The scientific evidence of the benefcial role of vitamin E in protection from UV damage was discussed in detail above. Vitamin E has several other possible therapeutic roles in dermatology. Many anecdotal reports support the use of topical vitamin E to enhance wound-healing and to prevent hypertrophic scars; however, the benefits are controversial. Two controlled studies failed to show scar prevention by topical vitamin E (63,64). The stability and formulation of the topical vitamin E used may have effected these inconclusive studies. New research on diabetic mouse models suggests involvement of oxidative stress in diabetic wound healing showed significantly improved wound healing with topical vitamin E (65,66). Vitamin E may have a role in treating atopic dermatitis. Forty-three patients treated with oral vitamin E for eight months showed improvement and near-remission concomitant with a 62% decrease in serum IgE levels (67).
Furthermore, very exciting recent evidence suggests that oxidative stress is involved in the pathophysiology of melanoma and nonmelanoma cancer (68) and that vitamin E slows melanoma growth by promoting tumor cell apoptosis and inhibiting vascular endothelial growth factor-mediated angiogenesis (69,70).
Of great interest to the cosmeceutical formulations, there is the clinical evidence that topical vitamin E is indeed effective in reversing the appearance of photoaging. Figure 5 demonstrates the dramatic correction of periorbital wrinkles after four months of once – daily application of 5% d-a-tocopherol cream. Histologic confirmation of correction of the UV-induced epidermal hypertrophy with thickened stratum corneum, increased apoptotic “sunburn cells” in the basal layer, and disruption of dermal collagen and elastin was demonstrated in mice after eight weeks of topical treatment (KE Burke, L Ricotti, EG Gross, unpublished observation). Resolution of post-UV inflammation was also observed. Further electron microscopic analysis confirmed correction of collagen and elastin fiber
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Figure 5 Correction of periorbital wrinkles after four months of once-daily treatment with 5% d-a-tocopherol cream. |
damage and demonstrated repair of UV-induced disruption of collagen fibers and basement membrane anchoring fibrils. This correction of UV damage by topical d-a- tocopherol (5%) is as effective as that of topical tretinoin (retinoic acid), the “gold standard” of topical anti-aging.