Anti-Aging Supplements for Skin (“Internal Skincare”) Part II

Since the interest in improving skin appearance and preserving youth is increasing exponentially, and in line with the creation of new cosmetic treatments and topical formulations, it is as good a time as ever to highlight the internal means by which this can be achieved.Internal agents are woefully underwritten in skincare when in fact, unlike nearly all of topical agents, these agents are capable of acting on skin through the dermis after they are digested and taken into the bloodstream. Topical skin creams and such do not permeate past the epidermis. If the face can be thought of as a house, internal skincare helps to improve skin appearance by repairing the foundation and improving the look of the exterior by re-structuring the interior.

The presented oral anti-skin aging supplements and compounds detailed below can be used alone or used as additives to topical skincare for possible synergistic benefits.


Continued …

Chlorophyll:

Do not underestimate the importance of adding ample greens to your diet. Older women given drinks containing concentrated amounts of chlorophyll extract revealed improvements in wrinkles and skin elasticity. Furthermore, higher doses of chlorophyll were found to increase procollagen gene and protein expression in photoprotected skin cells. Markers of UV damage following UV exposure were additionally found to be significantly decreased in a dose-dependment manner. Positive results from chlorophyll intake are thought to occur from direct up-regulation of collagen synthesis and from its antioxidant and antimutagenic properties. (1)

Coenzyme Q10: 

Coezyme Q10 is a vital player in cellular energy metabolism, and as such, has soared in popularity as an anti-aging supplement. Besides its supplementation aiding in health and improving complications from disease, COQ10 is apparently also beneficial to skin health.  In a very recent placebo-controlled double-blinded study, COQ10 supplementation with either 50mg or 150mg improved multiple parameters of skin health including seasonal declines in viscoelasticity, wrinkles, microrelief lines, and smoothness by 12 weeks. While periorbital lines showed similar noticeable improvement in both the low-dose and high-dose group, other facial lines (nasolabial folds, corners of the mouth lines, radial upper-lip lines) benefited only in the high-dose. Likewise, while a significant increase in skin firmness was observed in the low-dose group in comparison to placebo, this effect was achieved to a greater extent in the high-dose group. (2)

Obtaining similar improvement in skin to that observed in the above study likely requires advanced age and a bioavailable coenzyme Q10. Coenzyme Q10 levels progressively decrease with age starting after the early to mid 20s (3), and in the aforementioned study, participants were between the ages of 45 and 60. Also important to consider is that coenzyme Q10 supplements are generally not very bioavailable. In this study, Q10Vital was used, which is a water-soluble form that is 4x more bioavailable than standard Q10. Others options for bioavailable coenzyme Q10 supplements include “colloidal-Q10”, which can be any coenzyme Q10 supplement that uses a colloid delivery system, and  nano Q10. (4)

Omega-3 Fatty Acids: 

Unlike some other fats, omega-3 fatty acids are anti-inflammatory and thus suppress the generation of inflammatory cytokines and  prostaglandins. Inflammation not only has a prominent role in many diseases and conditions but also in skin health. Resulting oxidative stress caused by inflammation and inflammation itself is responsible for both intrinsic aging and photoaging. Inflammation is the most important contributor to skin aging as it contributes to complete skin production by leading to the induction of collagen and elastin-degrading enzymes and other damage to cellular proteins, lipids, and carbohydrates that are vital in maintaining skin integrity. (5)

By inhibiting inflammation, omega-3 can go a long way in reducing skin aging. Supplementing with high amounts of fish oil (10 g – 18% EPA/12% DHA) protects the skin against UV-induced erythema (i.e., sunburn) and lipid peroxidation while oxidizing itself instead. With chronic use (~6 months) MED increases significantly. (6) MED stands for Minimal Erythemal Dose, or more simply, the minimal amount of sun exposure needed to cause a sunburn. Lower amounts of fish oil can similarly be used to achieve a significant increase in MED in a longer period of time. With 3 g of fish oil (1.8 EPA + 1.2 DHA) supplemented daily, MED was shown to progressively rise and practically double by 6 months. (7) Omega-3 fatty acid saturation in skin is able to offset sunburn and limit UV-induced inflammation due to its reduction in PGE-2 (prostaglandin E2) production in response to UV exposure. (8) Consequently, n-3 fatty acids are also able to decrease the induction of collagen degradation enzymes and thus preserve collagen content.(9) Omega-3 fatty acids offer other benefits to skin such as improvement of elasticity. Taking a high quality, stabilized fish oil supplement (Eskimo Skin Care/dose: 9.6 g oil – 70% fish oil Eskimo-3, 20% evening primrose oil, 10% canola oil, and vitamin D 40 IU/ml, containing 12.7% eicosapentaenoic acid (EPA), 8.1% docosahexaenoic acid (DHA), plus 2.1% gamma-linolenic acid (GLA)) increased skin elasticity by 10% after 3 months in a controlled blinded pilot study. (10) As expected, consumption of omega-3 fatty acids is inversely related to the severity of photoaging. (31) Furthermore , plant-based n-3 fatty acids (e.g., comprising >50% ALA from 2.2 g/d of total fat) sourced from flaxseed reduced skin roughness and scaling in placebo-controlled double-blind study. (11)

