CO-AUTHOR: LIZA R. BRAUN, BA
Botanical ingredients found in nature are often formulated into skin care products intended to address fine lines, wrinkles, uneven tone, and texture. These ingredients possess antioxidant, anti-inflammatory and photoprotective properties that make them potential alternatives or adjunctive options to prescription medications.
Bygone are days of applying makeup to camouflage one’s melasma, sun damage, or acne. Your patients may want a product that addresses their underlying condition by providing resolution beyond, or in addition to, concealment. They will turn to you for your advice on how to prevent as well as correct, which can be attained by addressing mechanisms such as oxidative stress.
A patient’s unwillingness to try prescription medications before considering alternative or “natural” options is not unusual. Offering natural alternatives to prescription medications allows the patient to feel that you are listening to their needs. Don’t underestimate the side effects of steroids and retinoids and how they may negatively impact your patient. It is empowering as a dermatologist to be able to address this directly by being knowledgeable and aware of what products are available on the market, and being able to help your patients choose those products that are best to meet their needs.
As a dermatologist, patients will come to you seeking scientifically sound, evidence-based recommendations. In this section, we offer you some insight into which botanicals have evidentiary support. Dermatologic products containing green tea, mushroom extract, feverfew, niacinamide and soy will be addressed. Other products to consider, though not fully addressed here, are topical vitamins (e.g., E, C), grape seed extract, licorice, and coffeeberry.
Oxidative Stress and Aging
Anti-aging effects provided by the natural therapies reviewed in this section primarily work by addressing exogenous and endogenous oxidative stress, a critical mechanism in the aging process. UV radiation and environmental pollutants, such as cigarette smoke, hasten the aging process by generation of free radicals. These free radicals break down DNA, lipids and proteins leading to dysregulation of cellular signaling and carcinogenesis. The skin has the ability to offset this damage via melanin absorption of UV radiation, light scattering by the stratum corneum, and intrinsic antioxidants. Unfortunately, intrinsic and extrinsic free radicals increase with age in the setting of the skin’s decreased ability to regenerate. Consequently, elasticity and structural support are damaged leading to fine wrinkles, mottled pigmentation, and uneven texture. Sunscreen and hydration are cornerstones of the basic dermatologic regimen; however, adjunctive natural agents may provide additional benefit.
Green Tea
Tea, including white, black and green, contain polyphenols (also known as catechins), which retain many anti-aging properties as well as other valuable health effects. Polyphenols are natural pigments, including yellow, red or purple, which absorb radiation 1. Green tea in particular acts as an antioxidant by chelating metal ions and preventing the formation of endogenous reactive oxygen species (ROS)2. A major source of ROS generation is UV radiation, which leads to inflammation, premature aging, and DNA damage. Green tea is photoprotective and is able to repair DNA as well as prevent UVA/B photocarcinogenesis2.
In an in vitro study, dose-dependent topical green tea application, applied to the skin 20 minutes prior to UV exposure, decreased post-UV exposure erythema3. It also decreased photocarcinogenesis by preventing cyclobutane pyrimidine dimers, markers of DNA damage. The same study showed green tea polyphenols (GTPs) prevented UV penetration into deeper dermal layers1. GTPs also prevent phosphorylation of carcinogenic MAPK pathways induced by UV radiation2.
In a clinical human trial evaluating photoprotection with GTPs, investigators determined a 10% GTP solution provided near complete solar protection, while a 2.5% GTP solution was sufficiently photoprotective for most patients4.
Green tea polyphenols used in conjunction with sunscreen is an easily attainable and beneficial method for patients looking for natural solutions. You might consider recommending products with green tea as part of your patient’s morning routine, in addition to sunblock, to prevent photodamage from occurring. Including green tea as part of your patient’s evening routine allows for DNA repair to occur overnight.
Click here for Part 2 (conclusion) where we will explore more natural ingredients and how to integrate them into your practice.
Looking for holistic dermatology? Check out the series here.
Abbreviations
- ROS – Reactive oxygen species
- GTPs – Green tea polyphenols
- SOD – Superoxide dismutase
- SSPIs – Small serine protease inhibitors
References and Suggested Readings
- 1. Nichols, J. A. and S. K. Katiyar (2010). “Skin photoprotection by natural polyphenols: anti-inflammatory, antioxidant and DNA repair mechanisms.” Arch Dermatol Res 302(2): 71-83.
- 2. Afaq, F. and S. K. Katiyar (2011). “Polyphenols: skin photoprotection and inhibition of photocarcinogenesis.” Mini Rev Med Chem 11(14): 1200-1215.
- 3. Katiyar, S. K., et al. (2000). “Green tea polyphenol treatment to human skin prevents formation of ultraviolet light B-induced pyrimidine dimers in DNA.” Clin Cancer Res 6(10): 3864-3869.
- 4. Elmets, C. A., et al. (2001). “Cutaneous photoprotection from ultraviolet injury by green tea polyphenols.” J Am Acad Dermatol 44(3): 425-432
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