Topical Ascorbic Acid Research Articles

Topical Ascorbic Acid Mesotherapy with Microneedling versus Topical Tranexamic Acid Mesotherapy with Microneedling for Melasma: A Therapeutic Comparative Study

Background & objectives: Melasma is a common skin hyperpigmentation syndrome that frequently includes reproductive-aged females, and numerous therapies with various consequences have been suggested. Thus, the objective was to compare the microneedling and mesotherapeutic effects of ascorbic acid versus tranexamic acid for melasma treatments. Methods: This interventional therapeutic prospective study was conducted on 40 patients with melasma at Khabat Consultation Center for Skin Diseases, Sulaimaniyah, Iraq, from March 2022 to August 2022. Sociodemographic data of patients were collected together with a family history of melasma using a well-designed questionnaire. Half of the patients were treated with ascorbic acid, while the rest were treated with tranexamic acid using a derma pen. Results: Highly significant reduction of MASI score were seen before and after treatment (p<0.001) were seen in mean scores before and after treatments for both types of treatments (ascorbic acid and tranexamic acid). Moreover, ascorbic acid results in the highest mean score reduction in skin type III (p=0.746), while tranexamic acid results in the highest mean score in skin type IV (p<0.05). Furthermore, the dermal melasma recorded the highest mean score, and the lowest level was observed in the epidermal melasma for both ascorbic acid and tranexamic acid groups. No significant difference was found between both studied groups in sociodemographic data and other studied variables (family history, skin type, previous treatment, and duration of melasma). Conclusions: Both types of therapy mesotherapy was effective in treating melasma; however, their potencies varied on different skin types and according to melasma types.

A Cost-Based Analysis of Anti-aging Products Across Four Major United States Retailers.

Background In the field of aesthetic dermatology, there is currently very little data on affordability and cost analysis regarding cosmeceuticals as more demand from patients showing interest in cosmeceutical products to reduce and prevent aging continues to grow.Photoaging, a form of extrinsic aging from sun exposure, can be ameliorated by applying sunscreen and retinol products. Topical ascorbic acid and niacinamide have been shown to target the oxidative stress process that contributes to photoaging.These four products have been identified as the cosmeceutical ingredients with the most evidence-based data on photoaging prevention and treatment. Objective Given the demand for effective skin care,the paucity of data on cost differentiation, and the availability of cosmeceutical products, we analyzed the unit cost offour anti-aging products from major online and physical retailers in the United States. Such a cost comparison may facilitate more economically appropriate recommendations on skin care to consumers. Methods and materials We analyzed sunscreen, topical vitamin C (ascorbic acid), topical vitamin B3 (niacinamide), and topical vitamin A (retinol) products sold by four major United States retailers: Walmart, Ulta, Walgreens, and Amazon. The average cost in dollars per ounce (dollar/oz) was calculated for each product category at each retailer. Statistical analyses were done to determine statistical significance for each product category between retailers as well as between each category of product. Results Between the four retailers, Walmart offered the lowest cost per ounce for every product. In contrast, Amazon offered the highest cost per ounce for every product except for sunscreen. We also found that sunscreen products are less expensive per ounce as compared to retinol, ascorbic acid, and niacinamide products. Conclusion Dermatologists should be knowledgeable of product costs when providing patients with anti-aging product recommendations. Our study provides data on the financial cost by retail location of evidence-based anti-aging cosmeceuticals to better guide physicians in patient consulting and economical resource sharing.

The effect of low-intensity cold atmospheric plasma jet on photoaging-induced hyperpigmentation in mouse model.

