrest of HepG2 cells by activating the ATM pathway. Exp Ther Med 2018; 15:1975-1981. [PMID: 29434792 PMCID: PMC5776635 DOI: 10.3892/etm.2017.5648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 08/23/2017] [Indexed: 11/06/2022] Open
Abstract
Over the last two decades, inducing DNA damage of cancer cells by natural medicines has become a research hotspot in the field of cancer treatment. Although various natural medicines have anticancer effects, very few studies have been conducted to explore the anti-cancer effect of pine needle oil. In the present study, the role of pine needle oil in inducing G2/M arrest in HepG2 cells was investigated. The data revealed that pine needle oil could induce DNA damage in a dose-dependent manner. In the pine needle oil-treated HepG2 cells, the protein levels of phosphorylated (p)-ataxia-telangiectasia mutated (ATM), γ-H2A histone family, member X, p-p53, p-checkpoint kinase 2 and p-cell division cycle 25C were evidently increased, indicating that pine needle oil facilitated G2/M arrest in HepG2 cells through the ATM pathway. In response to the treatment with pine needle oil, ATM was activated in HepG2 cells, which subsequently phosphorylated downstream targets and induced G2/M arrest. In summary, the data of the present study indicated that pine needle oil induces G2/M arrest in HepG2 cells by facilitating ATM activation.
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Affiliation(s)
- Bing Qiu
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Wei Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154002, P.R. China
| | - Wenliang Qiu
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Wenling Mu
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Yujing Qin
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Yongcui Zhu
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Jianying Zhang
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Qingyi Wang
- Center for Computational and Integrative Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Dongjie Liu
- Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Zhangyi Qu
- Department of Hygienic Microbiology, Public Health College, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
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31
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Abstract
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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Sarkar R, Gokhale N, Godse K, Ailawadi P, Arya L, Sarma N, Torsekar RG, Somani VK, Arora P, Majid I, Ravichandran G, Singh M, Aurangabadkar S, Arsiwala S, Sonthalia S, Salim T, Shah S. Medical Management of Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group. Indian J Dermatol 2017; 62:558-577. [PMID: 29263529 PMCID: PMC5724303 DOI: 10.4103/ijd.ijd_489_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Melasma is one of the most common hyperpigmentary disorders found mainly in women and dark-skinned patients. Sunlight, hormones, pregnancy, and genetics remain the most implicated in the causation of melasma. Although rather recalcitrant to treatment, topical agents such as hydroquinone, modified Kligman's Regime, azelaic acid, kojic acid, Vitamin C, and arbutin still remain the mainstay of therapy with sun protection being a cornerstone of therapy. There are several new botanical and non botanical agents and upcoming oral therapies for the future. There is a lack of therapeutic guidelines, more so in the Indian setup. The article discusses available evidence and brings forward a suggested treatment algorithm by experts from Pigmentary Disorders Society (PDS) in a collaborative discussion called South Asian Pigmentary Forum (SPF).
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Affiliation(s)
- Rashmi Sarkar
- Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Narendra Gokhale
- Consultant Dermatologist, Sklinic Skin Clinic, Indore, Madhya Pradesh, India
| | - Kiran Godse
- Dermatology, D Y Patil Hospital, Mumbai, Maharashtra, India
| | - Pallavi Ailawadi
- Dermatology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
| | - Latika Arya
- Consultant Dermatologist, L A Skin and Aesthetic Clinic, New Delhi, India
| | - Nilendu Sarma
- Dermatology, Dr B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
| | - R G Torsekar
- Consultant Dermatologist, Fortis Hospital, Mumbai, Maharashtra, India
| | - V K Somani
- Consultant Dermatologist, Skintrendz, Himayat Nagar, Hyderabad, India
| | - Pooja Arora
- Dermatology, Dr RML Hospital and PGIMER, New Delhi, India
| | - Imran Majid
- Dermatology, Govt Medical College, Srinagar, Jammu and Kashmir, India
| | - G Ravichandran
- Senior Consultant and Coordinator, Dermatology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Mohan Singh
- Consultant Dermatologist, Mohan Skin Diseases Hospital, Phagwara, Punjab, India
| | | | - Shehnaz Arsiwala
- Consultant Dermatologist, Saifee Hospital, Prince Aly Khan Hospital, Mumbai, Maharashtra, India
| | - Sidharth Sonthalia
- Consultant Dermatologist, Skinnocence: The Skin Clinic, Gurgaon, Haryana, India
| | - T Salim
- Consultant Dermatologist, Cutis institute of Dermatology and Aesthetic Sciences, Calicut, Kerala, India
