VITAMIN C FOR SCARS & SKIN HEALTH
Vitamin C is vital for overall skin health and optimal scar healing.
Unfortunately, the body does not produce vitamin C on its own. The only way to ensure our skin gets enough vitamin C is to make sure we include enough in our diet and by using skin care products that contain vitamin C in a stable form.
Finding skin care products that contain stable vitamin C (L-ascorbic acid) can be difficult because it is inherently very unstable. L-ascorbic acid oxidizes and turns brown on repeat exposure to air and moisture. Once oxidized it is completely ineffective. To disguise this oxidation, many vitamin C skin care products are colored brown or dark yellow to begin with.
InviCible is a white scar cream containing a unique, patented dual complex of 17% vitamin C (L-ascorbic acid and tetrahexyldecyl ascorbate) which is completely stable and will not oxidize on exposure to air or moisture.
InviCible can improve scars and skin blemishes in many ways. Independent scientific studies (listed below) show that vitamin C:
- regulates healthy collagen formation
- improves skin hydration
- lightens dark scars and brown spots (hyperpigmentation)
- decreases inflammation and redness
- is a powerful anti-oxidant and prevents skin damage
Vitamin C (combination of 10% L-ascorbic acid and 7% tetrahexyldecyl ascorbate) leads to new collagen formation.
Improved scar appearance with combined use of silicone gel and vitamin C for Asian patients: a comparative case series.
Topical vitamin C leads to new collagen formation and limits breakdown of existing collagen by increasing the level of tissue inhibitor of matrix metalloproteinase (MMP) 1 mRNA.
Benefits of vitamin C include collagen synthesis, protection from sun damage, and lightening of pigmented skin lesions.
Possible mechanism of action by which vitamin C exerts its important anti-inflammatory and anti-oxidant effects.
Vitamin C significantly decreases redness (erythema) after carbon dioxide laser resurfacing.
Aging of the population, in particular the “baby boomers,” has resulted in increased interest in methods of reversal of photodamage. Non-invasive treatments are in high demand, and our knowledge of mechanisms of photodamage to skin, protection of the skin, and repair of photodamage are becoming more sophisticated and complex.
The objective of this study is to determine if the topical use of a vitamin C preparation can stimulate the skin to repair photodamage and result in clinically visible differences, as well as microscopically visible improvement.
Ten patients applied in a double-blind manner a newly formulated vitamin C complex having 10% ascorbic acid (water soluble) and 7% tetrahexyldecyl ascorbate (lipid soluble) in an anhydrous polysilicone gel base to one-half of the face and the inactive polysilicone gel base to the opposite side. Clinical evaluation of wrinkling, pigmentation, inflammation, and hydration was performed prior to the study and at weeks 4, 8, and 12. Two mm punch biopsies of the lateral cheeks were performed at 12 weeks in four patients and stained with hematoxylin and eosin, as well as in situ hybridization studies using an anti-sense probe for mRNA for type I collagen. A questionnaire was also completed by each patient.
A statistically significant improvement of the vitamin C-treated side was seen in the decreased photoaging scores of the cheeks (P = 0.006) and the peri-oral area (P = 0.01). The peri-orbital area improved bilaterally, probably indicating improved hydration. The overall facial improvement of the vitamin C side was statistically significant (P = 0.01). Biopsies showed increased Grenz zone collagen, as well as increased staining for mRNA for type I collagen. No patients were found to have any evidence of inflammation. Hydration was improved bilaterally. Four patients felt that the vitamin C-treated side improved unilaterally. No patient felt the placebo side showed unilateral improvement.
This formulation of vitamin C results in clinically visible and statistically significant improvement in wrinkling when used topically for 12 weeks. This clinical improvement correlates with biopsy evidence of new collagen formation.
Editorial note: this double-blind study shows that vitamin C (combination of 10% L-ascorbic acid and 7% tetrahexyldecyl ascorbate) leads to formation of new, normal collagen. This combination and silicone both improve skin hydration.
In Asians, facial scars, even fine surgical scars, often can be conspicuous and uncomfortable. The authors used a topical silicone gel containing vitamin C on facial scars for the purpose of making the scar less distinct.
The study enrolled 80 patients. For the experimental group, the topical silicone gel mixture containing vitamin C was applied from the time of stitch removal to 6 months after the operation. The control group did not undergo any adjunctive treatment. Each participant was evaluated using the modified Vancouver Scar Scale (VSS) as well as erythema and melanin indices by spectrophotometer.
With the modified VSS, the experimental group showed a significant decrease in scar elevation (p = 0.026) and erythema (p = 0.025). The hypo- or hyperpigmentation of the scars was more normalized in the experimental group. In the measured results via spectrophotometer, the experimental group showed a significant decrease in the melanin index (p = 0.045). The erythema index showed a statistically significant difference between the time of stitch removal and 6 months after the operation in the experiment group only.
Topical use of silicone gel containing vitamin C has the effect of improving the appearance of fine surgical scars in Asian facial skin.
Editorial note: this controlled study shows that topical treatment of new scars with stable vitamin C and silicone gel improves final scar appearance. After 6 months of treatment, scars are significantly flatter and less pigmented, with a color closer to that of normal skin.
