Protect and Defend: Assessing Topical Antioxidants

The skin is truly a remarkable organ with a range of critical functions. Among them is the ceaseless protection of the body. In addition to light at various wavelengths, the skin defends against environmental pollutants and aggressors. This constant exposure can take a toll, leading to oxidative stress and manifestations of skin signs of aging. Individuals in all areas of the world are exposed to environmental aggressors, and those living in urban areas may face particularly high levels of pollutants.

For years, dermatologists, aesthetically-minded physicians, and other healthcare professionals have led the charge in promoting use of sunscreen, and it seems those efforts are bearing fruit. Generations of consumers now view sunscreen as a daily requirement and are particularly attentive to the need to use SPF when they anticipate extensive sun exposure.

But science tells us that UV protection alone is not enough. Antioxidants can play an important role in comprehensively protecting and supporting the skin. In purposely-designed topical skincare formulations, antioxidants can deliver additional skin protection. Even better: they can also help to improve the appearance of signs of environmental damage in the skin, like discoloration and wrinkling. In this way, topical antioxidants both protect and repair.

At SkinCeuticals, we celebrate our legacy of pioneering topical antioxidant formulations as we continue to innovate to meet the needs of yo ur aesthetic patients. You can trust our formulations for clinically-tested benefits.

— Alison A. Murakami, PhD
VP, Medical Affairs

What are environmental aggressors and what do we know conclusively about their effects on the skin?

Patricia K. Farris, MD: We have an expanded understanding of which environmental aggressors might be important in skin aging. We as dermatologists and aesthetic physicians have focused heavily on ultraviolet light, and we know that it is a major contributor to the clinical features that we see in aging skin. But we have data now that suggests that other environmental factors, particularly air pollutants such as ozone, particulate matter, and cigarette smoke, are also important contributors to skin aging. So we can no longer disregard the impact that these other environmental exposures have on the skin.

An interesting clinical study demonstrated that living in an urban environment near vehicle exhaust emissions and other pollutants was associated with skin that had deeper wrinkling and more brown spots.¹ So it’s no surprise that the term “photoaging” has been replaced with the term atmospheric aging.²

Another piece of the puzzle is the role of longer wavelengths of light on skin aging. Exposure to visible light has gotten a lot of attention recently. Visible light triggers damaging free radicals that cause collagen degradation and trigger inflammation in the skin. In addition, we know that visible light induces hyperpigmentation in darker skin types, so protecting against visible light is important. Infrared, on the other hand, mediates its damage on skin by increasing mitochondrial oxidative stress.

How can skincare protect from these aggressors?

Dr. Farris: Sunscreen remains our go-to for UV protection and there are so many great choices in chemical and mineral sunscreens. But we know that sunscreen does not protect adequately against longer wavelengths of light and does not protect us from pollutants. So, this is where our topical antioxidants fit in. By neutralizing free radicals, antioxidants can mitigate the damaging effects of all wavelengths of light and pollutants. Most of the antioxidants we use in practice are combination antioxidants. Early studies showed that a single antioxidant such as vitamin C does protect skin, but combinations of antioxidants work better. So, combination products are what I and other dermatologists prefer.

What can be done via skincare once exposures have taken place?

Dr. Farris: There are a lot of options, particularly with topical cosmetics, that can improve the unwanted effects caused by environmental exposures. Retinols can improve the appearance of wrinkling, brown spots, and mottled hyperpigmentation leaving the skin looking more youthful. By helping to neutralize free radicals, antioxidants help to improve the overall appearance of photoaged skin, lighten discolorations, and improve the appearance of fine lines and wrinkles. I look at the retinols and antioxidants as having comprehensive benefits for treating environmentally damaged skin, because they really work in a multimodal way. We have a lot that we can offer patients in terms of topical treatments.

What are some of your specific recommendations for patients?

Dr. Farris: All of my skincare regimens start with a sunscreen and an antioxidant, and the specific recommendations vary based on specific skin qualities and objectives.

For patients who need comprehensive environmental protection, CE Ferulic is absolutely my go-to. But for those patients who have oilier skin and/or acne, Silymarin CF is a good choice. Silymarin has been shown to reduce lipid peroxidation. I use a lot of Phloretin CF gel; it’s great and men especially seem to like it. Phloretin and vitamin C are both known to inhibit tyrosinase, so these two antioxidants together do an excellent job to improve the appearance discoloration and brown spots.

A lot of the formulations in the marketplace are multitaskers, meaning they contain a combination of beneficial ingredients. We have so many choices now that it’s easy to find a product to fit any clinical scenario. You have to be flexible with skincare regimens and individualize them. I like having all the options that we have—we really have a plethora of effective products that we can use in different skin types and for treating various skin conditions.

I recommend patients use topical antioxidants in the morning underneath their sunscreen. I recommend Resveratrol B E for nighttime skin support. So we generally say that morning products protect skin, while evening products help improve the appearance of the skin. Certainly, antioxidants can be used in both of those positions within the skincare regimen.

Do antioxidants play a role in post-procedural care?

Dr. Farris: I now include antioxidants in my patients’ post-procedure routine, particularly post-laser, to support the skin throughout the healing process. I find these products may improve recovery time and reduce post-procedure erythema and edema. Also using antioxidants like vitamin C or phloretin may help reduce the possibility of post-inflammatory hyperpigmentation.

What is on the horizon in terms of protecting against environmental aggressors?

Dr. Farris: We’ve got a lot of new sunscreen products coming out, some of which contain antioxidants. And I think this is a nice addition to our treatment armamentarium as dermatologists and aesthetic physicians. We are understanding and learning more about the pathophysiology of environmental exposure. And we know that not only is it reactive oxygen species that are being upregulated by light and pollution, but free iron is also accumulating within the cells.³ The accumulation of iron triggers more free radicals and further upregulates oxidative stress. We’re seeing some preliminary data to suggest that using antioxidants in combination with topical iron chelators may help to mitigate the damage from environmental assaults from both light and pollutants.

1. Vierkötter A, Schikowski T, Ranft U, et al. Airborne particle exposure and extrinsic skin aging. J Invest Dermatol. 2010;130(12):2719-2726.

2. McDaniels D, Farris P, Valacchi G. Atmospheric skin aging-Contributors and inhibitors. J CosDerm. 2018, 17, 124-137.

3. Vierkötter A, Schikowski T, Ranft U, et al. Airborne particle exposure and extrinsic skin aging. J Invest Dermatol. 2010;130(12):2719-2726.

4. Patricia K. Farris, Giuseppe Valacchi. Ultraviolet light protection: Is it really enough? Antioxidants (Basel)H2022 Aug;H11(8): 1484.H Published online 2022 Jul 29.Hdoi:H10.3390/antiox1108148.