Cold atmospheric plasma (CAP) produces reactive oxygen/nitrogen species (RONS) in the target and can induce cytoprotective effects by activating hormesis-related pathways when its intensity is in the low range. The aim of this study is to evaluate the effect of low-intensified CAP (LICAP) on skin with photoaging-induced hyperpigmentation in an animal model. Changes in cell viability and RONS production following LICAP treatment were measured. For the in vivo study, 30 hairless mice underwent antecedent photoaging induction followed by the allocated therapy (i.e., LICAP, topical ascorbic acid (AA), or both). During the first 4 weeks of the treatment period (8 weeks), ultraviolet (UV)-B irradiation was concurrently administered. Visual inspection and measurement of the melanin index (MI) were performed to assess the change in skin pigmentation at Weeks 0, 2, 4, 6, and 8. RONS production increased linearly until the saturation point. Cell viability was not significantly affected by LICAP treatment. At Week 8, MI was significantly decreased in every treatment group compared with the values at Week 0 and Week 4. The treatment effect of the concurrent therapy group was superior to that of the LICAP and AA groups. LICAP appears to be a novel modality for photoprotection and pigment reduction in photodamaged skin. LICAP treatment and topical AA application seem to exert a synergistic effect.

Gingival Depigmentation Using Microneedling Technique With Topical Vitamin C: A Prospective Case Series.

Introduction Gingival pigmentation is mainly physiological due to the production of melanin. This study aimed to evaluate the effectiveness of a microneedling technique using topical ascorbic acid in treating gingival hyperpigmentation. Methods A case-series study was established, and 16 out of 42 participants enrolled in this study according to the inclusion and exclusion criteria. A microneedling technique was performed using a Dermapen instrument, followed by the topical application of ascorbic acid on the pigmented gingiva. Variations in the Dummett oral pigmentation index (DOPI) and Hedin melanin index (HMI) scores were considered for each patient. A one-month follow-up was conducted on all patients. Results All the reported cases demonstrated noticeable improvement at the end of the sessions. Moreover, seven patients showed complete depigmentation of the gingiva. Analysis using paired T-tests showed a statistically significant lower post-treatment DOPI score with a mean difference of 1.8 ± 0.7, 95% CI: 0.17-1.49. Similarly, the HMI score was lower post-treatment with a mean difference of 3.1 ± 0.7, 95% CI: 2.74-3.50. Conclusions Microneedling combined with topical ascorbic acid is a novel, non-invasive dental technique that can effectively treat gingival hyperpigmentation.

A comparative study of microneedling versus microneedling with topical Ascorbic Acid in the treatment of striae distensae

A comparative study of microneedling versus microneedling with topical Ascorbic Acid in the treatment of striae distensae

Systematic Review of Management of Superficial Basal Cell Carcinoma

Prevalence of Superficial Basal Cell Carcinoma (BCC) is ever increasing along with its referral to the dermatology and plastic surgery clinics. The multidisciplinary team is essential for decision making, especially where surgery can cause significant cosmetic deformities. This systematic review conglomerates various treatment options in superficial BCC management, particularly in anatomically sensitive areas. A database search using PubMed and Scopus from 2010 to 2022 was conducted. English language randomised controlled trials (RCT), non-randomised clinical trials and prospective studies were included. ROB 2 and ROBINS-I tools were used for risk of bias assessment of randomised controlled trials and prospective studies respectively. Topical treatments, photodynamic therapy (PDT), surgical excision, cryosurgery, curettage, laser therapy and combination therapies were analysed in 20 studies, 9 of which were RCTs with a total cohort of 2807 patients. Imiquimod emerged as gold standard treatment but current combination therapies, such as CO2 laser and PDT, and novel treatment modalities, such as topical ascorbic acid, can offer good results in terms of tumour free interval and cosmetic outcomes. Newer and combination treatments should be considered in the management armamentarium of superficial BCCs.

In vivo evaluation of topical ascorbic acid application on skin aging by 50MHz ultrasound.