Although omega-3 fatty acid contents in the skin are normally low (<2%), these levels can be increased significantly by oral supplementation. For example, by supplementing with 4 g of EPA, one can be expected to raise the EPA levels in their skin 8-fold (12Supplementation with “mega” high doses (e.g., >3 g) of omega-3 fatty acids has its risks, such as an increased risk of bleeding, so it is advised to limit the amount needed for anti-inflammatory activity. In other words, omega-3 fatty acids can exert their anti-inflammatory effects by inhibiting the inflammatory effects of excess omega-6 fatty acids. The dietary ratio of omega-6 to omega-3 fatty acids should not be higher than 3:1. Therefore, one should limit their daily intake of omega-6 fats so less supplementary amounts of omega-3 fats are needed.

Silicon:

Silicon may not be the first compound one might attribute to skincare, but this mineral is involved in collagen synthesis, glycosaminoglycan (i.e., an equally important component of skin intregity, found in the extracelluar matrix) synthesis,  and in the activation of hydroxylating enzymes, which contribute to the strength and elasticity of skin. (13) One study that incorporated choline-stabilized orthosilicic acid (i.e., the biological form of silicone) found that decreased skin roughness and improved mechanical properties in middle-aged to elderly women with photodamaged skin while these parameters declined in the placebo group during the 20 week study duration. (14) Unsurprisingly, the positive benefits on skin markers corroborated with the increased serum silicon  concentrations with the daily supplemental intake of 10 mg in the treatment group. (15) This highly bioavailable form of silicon has also been found to increase the collagen content of skin in animals when given in low doses. (16)

Although supplemental silicon should already be taken for its role in bone strength, its beneficial roles in the skin is yet another reason to add silicon or silicon-containing supplements to the daily routine. For improvement or maintenance of skin health with silicon, it is recommended that bioavailable silicon supplements (in the form of orthosilicic acid) are taken. Silicon is found within cereal grain and vegetable foods, but modern food processing can decrease the amounts of naturally present silicon concentrations. Moreover, even a Si-rich diet (~45 mg/day) is inadequate to raise Si serum values to the levels of those attained with short-term supplementation with  10 mg of  choline-stabilized orthosilicic acid. (14)

Other Carotenoids – Zeaxanthin and Lutein:

In the previous article on anti-aging supplements (Anti-Aging Supplements for Skin (“Internal Skincare”) Part I), beta-carotene and lycopene were focused on for their ability to offer protection for the skin. Other carotenoids, such as zeaxanthin and lutein, also have important anti-aging abilities that should not go unnoticed.

Zeaxanthin, lutein, or both carotenoids together produce notable benefits in skin health. A zeaxanthin-based supplement (also containing: sea buckthorn fruit oil, wheat ceramides, alpha lipoic acid, green tea, red clover leaf, gotu kola seed, maritime pine bark, vitamins C, E, D3) had a positive effect on fine lines and wrinkle count on women of ages 35 to 65 as early as by week 4 and week 12 of the study compared to the placebo group where wrinkle count worsened. (17) Like zeaxanthin, lutein is a potent free radical scavenger and when included in the diet, is found in epidermal and dermal components of the skin  and related to lower markers of inflammation. (18-19) When lutein was part of an antioxidant formula (3 mg lutein with: 5 mg vitamin C, 5 mg tocopherol, and 2.5 mg α-lipoic acid), skin hydration and superficial skin lipids increased while skin peroxides (i.e., a measure of oxidation in the skin) decreased in the treated group. (20) When investigating the association of wrinkles with dietary intake, it was observed that eggs and leafy green vegetables had a negative association with skin wrinkling, likely in part due to their high and bioavailable lutein content. (21) Combination treatment of zeaxanthin and lutein (lutein 10 mg/day, zeaxanthin 0.6 mg/day) was shown to benefit multiple features of skin health including skin hydration, photoprotective activity, elasticity, and additionally, it protected against skin lipid perioxidation throughout the 12 weeks of usage. (22) A newer study also investigating the skin-specific effects of a zeaxanthin/lutein combo (10 mg lutein, 2 mg zeaxanthin) found  an improvement in skin elasticity, a self-reported improvement in skin tone (e.g., firmness, texture, radiance, pore size), and a skin-lightening effect by the end of the 12 week period. While most skin lightening products decrease photoprotection of the skin and increase DNA damage, this lightening effect observed is due to the combo’s antioxidant and anti-inflammatory activity, and conversely, to its increase in photoprotection, as evidenced by the protection against erythema. (23)