| | - Swapnil Shah
- Consultant Dermatologist, Solapur, Maharashtra, India
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Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. J Am Acad Dermatol 2017; 77:607-621. [PMID: 28917452 DOI: 10.1016/j.jaad.2017.01.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/13/2017] [Accepted: 01/22/2017] [Indexed: 11/22/2022]
Abstract
Postinflammatory hyperpigmentation (PIH) occurs after various dermatoses, exogenous stimuli, and dermatologic procedures. The clinical course of PIH is chronic and unpredictable, although the probability of resolution of epidermal hyperpigmentation is better than those of dermal hyperpigmentation. PIH can be prevented or alleviated. When it does occur, the underlying inflammatory conditions should be sought and treated as the first step to reduce the progression of inflammation and PIH (which is an inflammatory consequence). If the inflammatory conditions subsides or there is no evidence of inflammation at the time of diagnosis, the treatments of PIH should be considered as the next step. Understanding the available treatment options helps the physician choose the appropriate treatment for each patient. Having a reproducible model for PIH is essential for the development of treatment modalities. The second article in this 2-part continuing medical education series on PIH specifically addresses the evidence that supports medical and procedural treatments of PIH and other forms of acquired hyperpigmentation. It also describes a PIH model and provides an algorithm for clinical practice along with discussion about the prevention of PIH.
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35
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Choubey V, Sarkar R, Garg V, Kaushik S, Ghunawat S, Sonthalia S. Role of oxidative stress in melasma: a prospective study on serum and blood markers of oxidative stress in melasma patients. Int J Dermatol 2017; 56:939-943. [PMID: 28681382 DOI: 10.1111/ijd.13695] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Melasma is a common pigmentary disorder presenting in the dermatological clinic. Many factors have been implicated in the pathogenesis, however, the cause still remains elusive. Recently the effect of oxidative damage has been proposed in the etiopathogenesis of melasma. This study was undertaken to evaluate the role of oxidative stress in patients with melasma. MATERIAL AND METHODS Fifty patients with melasma, age 18 years of age and older, and an equal number of age and sex-matched controls were included in the study. Baseline severity assessment using the modified Melasma Area and Severity Index (modified MASI score) was done in all patients. Serum malondialdehyde, blood superoxide dismutase, and blood glutathione peroxidase levels were measured in cases and controls group and results were compared. RESULT The serum levels of malondialdehyde, superoxide dismutase, and blood glutathione were significantly higher among the cases compared to controls. The difference in the serum concentrations was significant between the two groups (P < 0.01). A positive correlation was found between these enzyme levels and severity of melasma (modified MASI score); however, this correlation was statistically significant with serum malondialdehyde only. The level of oxidative stress among the male and female melasma patients was not statistically different. CONCLUSION Oxidative stress was found to be increased in cases of melasma compared to the control group in this study. This substantiates the role of oxidative stress in etiopathogenesis of melasma; however, further studies are required to reach a definitive conclusion.
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Affiliation(s)
- Vikrant Choubey
- Department of Dermatology, Venereology and Lepreology, Maulana Azad Medical College, New Delhi, India
| | - Rashmi Sarkar
- Department of Dermatology, Venereology and Lepreology, Maulana Azad Medical College, New Delhi, India
| | - Vijay Garg
- Department of Dermatology, Venereology and Lepreology, Maulana Azad Medical College, New Delhi, India
| | - Smita Kaushik
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
| | - Sneha Ghunawat
- Department of Dermatology, Venereology and Lepreology, Maulana Azad Medical College, New Delhi, India
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Ephrem E, Elaissari H, Greige-Gerges H. Improvement of skin whitening agents efficiency through encapsulation: Current state of knowledge. Int J Pharm 2017; 526:50-68. [DOI: 10.1016/j.ijpharm.2017.04.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/05/2017] [Accepted: 04/07/2017] [Indexed: 12/31/2022]
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37
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Zhou LL, Baibergenova A. Melasma: systematic review of the systemic treatments. Int J Dermatol 2017; 56:902-908. [DOI: 10.1111/ijd.13578] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 12/16/2016] [Accepted: 01/10/2017] [Indexed: 11/27/2022]
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Abstract
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.
