In search of supplements for skin aging

True scientific evidence backing the use of supplements for the prevention of skin aging and sun damage is often shady, but bright spots sometimes shine through, for example, when the science and anecdotal evidence suggest swallowing a vitamin, extract or other ingredient does make a difference in patients’ skin.

Leslie Baumann, M.D.“Topical skincare is important, but some ingredients just do not penetrate well into the skin when applied topically. In that case, supplements are a preferred delivery method. I use supplements even when I am using ingredients that do get in topically, in many cases, because I believe that I get higher levels in the skin when I combine oral and topical use,” says Leslie Baumann, M.D., a dermatologist, researcher and author in Miami, and CEO of Skin Type Solutions Franchise Systems. 

Proven: sun-damage prevention and more

A bright star in supplementation and skin aging is Polypodium leucotomos (PL) extract, which has been shown in studies to reduce photoaging. The marketed supplement, Heliocare (Ferndale Healthcare), is derived from a fern native to Central and South Americas. Taken daily, this super antioxidant offers around SPF 8 protection, according to

Joel Schlessinger, M.D.Joel Schlessinger, M.D., a cosmetic surgeon and dermatologist in Omaha, Nebraska, and owner of the skincare product website LovelySkin.com.

“This is one of the most effective botanicals we see in practice, and while it alone won't do it all for sun protection, it greatly enhances the effects and longevity of sunscreen, as well as protects areas that may be difficult to cover or 'forgotten' while applying,” Dr. Schlessinger says.

Oral supplementation with PL extract could benefit other dermatologic patients, including those with vitiligo and polymorphic light eruption, according to Dr. Schlessinger.   

Two recent studies suggest the extract has some real potential power. According to research reported in the July 2014 issue of the International Journal of Dermatology, “The use of a systemic protective agent would provide significant advantages such as a more uniform coverage over the total body surface area, regardless of individual factors such as potency of the creams, amount applied, sweating or bathing. Oral administration of PL extracts and its favorable safety profile could have significant implications in the prevention of skin cancer" (El-Haj N, Goldstein N. Int J Dermatol. 2014 Jul 11).

In a review published in the March issue of the Journal of Clinical Aesthetic Dermatology, researchers found oral administration of the PL extract notably improved melasma in women after 12 weeks. They concluded PL supplementation seems to help treat vitiligo and melasma and might impact postinflammatory hyperpigmentation (Nestor M, et al. J Clin Aesthet Dermatol. 2014;7:13-7).

Dr. Baumann says she prescribes oral PL extract for herself and her patients. She recommends one supplement a day.

“It helps prevent erythema and sunburn cells,” she says. “I also use it to protect patients on sun-sensitizing drugs, like doxycycline. I did a study showing that it helped melasma so I put all my melasma patients on it.”

Although effective, Heliocare is an adjunct, rather than a first-line, sun protection therapy for patients. Both the company and skincare experts advise that it should be used in combination with topical sunscreen.

Next: Antioxidants for prevention

Antioxidants for prevention

Dr. Baumann, whose book Cosmeceuticals and Cosmetic Ingredients (McGraw Hill) comes out in December, says there is evidence to support use of other supplements.

Antioxidant supplementation, for example, picks up where the environment depletes skin of antioxidants, she says.

“Many doctors believe that increasing the level of antioxidants in the skin is an important part of protecting the skin from aging, skin pigmentation and maybe even skin cancer. Supplements are a good way to achieve this,” Dr. Baumann says.

When guiding patients about antioxidant supplementation, however, the challenge is that there is no one best antioxidant when it comes to protecting the skin. Each has benefits and drawbacks, and they seem to work better as a group, Dr. Baumann says. The antioxidant supplements she uses most for skin aging prevention are coenzyme Q10, and vitamins C and E because studies show UV light depletes vitamins E and C, glutathione and coenzyme Q10 in the epidermis and dermis.

“Vitamin C and E network together. Vitamin C needs an acidic environment to be absorbed, so the stomach is a perfect place to absorb vitamin C,” Dr. Baumann says.

She recommends patients take 500 mg vitamin C daily.

“However, vitamin C supplementation does not result in enough vitamin C in the skin, so a topical should be used when possible,” she says.

Coenzyme Q10, she says, increases adenosine triphosphate (ATP), or cell energy. Patients should take it in the morning because CoQ10 causes a caffeine type effect, according to Dr. Baumann. She recommends 200 mg of CoQ10 in the morning and 400 IU of vitamin E daily.

Next: Glucosamine for improvement

Glucosamine for improvement

In contrast to supplements for prevention, glucosamine may be an effective supplement for improving the appearance of aging to the skin, according to Dr. Baumann.

Glucosamine and its derivative N-acetyl glucosamine are amino-monosaccharides, known to act as substrate precursors for the production of polymers, such as glycosaminoglycans (notably, hyaluronic acid) and for proteoglycans synthesis, she says. N-acetyl glucosamine has been reported to hinder melanin production in melanocyte culture. The ingredient has been used as cosmeceutical agent intended for pigment lightening.

Because glucosamine increases production of hyaluronic acid in the joints and skin, most studies have been performed on the supplement’s potential role in osteoarthritis. However, others have examined glucosamine’s effect on skin.

In 2001, researchers reported that use of an oral supplement containing glucosamine, minerals, and various antioxidant compounds might improve the appearance of visible wrinkles and fine lines. But the supplement did not affect epidermal hydration (Murad H, Tabibian MP. J Dermatolog Treat. 2001;12:47-51).

In 2005, Kambayashi et al analyzed the effect of newly synthesized molecule topical  N-retinoyl-D-glucosamine (GRA), in which the researchers attached glucosamine to the polar end group of all-trans retinoic acid. In irradiated hairless mice, topical GRA appeared to repair photoaged skin damage without the irritation caused by topical retinoic acid (Kambayashi H, et al. Br J Dermatol. 2005;153(suppl 2):30-36).

In 2006, a published review of glucosomine noted that glucosamine has been shown to enhance skin hydration, reduce wrinkles, facilitate wound healing and effectively treat hyperpigmentation. In addition, glucosamine was reported to exhibit anti-inflammatory and chondroprotective activity (Bissett DL. J Cosmet Dermatol. 2006;5:309-315).

Dr. Baumann recommends patients take 1,500 mg of glucosamine daily.