Keratin: 

Most know keratin as a core protein in hair that contributes to its strength and flexibility. In the skin, keratin is found in multiple layers, and like in hair, it helps maintain skin’s elasticity and smoothness while locking in moisture. Keratin is made up of several essential and non-essential amino acids necessary to form skin proteins, which makes it vital in influencing skin quality. ( 24-25)

When high quality keratin is combined with skin-health-promoting vitamins, measurable benefits in skin quality are seen. In a double-blinded placebo-controlled clinical trial, participants who were given keratin with supporting vitamins (e.g., Zinc, Vitamin B3, Copper, Vitamin B5, Vitamin B6 and Vitamin B8 (Biotin)) had significant and increasing improvements in moisture, elasticity, roughness, wrinkle depth, and skin protein content throughout the 90 day study duration. (26)

Not all keratin supplements are created equal. High quality keratin, such as that obtained from sheep’s wool and processed in peptide form (Cynatine HNS), is recommended for its apparent bioavailability.  Daily amounts of 500 mg are advised based on the successful results observed in the clinical trial.

Oligonol:

Oligonol is a rather newly available oligomerized polyphenol supplement derived from the lychee fruit and green tea extracts. The polyphenols within Oligonol are mono- or oligomerized through manufacturing, enhancing the bioavailability of this formulation.  (27) When it is compared against other renowned antioxidants such as grape seed extract, Oligonol demonstrates significantly higher antioxidant capacity in human plasma due to its low-molecular weight polyphenols. (28)

In an unpublished clinical study in Japan, female participants between the ages 26-60 estimated skin age, pigmentary deposits, and wrinkles around the eye area were reduced by 12 weeks with 100 mg of Oligonol twice daily. Half of the participants reported an improvement of their skin condition, mainly their skin roughness and wrinkles. Even more, results are most apparent in those over 40 years of age. (29) The same daily dosage of Oligonol was used in a later study presented at the Experimental Biology Annual Meeting. This time, the study group was made up of sedentary males, and the results were equally if not more impressive. After 12 weeks, nearly three quarters of the participants revealed decreased fine lines (as evidenced by Dermalite photographs and the evaluation by trained observers). Furthermore, reductions in sleep wrinkles and deep wrinkles were seen in 18.2% of the study group, and additionally, an overall lightening and brightening with less redness, blotchiness, and freckles of the skin was noted. (30)

Fernblock (Polypodium leucotomos Extract):

This natural antioxidant and anti-inflammatory fern leaf extract is one of the few oral supplements that can confer significant photoprotection. With ingestion of reasonable daily dosages (480-1200 mg), this extract has been shown to decrease UVR sensitivity, including protecting against erythema (i.e., sunburn) and UV-induced oxidative stress (which can compromise skin structure). (32, 41) In addition, PL extract activates tumor suppressor p53 (preventing the development of actinic keratosis), inhibits UV-mediated COX-2 expression and subsequent inflammation (preventing inflammation-induced loss of subcutaneous fat and accelerated skin aging), facilitates the removal of UV photoproducts (enhancing DNA repair), decreases oxidative DNA damage, reduces UV-induced mutagenesis, favorably affects elastin expression, preserves membrane integrity, and protects skin cells (fibroblasts AND keratinocytes) against damage and death. (33-34,36,40) In in vivo human clinical trials, this translates to reports of  protection from UV damage such as preservation of important Langerhans cells, reduction of sunburn cells, decreased hyperpigmentation, significant inhibition of UV-induced mitochondrial DNA damage, and strong reductions in UV and infrared-visible radiation-triggered collagen degradation enzymes. (36-39) The photoprotective dose is 7.5 mg/kg, and toxicity appears to be negligible, even at high dosages. (41) With that said, PL extract should not be used to replace topical sunblock, but rather, it should be used as a complement to external sunblock to achieve the highest level of UV protection.