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Affiliation(s)
- Mohammad Abid Keen
- Department of Dermatology, STD and Leprosy, Government Medical College and Associated SMHS Hospital, Srinagar, Jammu and Kashmir, India
| | - Iffat Hassan
- Department of Dermatology, STD and Leprosy, Government Medical College and Associated SMHS Hospital, Srinagar, Jammu and Kashmir, India
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Grether-Beck S, Marini A, Jaenicke T, Krutmann J. French Maritime Pine Bark Extract (Pycnogenol®) Effects on Human Skin: Clinical and Molecular Evidence. Skin Pharmacol Physiol 2015; 29:13-7. [DOI: 10.1159/000441039] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/09/2015] [Indexed: 11/19/2022]
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40
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, Ayres EL, Addor FAS, Miot HA, Ponzio H, Duarte I, Neffá J, Cunha JAJD, Boza JC, Samorano LDP, Corrêa MDP, Maia M, Nasser N, Leite OMRR, Lopes OS, Oliveira PD, Meyer RLB, Cestari T, Reis VMSD, Rego VRPDA. Brazilian consensus on photoprotection. An Bras Dermatol 2015; 89:1-74. [PMID: 25761256 PMCID: PMC4365470 DOI: 10.1590/abd1806-4841.20143971] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/28/2014] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions with a large heterogeneity of climates
and massive mixing of the population. Almost the entire national territory is located
between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the
south certainly makes Brazil one of the countries of the world with greater extent of
land in proximity to the sun. The Brazilian coastline, where most of its population
lives, is more than 8,500 km long. Due to geographic characteristics and cultural
trends, Brazilians are among the peoples with the highest annual exposure to the sun.
Epidemiological data show a continuing increase in the incidence of non-melanoma and
melanoma skin cancers. Photoprotection can be understood as a set of measures aimed
at reducing sun exposure and at preventing the development of acute and chronic
actinic damage. Due to the peculiarities of Brazilian territory and culture, it would
not be advisable to replicate the concepts of photoprotection from other developed
countries, places with completely different climates and populations. Thus the
Brazilian Society of Dermatology has developed the Brazilian Consensus on
Photoprotection, the first official document on photoprotection developed in Brazil
for Brazilians, with recommendations on matters involving photoprotection.
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Affiliation(s)
- Sérgio Schalka
- Photobiology Department, Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eloisa Leis Ayres
- Center of Dermatology Prof. Rene Garrido Neves, City Health Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | - Humberto Ponzio
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Duarte
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Jane Neffá
- Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | | | | - Marcus Maia
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Nilton Nasser
- Federal University of Santa Catarina, Blumenau, SC, Brazil
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Tuong W, Walker L, Sivamani RK. Polyphenols as novel treatment options for dermatological diseases: A systematic review of clinical trials. J DERMATOL TREAT 2014; 26:381-8. [DOI: 10.3109/09546634.2014.991675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jaiswal R, Karar MGE, Gadir HA, Kuhnert N. Identification and characterisation of phenolics from Ixora coccinea L. (Rubiaceae) by liquid chromatography multi-stage mass spectrometry. PHYTOCHEMICAL ANALYSIS : PCA 2014; 25:567-576. [PMID: 25185927 DOI: 10.1002/pca.2530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 05/22/2014] [Accepted: 05/30/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Ixora coccinea L. leaves and stem are used in traditional Sudanese and Ayurvedic medicinal systems for the treatment of diarrhoea, fever, headache, skin diseases, eye trouble, wounds, sores and ulcers. Recent studies show that I. coccinea has anti-oxidant, anti-bacterial, anti-cancer, anti-inflammatory, analgaesic, anti-diarrhoeal, hepatoprotective, cardioprotective, anti-mutagenic, wound healing and anti-tumour activities. Ixora coccinea is a rich source of polyphenols such as proanthocyanidins, flavonoids, flavonoids glycosides and tannins. OBJECTIVES To develop a LC-MS(n) method for the identification and characterisation of phenolic compounds of I. coccinea L. leaves and stem. METHODS Aqueous methanolic (70% methanol) extracts of I. coccinea leaves and stem were used for LC-MS(n) to ensure efficient extraction of phenolics. A C18 amide reverse-phase HPLC column allowed separation of the phenolic compounds, including different isomers. For the LC-MS measurements, negative ion mode was used in order to obtain better tandem mass spectra and high-resolution mass spectra. RESULTS The phenolics were identified by their typical UV absorptions at 254, 280 and 320 nm. All the flavonol glycosides showed a neutral loss of the glycan part; hydroxycinnamates showed loss of the cinnamoyl/cinnamic acid part; while proanthocyanidins showed a Diels-Alder fragment in negative ion mode mass spectra. CONCLUSION It was possible to identify C-3 and C-7 flavonol glycosides by their order of elution and it was also possible to predict the glycosylation position in flavonol diglycosides from their tandem mass spectra.
