title: A topical antioxidant solution containing vitamins C and E stabilized by ferulic acid provides protection for human skin against damage caused by ultraviolet irradiation.
abstract: BACKGROUND
  Skin cancer and photoaging changes result from ultraviolet (UV)-induced oxidative stress. Topical antioxidants may protect skin from these effects.
  
  
  OBJECTIVE
  We sought to determine whether a stable topical formulation of 15% L-ascorbic acid, 1% alpha-tocopherol, and 0.5% ferulic acid (CEFer) could protect human skin in vivo from substantial amounts of solar-simulated UV radiation.
  
  
  METHODS
  CEFer and its vehicle were applied to separate patches of normal-appearing human skin for 4 days. Each patch was irradiated with solar-simulated UV, 2 to 10 minimal erythema doses, at 2-minimal erythema dose intervals. One day later, skin was evaluated for erythema and sunburn cells, and immunohistochemically for thymine dimers and p53. UV-induced cytokine formation, including interleukin (IL)-1alpha, IL-6, IL-8, and IL-10, and tumor necrosis factor-alpha, were evaluated by real-time polymerase chain reaction.
  
  
  RESULTS
  CEFer provided significant and meaningful photoprotection for skin by all methods of evaluation.
  
  
  CONCLUSIONS
  The number of patients evaluated was relatively small.
  
  
  CONCLUSIONS
  CEFer provided substantial UV photoprotection for skin. It is particularly effective for reducing thymine dimer mutations known to be associated with skin cancer. Its mechanism of action is different from sunscreens and would be expected to supplement the sun protection provided by sunscreens.
authors.affiliation: Division of Dermatology, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Murray
authors.forename: James A
authors.initials: JA
authors.lastname: Burch
authors.forename: Robert D
authors.initials: RD
authors.lastname: Streilein
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Iannacchione
authors.forename: Russell P
authors.initials: RP
authors.lastname: Hall
authors.forename: Sheldon R
authors.initials: SR
authors.lastname: Pinnell
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D003373:Coumaric Acids / Q000627:therapeutic use*; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D004249:DNA Damage / Q000187:drug effects*; D017931:DNA Primers; D004338:Drug Combinations; D004890:Erythema / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007150:Immunohistochemistry; D016133:Polymerase Chain Reaction; D011740:Pyrimidine Dimers / Q000032:analysis; D012333:RNA, Messenger / Q000032:analysis; D011829:Radiation Dosage; D012867:Skin / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects*; D012878:Skin Neoplasms / Q000235:genetics / Q000517:prevention & control; D018709:Statistics, Nonparametric; D013471:Sunburn / Q000235:genetics / Q000517:prevention & control*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014466:Ultraviolet Rays / Q000009:adverse effects; D024502:alpha-Tocopherol / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D003373:Coumaric Acids; D016207:Cytokines; D017931:DNA Primers; D004338:Drug Combinations; D011740:Pyrimidine Dimers; D012333:RNA, Messenger; D016159:Tumor Suppressor Protein p53; C004999:ferulic acid; D024502:alpha-Tocopherol; D001205:Ascorbic Acid