References:

1. Cho S, Lee DH, Won CH, et al. Drink containing chlorophyll extracts improves signs of photoaging and increases type I procollagen in human skin in vivo. Korean J Invest Dermatol. 2006;13:111-9.

2. Žmitek K, Pogačnik T, Mervic L, et al. The effect of dietary intake of coenzyme Q10 on skin parameters and condition: Results of a randomised, placebo‐controlled, double‐blind study. BioFactors. 2016 Aug 1.

3. Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clinical pharmacology in drug development. 2014 Jan 1;3(1):13-7.

4. Villalba JM, Parrado C, Santos-Gonzalez M, et al. Therapeutic use of coenzyme Q10 and coenzyme Q10-related compounds and formulations. Expert opinion on investigational drugs. 2010 Apr 1;19(4):535-54.

5. Pillai S, Oresajo C, Hayward J. Ultraviolet radiation and skin aging: roles of reactive oxygen species, inflammation and protease activation, and strategies for prevention of inflammation‐induced matrix degradation–a review. International journal of cosmetic science. 2005 Feb 1;27(1):17-34.

6.Watson RR, Zibadi S. Bioactive dietary factors and plant extracts in dermatology. Humana Press; 2013.

7. Preedy VR, editor. Handbook of diet, nutrition and the skin. Springer Science & Business Media; 2012.

8. Ibid

9. Kim HH, Shin CM, Park CH, Kim KH, Cho KH, Eun HC, Chung JH. Eicosapentaenoic acid inhibits UV-induced MMP-1 expression in human dermal fibroblasts. Journal of lipid research. 2005 Aug 1;46(8):1712-20.

10. Segger D, Matthies A, Saldeen T. Supplementation with Eskimo® Skin Care improves skin elasticity in women. A pilot study. Journal of Dermatological Treatment. 2008 Jan 1;19(5):279-83.

11. De Spirt S, Stahl W, Tronnier H, Sies H, Bejot M, Maurette JM, et al. Intervention with flaxseed and borage oil supplements modulates skin condition in women. Br J Nutr 2009;101:440-5.

12. Pilkington SM, Watson RE, Nicolaou A, Rhodes LE. Omega‐3 polyunsaturated fatty acids: photoprotective macronutrients. Experimental dermatology. 2011 Jul 1;20(7):537-43.

13. Araújo LA, Addor F, Campos PM. Use of silicon for skin and hair care: an approach of chemical forms available and efficacy. Anais brasileiros de dermatologia. 2016 Jun;91(3):331-5.

14. Barel A, Calomme M, Timchenko A, Paepe KD, Demeester N, Rogiers V, Clarys P, Berghe DV. Effect of oral intake of choline-stabilized orthosilicic acid on skin, nails and hair in women with photodamaged skin. Archives of Dermatological Research. 2005 Oct 1;297(4):147-53.

15. Ibid

16. Calomme MR, Berghe DA. Supplementation of calves with stabilized orthosilicic acid. Biological trace element research. 1997 Feb 1;56(2):153-65.

17. Schwartz S, Frank E, Gierhart D, Simpson P, Frumento R. Zeaxanthin‐based dietary supplement and topical serum improve hydration and reduce wrinkle count in female subjects. Journal of cosmetic dermatology. 2016 Jun 1.

18. Alaluf S, Heinrich U, Stahl W, Tronnier H, Wiseman S. Dietary carotenoids contribute to normal human skin color and UV photosensitivity. The Journal of nutrition. 2002 Mar 1;132(3):399-403.

19. Kritchevsky SB, Bush AJ, Pahor M, Gross MD. Serum carotenoids and markers of inflammation in nonsmokers. Am J Epidemiol. 2000;152:1065-1071.

20. Morganti P, Bruno C, Guarneri F, Cardillo A, Del Ciotto P, Valenzano F. Role of topical and nutritional supplement to modify the oxidative stress. International journal of cosmetic science. 2002 Dec 1;24(6):331-9.

21. Purba MB, Kouris-Blazos A, Wattanapenpaiboon N, Lukito W, Rothenberg EM, Steen BC, Wahlqvist ML. Skin wrinkling: can food make a difference?. Journal of the American College of Nutrition. 2001 Feb 1;20(1):71-80.