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Affiliation(s)
- Rakesh Jaiswal
- School of Engineering and Science, Chemistry, Jacobs University Bremen, Campus Ring 8, 28759, Bremen, Germany
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Jaiswal R, Halabi EA, Karar MGE, Kuhnert N. Identification and characterisation of the phenolics of Ilex glabra L. Gray (Aquifoliaceae) leaves by liquid chromatography tandem mass spectrometry. PHYTOCHEMISTRY 2014; 106:141-155. [PMID: 25086488 DOI: 10.1016/j.phytochem.2014.07.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 07/10/2014] [Accepted: 07/14/2014] [Indexed: 05/25/2023]
Abstract
The phenolics of the leaves of Ilex glabra L. Gray (Aquifoliaceae) were investigated qualitatively by LC-MS(n). Thirty-two phenolics were detected and characterised on the basis of their unique fragmentation pattern in the negative ion mode tandem MS spectra. All of them were extracted for the first time from this source and fifteen of them were not reported previously in nature. For the positive identification of phenolic glucosides by LC-MS(n) a series of authentic standards and experiments were carried out. This is the first report of a full characterisation of 3,4-dihydroxybenzoyl glucosides, 3,4-dihydroxybenzyl glucosides, 4-hydroxybenzoyl glucosides, chlorogenic acid glucosides and vanillic acid glucosides by LC-MS(2-4).
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Affiliation(s)
- Rakesh Jaiswal
- School of Engineering and Science, Chemistry, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany.
| | - Elias A Halabi
- School of Engineering and Science, Chemistry, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany
| | | | - Nikolai Kuhnert
- School of Engineering and Science, Chemistry, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany.
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Gui M, Du J, Guo J, Xiao B, Yang W, Li M. Aqueous Extract of Chrysanthemum morifolium ( Jú Huā) Enhances the Antimelanogenic and Antioxidative Activities of the Mixture of Soy Peptide and Collagen Peptide. J Tradit Complement Med 2014; 4:171-6. [PMID: 25161922 PMCID: PMC4142455 DOI: 10.4103/2225-4110.128897] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The possible synergistic effect between the aqueous extract of Chrysanthemum morifolium ( Jú Huā) (AECM) and the peptide mixture (PM) containing soy peptide and collagen peptide was investigated in an ultraviolet (UV) irradiation-induced skin damage mouse model. The irradiated mice were treated with the PM or PM + AECM (containing PM and AECM), respectively. Both PM and PM + AECM groups displayed an apparent photoprotective effect on the UV-irradiated skin damage of mice. Histological evaluation demonstrated that the epidermal hyperplasia and melanocytes in the basal epidermal layer of the UV-irradiated skin in mice decreased when treated with either PM or PM + AECM. Further study showed that soy peptide, collagen peptide, and AECM also inhibited the activities of mushroom tyrosinase with IC50 values of 82.3, 28.2, and 1.6 μg/ml, respectively. Additionally, PM + AECM reduced melanogenesis by 46.2% at the concentration of 10 mg/ml in B16 mouse melanoma cells. Meanwhile, the UV-induced increase of antioxidative indicators, including glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and malondialdehyde (MDA), was reduced significantly after treatment with 1.83 g/kg/dbw of PM + AECM. This evidence supported the synergistic antioxidative effect of AECM with PM. These results demonstrated that oral intake of PM and AECM had synergistic antimelanogenic and antioxidative effects in UV-irradiated mice.