Ascorbic acid (AA) is a powerful antioxidant capable of acting significantly both in the prevention and treatment of the skin aging process. One way to assess the in vivo efficacy of anti-aging treatments is by using the high-frequency ultrasound (HFUS) skin image analysis technique, a non-invasive approach that allows for a new level of evaluating the effectiveness of dermatological and cosmetic products. The aim of the present study was to assess the performance of a topical emulsion of liquid crystalline structures containing AA using the 50MHz HFUS skin image analysis method. Twenty-five healthy female participants between 35 and 60years were included, all of whom randomly applied a placebo formulation and an AA-containing formulation to each forearm, once a day, for 30days. HFUS measurements were performed before using the products (T0), 2h later (T2h), and after 30days of use (T30d). The analyzed parameters included total skin, dermal, and epidermal echogenicity; variation and mean thickness of total skin, the epidermis and dermis; and surface roughness. Statistical analyses were performed using the Friedman test, followed by Dunn's test for comparisons of multiple means (α=0.05). A significant increase in total skin and dermal echogenicity was observed after topical AA application. Our findings suggest that collagen synthesis significantly increased after topical therapy with AA, which was responsible for the increment in dermal echogenicity. This study showed, through the HFUS technique, that the topical use of AA promoted dermal redensification after 30days of application.

Randomized trial of topical ascorbic acid in DMSO versus imiquimod for the treatment of basal cell carcinoma

Skin cancer is the most common cancer in the United States and among Caucasians worldwide, with more people diagnosed each year than all other cancers combined. Basal cell cancer is the most common form with an estimated 4.3 million cases diagnosed annually, and treatment costs estimated at $4.8 billion. The objective of this study was to compare efficacy of a topical solution consisting of 30% ascorbic acid in 95% dimethylsulfoxide with topical imiquimod in the treatment of basal cell carcinoma. Twenty-five patients with 29 biopsy confirmed basal cell carcinomas were randomly assigned to receive either the topically applied ascorbic acid treatment twice daily for 8 weeks or topical imiquimod, a standard and well characterized topical treatment. After 8 weeks, post-treatment biopsy of lesions showed complete resolution of 13/15 (86.7%) in the ascorbic acid group, while 8/14 (57.1%) lesions in the IMQ group were resolved (p < 0.05 Chi Square). Topical ascorbic acid was superior at 8 weeks, and non-inferior at 12 weeks to topical imiquimod in the treatment of low risk nodular and superficial lesions. In addition, ascorbic acid was associated with fewer adverse effects than imiquimod. 70% of patients in the imiquinod group showed residual hypopigmentation at 30mo follow up versus 0% in the ascorbate group.

Efficacy of Combined Trichloroacetic Acid Peel and Topical Ascorbic Acid in Treating Epidermal Melasma

ABSTRACT Background: Melasma, a common dermatological problem which has no standard recommended therapy. This study aimed to compare the clinical efficacy of combined trichloroacetic acid peel and ascorbic acid with trichloroacetic acid peel alone in epidermal melasma. Methods: A quasi-experimental study was conducted on 148 patients with epidermal melasma, in the dermatology department of Pak Emirates Military Hospital, Rawalpindi from August 2019 to January 2020. Patients were randomly allocated into two groups; Group A (n=74) was given trichloroacetic acid peel 20% (weekly) plus ascorbic acid cream (once daily). Group B (n=74) was given trichloroacetic acid peel alone (weekly). Melasma Area and Severity Index (MASI) scores were calculated at baseline visit, 6th week and 3rd month. Efficacy was measured as a reduction in post-treatment MASI score to ≤10. Post-stratification Chi-square test was applied considering p-value ≤0.05 as statistically significant. Results: The mean age of patients was 31.63±8.20 years with a predominance of female gender 117(79.1%). The mean duration of persistence of melasma symptoms was 42.59±21.56 months while Fitzpatrick type IV (51%) was revealed as the dominant skin type. MASI score at the baseline, 6th week and 3rd month visits were 18.11±3.49, 12.48±3.16 and 7.74±3.91, respectively. Overall, the treatment was efficacious in 106(71.6%) patients. Reduction in MASI score was significantly higher in group A (83.8%) than group B (59.5%). Conclusion: The combination of trichloroacetic acid peel and ascorbic acid was more effective than trichloroacetic acid peel alone (p=0.001) in the treatment of epidermal melasma. Keywords: Ascorbic Acid; Trichloroacetic Acid; Melasma; Efficacy.

