Systemic Photoprotection
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PHOTODERMATOLOGY (B ADLER AND V DELEO, SECTION EDITORS)
Systemic Photoprotection Jennifer H. Taylor 1 & Cheryl F. Rosen 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Systemic photoprotection is an attractive concept; however, its use has been limited by a lack of robust evidence. We performed a review to evaluate the evidence for systemic photoprotection and skin cancer prevention in humans by vitamins C, D and E, carotenoids, nicotinamide, retinoids, polyphenols, Polypodium leucotomos extract, NSAIDs and afamelanotide. Recent Findings In a randomized controlled trial, compared with placebo, a 13% reduction in actinic keratoses and a 23% reduction in keratinocyte carcinoma were found with continued nicotinamide use over 12 months, although the result should be interpreted with caution. A synthetic melanotropin, Nle4-D-Phe7-a-MSH, showed promising results in photoprotection but was limited by its side effect profile. Summary Various photoprotective agents have shown promise in the reduction of the acute response to UV radiation, but there is insufficient evidence for their mainstream use presently. There is evidence for keratinocyte skin cancer prevention with the use of retinoids and nicotinamide in certain populations. Keywords Systemic photoprotection . Oral photo protection . Polypodium leucotomos extract . Polyphenols . Nicotinamide . Retinoids
Introduction The deleterious effects of ultraviolet (UV) radiation on skin are mediated by a number of mechanisms that can ultimately lead to skin cancer. These include the production of reactive oxygen species leading to oxidative damage to tissues, UVinduced DNA mutations and immunosuppression [1–6]. Photoprotection aims to limit these effects and encompasses prevention of acute responses such as erythema and tanning, as well as chronic effects such as wrinkling, photoageing and skin cancer. Systemic photoprotection refers to compounds taken internally that offer protection against the effects of UV radiation [1, 2, 6] and represents an attractive
This article is part of the Topical Collection on Photodermatology * Cheryl F. Rosen [email protected] Jennifer H. Taylor [email protected] 1
Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
concept owing to the potential ease of use compared with topical modalities. However, the use of systemic photoprotection has thus far been limited by a lack of robust evidence demonstrating protection. Much of the literature on this topic focuses on a reduction of the Minimal Erythema Dose (MED) as a marker of photoprotection, while other studies assessed cellular changes or clinical outcomes, i.e. incidence of skin cancer, to investigate this concept. Herein, we review the data on systemic protection in humans in vivo.
Vitamins The main source of vitamins and minerals is through our diet, particularly fruits and vegetables [2, 6]. In addition, both individual vitamins and vitamin mixtures are sold over the counter. Although the photoprotection ga
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