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Affiliation(s)
- Min Gui
- Amway (China) Research and Development Center, Shanghai, China
| | - Jun Du
- Amway (China) Research and Development Center, Shanghai, China
| | - Jianmin Guo
- State Key Laboratory of New Drug Evaluation in Guangzhou, Guangzhou Institute of Pharmaceutical Industry, Guangzhou, China
| | - Baiquan Xiao
- State Key Laboratory of New Drug Evaluation in Guangzhou, Guangzhou Institute of Pharmaceutical Industry, Guangzhou, China
| | - Wei Yang
- State Key Laboratory of New Drug Evaluation in Guangzhou, Guangzhou Institute of Pharmaceutical Industry, Guangzhou, China
| | - Minjie Li
- Amway (China) Research and Development Center, Shanghai, China
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Jaiswal R, Kuhnert N. Identification and characterization of the phenolic glycosides of Lagenaria siceraria Stand. (bottle gourd) fruit by liquid chromatography-tandem mass spectrometry. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:1261-1271. [PMID: 24447091 DOI: 10.1021/jf4053989] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Bottle gourd, Lagenaria siceraria Stand. (Cucurbitaceae), fruit is used in folk medicines and for culinary purposes in Asia. The phenolics of bottle gourd fruit were investigated qualitatively by LC-MS(n). Twenty-two phenolic glycosides were detected and characterized on the basis of their unique fragmentation pattern in the negative ion mode tandem MS spectra. Twenty of them were extracted for the first time from this source, and twelve of them have not been reported previously in nature. It was also possible to distinguish between the individual classes of isobaric phenolic glycosides by tandem and high-resolution mass spectrometry. In this study we also discuss the mass spectrometric fragmentation mechanism of 6-(hydroxycinnamoyl)glucoses. This is the first report of the full characterization of phenolic glycosides of bottle gourd fruit by LC-MS²⁻⁴.
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Affiliation(s)
- Rakesh Jaiswal
- Chemistry, School of Engineering and Science, Jacobs University Bremen , Campus Ring 1, 28759 Bremen, Germany
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Jaiswal R, Karaköse H, Rühmann S, Goldner K, Neumüller M, Treutter D, Kuhnert N. Identification of phenolic compounds in plum fruits (Prunus salicina L. and Prunus domestica L.) by high-performance liquid chromatography/tandem mass spectrometry and characterization of varieties by quantitative phenolic fingerprints. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2013; 61:12020-12031. [PMID: 24152059 DOI: 10.1021/jf402288j] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Plums (Prunus domestica L. and Prunus salicina L.) are edible fruits mostly consumed in America, China, and Europe. We have used LC-MS(n) to detect and characterize the phenolic compounds in plum varieties. Forty-one phenolics were detected comprising caffeoylquinic acids, feruloylquinic acid, p-coumaroylquinic acids, methyl caffeoylquinates, methyl p-coumaroylquinate, caffeoylshikimic acids, catechin, epicatechin, rutin, esculin, quercetin, quercetin-3-O-hexosides, dimeric proanthocyanidins, trimeric proanthocyanidins, caffeoyl-glucoside, feruloyl-glucoside, p-coumaroyl-glucoside, vanillic acid-glucosides, 3,4-dihydroxybenzoyl-glucoside, quercetin-3-O-pentosides, quercetin-3-O-rhamnoside, quercetin-pentoside-rhamnosides, and 3-p-methoxycinnamoylquinic acid. This is the first time when 3-p-methoxycinnamoylquinic acid is reported in nature. Chlorogenic acids and proanthocyanidins were the major phenolics present in plums. Furthermore, HPLC with DAD and chemical reaction detection was used to generate quantitative phenolic fingerprints from the fruit flesh of 33 plum varieties. The predominant compound was 3-caffeoylquinic acid in nearly all varieties studied; generally, however, the qualitative and quantitative profiles showed high diversity even among closely related progenies.
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Affiliation(s)
- Rakesh Jaiswal
- School of Engineering and Science, Chemistry, Jacobs University Bremen , 28759 Bremen, Germany
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Fisk WA, Agbai O, Lev-Tov HA, Sivamani RK. The use of botanically derived agents for hyperpigmentation: a systematic review. J Am Acad Dermatol 2013; 70:352-65. [PMID: 24280646 DOI: 10.1016/j.jaad.2013.09.048] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Hyperpigmentation disorders are common among those seeking care from dermatologists and primary care physicians. The cosmeceutical and natural product industries are rapidly growing and many botanical agents are purported to improve hyperpigmentation disorders. OBJECTIVE We sought to review clinical evidence for the use of botanical agents in the treatment of hyperpigmentation. METHODS We searched MEDLINE and Embase databases and a total of 26 articles met inclusion criteria. Study methodology was analyzed and the reproducibility of the studies was graded. RESULTS Several botanical agents appear promising as treatment options but few studies were methodologically rigorous. Several plant extract and phytochemicals effectively lighten signs of epidermal melasma and hyperpigmentation induced by ultraviolet radiation exposure. Results were mixed for treatment of solar lentigines or dermal hyperpigmentation. LIMITATIONS There were few rigorously designed studies; future research will be critical to further ascertain the discussed results. CONCLUSIONS The subtype of hyperpigmentation is important for treatment prognosis, with dermal hyperpigmentation less responsive to treatment. Botanical extracts may play an integrative role in the treatment of hyperpigmentation and further studies that integrate them with standard therapies are needed. Side effects, including worsened hyperpigmentation, need to be discussed when considering these therapies.