Comparative Study between Effectiveness of Dermapen versus Dermapen Combined with Topical Ascorbic Acid in Treatment of Stretch Marks

Comparative Study between Effectiveness of Dermapen versus Dermapen Combined with Topical Ascorbic Acid in Treatment of Stretch Marks

The effect of topical ascorbic acid on cutaneous healing

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

Vitamin C mesotherapy versus topical application for gingival hyperpigmentation: a clinical and histopathological study.

Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation. Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman's tests, respectively. The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797). Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation. Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.

Complete response of cutaneous SCC to topical treatment with ascorbic acid solution: A case report.

Clinical use of topical ascorbic acid solution could have both the role as an adjunct to consolidated therapies and as an alternative to them, for the treatment of BCC and SCC of the skin.

Topical Ascorbic Acid Ameliorates Oxidative Stress-Induced Corneal Endothelial Damage via Suppression of Apoptosis and Autophagic Flux Blockage.

Compromised pumping function of the corneal endothelium, due to loss of endothelial cells, results in corneal edema and subsequent visual problems. Clinically and experimentally, oxidative stress may cause corneal endothelial decompensation after phacoemulsification. Additionally, in vitro and animal studies have demonstrated the protective effects of intraoperative infusion of ascorbic acid (AA). Here, we established a paraquat-induced cell damage model, in which paraquat induced reactive oxygen species (ROS) production and apoptosis in the B4G12 and ARPE-19 cell lines. We demonstrate that oxidative stress triggered autophagic flux blockage in corneal endothelial cells and that addition of AA ameliorated such oxidative damage. We also demonstrate the downregulation of Akt phosphorylation in response to oxidative stress. Pretreatment with ascorbic acid reduced the downregulation of Akt phosphorylation, while inhibition of the PI3K/Akt pathway attenuated the protective effects of AA. Further, we establish an in vivo rabbit model of corneal endothelial damage, in which an intracameral infusion of paraquat caused corneal opacity. Administration of AA via topical application increased its concentration in the corneal stroma and reduced oxidative stress in the corneal endothelium, thereby promoting corneal clarity. Our findings indicate a perioperative strategy of topical AA administration to prevent oxidative stress-induced damage, particularly for those with vulnerable corneal endothelia.

Electrospun wound dressing as a promising tool for the therapeutic delivery of ascorbic acid and caffeine.

Aim: The aim of this work is to formulate a wound dressing for the delivery of ascorbic acid and caffeine. Method: A wound dressing was developed from electrospun nanofiber containing ascorbic acid and caffeine. In vitro drug release was performed at 25°C and 32°C. Wound healing activity of the nanofiber mats wastested in vivo using rat model with skin excision. Antifungal activity of the dressing was tested on Candida albicans using the disc diffusion method. Results & conclusion: Zone of inhibition was 6.7mm for caffeine dressing; however, inhibition zone increased to 16.7mm for samples containing both caffeine and ascorbic acid. Animals treated with ascorbic acid showed collagen deposition and very few fibroblast cells. Blood vessels and fibroblasts were increased in caffeine-loaded dressings compared with the ascorbic acid group. The findings of the present work suggest the benefits of topical ascorbic acid and caffeine for its high wound healing effects.