22. Palombo P, Fabrizi G, Ruocco V, Ruocco E, Fluhr J, Roberts R, Morganti P. Beneficial long-term effects of combined oral/topical antioxidant treatment with the carotenoids lutein and zeaxanthin on human skin: a double-blind, placebo-controlled study. Skin pharmacology and physiology. 2007 Apr 19;20(4):199-210.

23. Juturu V, Bowman JP, Deshpande J. Overall skin tone and skin-lightening-improving effects with oral supplementation of lutein and zeaxanthin isomers: a double-blind, placebo-controlled clinical trial. Clinical, cosmetic and investigational dermatology. 2016;9:325.

24. Simmonds DH. The Amino Acid Composition of Keratins: Part V: A Comparsion of the Chemical Composition of Merino Wools of Differing Crimp with that of Other Animal Fibers. Textile Research Journal. 1958 Apr;28(4):314-7.

25. Ward WH, Lundgren HP. The formation, composition, and properties of the keratins. Advances in protein chemistry. 1954 Dec 31;9:243-97.

26. Beer C, Wood S, Veghte RH. A randomized, double‐blind, placebo‐controlled clinical trial to investigate the effect of Cynatine® HNS on skin characteristics. International journal of cosmetic science. 2013 Dec 1;35(6):608-12.

27. Kitadate K, Homma K, Roberts A, et al. Thirteen-week oral dose toxicity study of Oligonol containing oligomerized polyphenols extracted from lychee and green tea. Regulatory Toxicology and Pharmacology. 2014 Feb 28;68(1):140-6.

28. Hackman RM, Polagruto JA, Zhu QY, et al. Flavanols: digestion, absorption and bioactivity. Phytochemistry Reviews. 2008 Jan 1;7(1):195.

29. Almendarez S. Ageless Skin Care Ingredients.

30. Ibid

31. Nematy M, Mehdizadeh A, Razmpour F. A review on nutrition and skin aging. Iranian Journal of Dermatology. 2015;18(1):20-4.

32. Jansen R, Wang SQ, Burnett M, et al. Photoprotection: part I. Photoprotection by naturally occurring, physical, and systemic agents. Journal of the American Academy of Dermatology. 2013 Dec 31;69(6):853-e1.

33. Kim J, Vaish V, Feng M, et al. Transgenic expression of cyclooxygenase-2 (COX2) causes premature aging phenotypes in mice. Aging (Albany NY). 2016;8(10):2392-2405. doi:10.18632/aging.101060.

34. Rinnerthaler M, Bischof J, Streubel MK, et al. Oxidative Stress in Aging Human Skin. Breitenbach M, Eckl P, eds. Biomolecules. 2015;5(2):545-589. doi:10.3390/biom5020545

35. Aguilera P, Carrera C, Puig-Butille JA, et al. Benefits of oral Polypodium Leucotomos extract in MM high risk patients. Journal of the European Academy of Dermatology and Venereology : JEADV. 2013;27(9):1095-1100. doi:10.1111/j.1468-3083.2012.04659.x.

36. Alonso-Lebrero JL, Domı́ C, Tejedor R, et al. Photoprotective properties of a hydrophilic extract of the fern Polypodium leucotomos on human skin cells. Journal of Photochemistry and Photobiology B: Biology. 2003 Apr 30;70(1):31-7.

37. Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Orally administered Polypodium leucotomos extract decreases psoralen-UVA–induced phototoxicity, pigmentation, and damage of human skin. Journal of the American Academy of Dermatology. 2004 Jan 31;50(1):41-9.

38. Villa A, Viera MH, Amini S, et al. Decrease of ultraviolet A light–induced “common deletion” in healthy volunteers after oral Polypodium leucotomos extract supplement in a randomized clinical trial. Journal of the American Academy of Dermatology. 2010 Mar 1;62(3):511-3.

39. Truchuelo M, Jiménez N, Mascaraque M, et al. 597 Pilot study to assess the effects of a new oral photoprotector against infrared-visible radiations. Journal of Investigative Dermatology. 2016 May 31;136(5):S106.

40. Philips N, Smith J, Keller T, et al. Predominant effects of Polypodium leucotomos on membrane integrity, lipid peroxidation, and expression of elastin and matrixmetalloproteinase-1 in ultraviolet radiation exposed fibroblasts, and keratinocytes. Journal of dermatological science. 2003 Jun 30;32(1):1-9.

41. Gonzalez S, Gilaberte Y, Philips N, et al. Fernblock, a nutriceutical with photoprotective properties and potential preventive agent for skin photoaging and photoinduced skin cancers. International journal of molecular sciences. 2011 Nov 29;12(12):8466-75.

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