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Affiliation(s)
- Whitney A Fisk
- School of Medicine, University of California-Davis, Sacramento, California
| | - Oma Agbai
- Department of Dermatology, University of California-Davis, Sacramento, California
| | - Hadar A Lev-Tov
- Department of Dermatology, University of California-Davis, Sacramento, California; Veterans Affairs Northern California Health Care System, Mather, California
| | - Raja K Sivamani
- Department of Dermatology, University of California-Davis, Sacramento, California.
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Gulati OP. Pycnogenol® in chronic venous insufficiency and related venous disorders. Phytother Res 2013; 28:348-62. [PMID: 23775628 DOI: 10.1002/ptr.5019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/14/2013] [Indexed: 11/06/2022]
Abstract
The present review provides an update of the biological profile of Pycnogenol in the light of its use in the treatment of chronic venous insufficiency (CVI) and related venous disorders such as deep vein thrombosis (DVT), post-thrombotic syndrome, long haul air-travel-related leg oedema, venous ulcers and acute haemorrhoids. Pycnogenol is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. subsp. atlantica. Its strong antioxidant, anti-inflammatory and vasodilator activities, antithrombotic effects and collagen stabilizing properties make it uniquely able to target the multi facet pathophysiology of CVI and related venous disorders. Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long haul flights and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration. This review highlights clinical research findings on the safety, compliance and efficacy of Pycnogenol, including its use in combination products.
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Abstract
Cosmeceuticals are topical cosmetic-pharmaceutical hybrids that enhance the beauty through constituents that provide additional health-related benefit. Cosmeceuticals are commonly used for hyperpigmentation. These disorders are generally difficult to treat, hence the need for skin lightening agents including, cosmeceuticals. These agents selectively target hyperplastic melanocytes and inhibit key regulatory steps in melanin synthesis. With the recent safety concern regarding use of hydroquinone, the need for alternative natural, safe and efficacious skin lightening agents is becoming all the more necessary and the article attempts to look at other alternative cosmeceuticals available or maybe upcoming in the future. We carried out a PUBMED search using the following terms “cosmeceuticals, hyperpigmentation, skin lightening agents.” We cited the use of various agents used for the treatment of hyperpigmentation, mainly melasma and post-inflammatory hyperpigmentation. We describe the safety and efficacy of these agents and their advantage over the conventional therapy.
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Affiliation(s)
- Rashmi Sarkar
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Song M, Mun JH, Ko HC, Kim BS, Kim MB. Korean red ginseng powder in the treatment of melasma: an uncontrolled observational study. J Ginseng Res 2013; 35:170-5. [PMID: 23717059 PMCID: PMC3659531 DOI: 10.5142/jgr.2011.35.2.170] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 03/30/2011] [Accepted: 04/05/2011] [Indexed: 11/22/2022] Open
Abstract
Exposure to the sun, ultraviolet radiation, and oxidative stress are the chief etiologic factors responsible for melasma. The ingredients of Korean red ginseng powder, which include ginsenoside and phenolic compounds, have antioxidative effects and reduce ultraviolet B-induced pigmentation. This study was designed to evaluate the effectiveness and safety of Korean red ginseng powder in patients with melasma. In 25 female patients, 3 g of Korean red ginseng powder was orally administered for a 24 week period. The level of pigmentation and erythema were determined and clinical improvement was evaluated by the melasma area and severity index (MASI), melasma quality of life scale (MELASQoL), and patient- and investigator-rated global improvement scale. After 24 weeks, the MASI score decreased from 8.8 to 5.6, and MELASQoL showed improvement in 91% of patients (p<0.05). The mean level of pigmentation decreased from 184.3 to 159.7 and erythema levels decreased from 253.6 to 216.4 (p<0.05). Additionally, 74% of the patients showed some improvement in both patient- and investigator-rated global improvement scales at week 24. Korean red ginseng powder was well tolerated by most of the patients. In conclusion, Korean red ginseng powder showed good tolerability and beneficial effects in patients with melasma. The use of Korean red ginseng would be counted as a useful adjunctive therapy for patients with melasma.
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Affiliation(s)
- Margaret Song
- Department of Dermatology, Pusan National University School of Medicine, Busan 602-739, Korea
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