Ascorbic Acid in Skin Health

Ascorbic acid (vitamin C) is a water-soluble vitamin and a recognized antioxidant drug that is used topically in dermatology to treat and prevent the changes associated with photoaging, as well as for the treatment of hyperpigmentation. Ascorbic acid has neutralizing properties of free radicals, being able to interact with superoxide, hydroxyl and free oxygen ions, preventing the inflammatory processes, carcinogens, and other processes that accelerate photoaging in the skin. Current research focuses on the search for stable compounds of ascorbic acid and new alternatives for administration in the dermis. Unlike plants and most animals, humans do not have the ability to synthesize our own ascorbic acid due to the deficiency of the enzyme L-gulono-gamma-lactone oxidase, which catalyzes the passage terminal in the ascorbic acid biosynthesis. To deal with this situation, humans obtain this vitamin from the diet and/or vitamin supplements, thus preventing the development of diseases and achieving general well-being. Ascorbic acid is involved in important metabolic functions and is vital for the growth and maintenance of healthy bones, teeth, gums, ligaments, and blood vessels. Ascorbic acid is a very unstable vitamin and is easily oxidized in aqueous solutions and cosmetic formulations. Ascorbic acid is extensively used as an ingredient in anti-aging cosmetic products, as sodium ascorbate or ascorbyl palmitate. This review discusses and describes the potential roles for ascorbic acid in skin health and their clinical applications (antioxidative, photoprotective, anti-aging, and anti-pigmentary effects) of topical ascorbic acid on the skin and main mechanisms of action. Considering the instability and difficulty in administering ascorbic acid, we also discuss the importance of several factors involved in the formulation and stabilization of their topical preparations in this review.

Topical Tranexamic Acid Versus Topical Ascorbic Acid in the Treatment of Melasma: Randomized Clinical Trial

Topical Tranexamic Acid Versus Topical Ascorbic Acid in the Treatment of Melasma: Randomized Clinical Trial

Calcium Hydroxylapatite Combined with Microneedling and Ascorbic Acid is Effective for Treating Stretch Marks.

Background:Stretch marks can have a negative psychological impact on some individuals. Methods are available for treating stretch marks, but high-quality evidence supporting their use is limited. We treat stretch marks using injections of diluted calcium hydroxylapatite (CaHA, Radiesse) filler combined with microneedling and topical ascorbic acid. This retrospective study evaluated the effectiveness of this combined therapy.Methods:Subjects presented with red (n = 25) or white (n = 10) striae on their buttocks, thighs, knees, abdomen, and breasts. CaHA filler was diluted 1:1 with lidocaine 2% without epinephrine. A maximum of 3.0 mL of filler was injected per patient at all skin depths using a 23G needle. This was immediately followed by microneedling and topical application of 20% ascorbic acid. Microneedling with ascorbic acid was repeated after 1 and 2 months. Skin biopsies were obtained from a patient who later underwent abdominoplasty.Results:The mean (±SD) pretreatment Manchester Scar Scale scores were 12.0 (±0.8), decreasing to 7.1 (±1.4) 1 month after the final treatment, indicating improvement in stretch mark appearance (P < 0.001). Subjects were very satisfied (n = 22; 62.9%), satisfied (n = 8; 22.9%), neither satisfied nor dissatisfied (n = 4; 11.4%), or unsatisfied (n = 1; 2.8%) with their treatment results. Analysis revealed a significant correlation between Scar Scale scores and Patient Satisfaction scores (r = 0.483; P = 0.003). Skin biopsies showed increased quantity and quality of collagen and elastin fibers in areas treated with combination therapy. Procedures were well tolerated.Conclusion:Combining 1:1 diluted CaHA with microneedling and topical ascorbic is safe and effective for treating stretch marks.

Clinical Efficacy and Safety on Combining 20% Trichloroacetic Acid Peel with Topical 5% Ascorbic Acid for Melasma.

Trichloroacetic Acid (TCA) is a versatile peeling agent for treatment of melasma. However, Post-Inflammatory Hyperpigmentation (PIH) is reported to be the most common side-effect associated with TCA peel. Topical Ascorbic Acid (AA) due to its effect as antioxidant and tyrosinase inhibitor helps to prevent PIH and maintains the response. To assess the clinical efficacy, safety and reduction in Melasma Quality of Life (MELASQOL) on combining 20% TCA peel with 5% ascorbic acid cream in epidermal melasma. This study was conducted in the Department of Dermatology, Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak. This was an open labelled prospective randomized study in which 60 patients of epidermal melasma were enrolled for 12 weeks. Patients were divided into two groups: Combination group received 20% TCA peel every two weeks with once daily 5% ascorbic acid cream and Control group received only 20% TCA peel. Melasma Area Severity Index (MASI) was used for evaluating clinical improvement of melasma. Improvement in Quality Of Life (QoL) was assessed by MELASQOL scale in both groups. Adverse effects were evaluated at each visit. All statistical analysis was carried out with SPSS 20th version. The difference in change in mean MASI scoring and MELASQOL scores between the two groups were analysed using Mann-Whitney test. The side effects between the two groups were compared using Chi-square test. The combination group demonstrated a statistically significant improvement in MASI, percentage decrease in MASI and quality of life as compared to control group after treatment. At the baseline there was no statistically significant difference in MASI between the two groups (i.e., MASI in combination group and control group were 23.55±4.61 and 23.613±4.088 respectively). However, it was statistically significant at the end of therapy (i.e., MASI in combination group was 9.50±5.31 and in control group was 15.10±4.44). When the results were analysed in terms of percentage decrease in MASI from baseline, there was statistically significant difference in combination group (i.e., 10.87±4.11) as compared to control group (i.e., 6.3±1.97) after 2nd week of therapy. When the mean MELASQOL scores were compared between the two groups at the end of therapy (i.e., 12 weeks), it was found to be statistically significantly lower in combination group (16.60±8.03) as compared to control group (25.90±8.17). Minor adverse effects like post peel erythema, pruritus, burning and stinging sensation were observed in some of the patients, which didn't necessitate termination of the therapy. Combination of 20% TCA peel with topical 5% ascorbic acid is a highly effective, safe and promising therapeutic option in treatment of melasma which significantly improves the QoL.

Phosphatidylcholine liposomes as carriers to improve topical ascorbic acid treatment of skin disorders.

Liposomes have been intensively investigated as carriers for different applications in dermatology and cosmetics. Ascorbic acid has potent antioxidant and anti-inflammatory properties preventing photodamage of keratinocytes; however, due to its instability and low skin penetration, an appropriate carrier is mandatory to obtain desirable efficacy. The present work investigates the ability of a specific ascorbate phosphatidylcholine (PC) liposome to overcome the barrier of the stratum corneum and deliver the active agent into the dermis to prevent photodamage. Abdominal skin from ten patients was used. Penetration of PC liposomes was tested ex vivo in whole skin, epidermis, and dermis by means of fluorescein and sodium ascorbate. Histology and Franz diffusion cells were used to monitor the percutaneous absorption. Ultraviolet (UV)-high performance liquid chromatography was used to analyze diffusion of sodium ascorbate through the different skin layers, while spectrofluorimetry and fluorescent microscopy were used for fluorescein monitoring. UVA/UVB irradiation of whole skin was applied to analyze the antioxidant capacity by Trolox assay and anti-inflammatory effects by tumor necrosis factor alpha and interleukin 1 beta enzyme-linked immunoassay. PC liposomal formulation improved skin penetration of fluorescein and ascorbate. Fluorescein PC liposomes showed better diffusion through epidermis than dermis while ascorbate liposomes showed better diffusion through the dermis than the epidermis. Ascorbate PC liposomes showed preventive antioxidant and anti-inflammatory properties on whole human skin irradiated with UVA/UVB. In summary, ascorbate PC liposomes penetrate through the epidermis and allow nonstable hydrophilic active ingredients reach epidermis and dermis preventing skin photodamage.