3. Nusgens BV, Humbert P, Rougier A, et al. Topically applied vitamin C enhances the mRNA level of collagens I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis. J Invest Dermatol 2001 Jun;116(6):853-859.
Ascorbic acid (vitamin C) is a cofactor required for the function of several hydroxylases and monooxygenases. It is not synthesized in humans and some other animal species and has to be provided by diet or pharmacologic means. Its absence is responsible for scurvy, a condition related in its initial phases to a defective synthesis of collagen by the reduced function of prolylhydroxylase and production of collagen polypeptides lacking hydroxyproline, therefore, they are unable to assemble into stable triple-helical collagen molecules. In fibroblast cultures, vitamin C also stimulates collagen production by increasing the steady-state level of mRNA of collagen types I and III through enhanced transcription and prolonged half-life of the transcripts. The aim of the experimental work has been to evaluate the effect on dermal cells of a preparation of vitamin C topically applied on one side vs placebo on the other side of the dorsal face of the upper forearm of postmenopausal women. Biopsies were collected on both sides and the level of mRNA measured by non-competitive reverse transcription-polymerase chain reaction made quantitative by the simultaneous transcription and amplification of synthetic RNA used as internal standards. The mRNA of collagen type I and type III were increased to a similar extent by vitamin C and that of three post-translational enzymes, the carboxy- and amino-procollagen proteinases and lysyloxidase similarly increased. The mRNA of decorin was also stimulated, but elastin, and fibrillin 1 and 2 were not modified by the vitamin. The expression of matrix metalloproteinases 1, 2, and 9 was not significantly changed, but an increased level of tissue inhibitor of matrix metalloproteinase 1 mRNA was observed without modification of tissue inhibitor of matrix metalloproteinase 2 mRNA. The stimulating activity of topical vitamin C was most conspicuous in the women with the lowest dietary intake of the vitamin and unrelated to the level of actinic damage. The results indicate that the functional activity of the dermal cells is not maximal in postmenopausal women and can be increased.
Editorial note: this study shows that topical vitamin C leads to new collagen formation. It also limits breakdown of existing collagen by increasing the level of tissue inhibitor of matrix metalloproteinase (MMP) 1 mRNA.
Cosmeceuticals containing antioxidants are among the most popular antiaging remedies. Topically applied antioxidants exert their benefits by offering protection from damaging free radicals produced when skin is exposed to ultraviolet light or allowed to age naturally. Vitamin C is a naturally occurring potent water-soluble antioxidant. Accordingly, it has been incorporated into a variety of cosmeceuticals designed to protect and rejuvenate photoaged skin.
This article reviews the scientific data and clinical studies supporting the use of topically applied vitamin C for treating photoaged skin. Other innovative uses for vitamin C cosmeceuticals are also discussed.
A significant body of scientific research supports the use of cosmeceuticals containing vitamin C. Cutaneous benefits include promoting collagen synthesis, photoprotection from ultraviolet A and B, lightening hyperpigmentation, and improvement of a variety of inflammatory dermatoses. Because of the diverse biologic effects of this compound, topical vitamin C has become a useful part of the dermatologist’s armamentarium.
Editorial note: very few scar treatments contain vitamin C. Scars heal through a process of new collagen formation. This article highlights the benefits of vitamin C including collagen synthesis, protection from sun damage, and lightening of pigmented skin lesions (such as dark scars and hyperpigmentation).
Extracellular stimuli signal for activation of the transcription factor NFkappaB, leading to gene expression regulating processes involved in immune responses, inflammation, and cell survival. Tumor necrosis factor-alpha (TNFalpha) activates NFkappaB via a well-defined kinase pathways involving NFkappaB-inducing kinase (NIK), which activates downstream multisubunit IkappaB kinases (IKK). IKK in turn phosphorylates IkappaB, the central regulator of NFkappaB function. We found that intracellular vitamin C inhibits TNFalpha-induced activation of NFkappaB in human cell lines (HeLa, monocytic U937, myeloid leukemia HL-60, and breast MCF7) and primary endothelial cells (HUVEC) in a dose-dependent manner. Vitamin C is an important antioxidant, and most cells accumulate ascorbic acid (AA) intracellularly by transporting the oxidized form of the vitamin, dehydroascorbic acid (DHA). Because ascorbic acid is a strong pro-oxidant in the presence of transition metals in vitro, we loaded cells with vitamin C by incubating them with DHA. Vitamin C-loaded cells showed significantly decreased TNFalpha-induced nuclear translocation of NFkappaB, NFkappaB-dependent reporter transcription, and IkappaBalpha phosphorylation. Our data point to a mechanism of vitamin C suppression of NFkappaB activation by inhibiting TNFalpha-induced activation of NIK and IKKbeta kinases independent of p38 MAP kinase. These results suggest that intracellular vitamin C can influence inflammatory, neoplastic, and apoptotic processes via inhibition of NFkappaB activation.
Editorial note: this study shows how vitamin C may exert its important anti-inflammatory and anti-oxidant effects.
Postoperative erythema of several months duration is a universal and problematic side effect of cutaneous carbon dioxide (CO2) laser resurfacing.
This study was conducted in order to determine the effectiveness of two formulations of topical ascorbic acid in reducing the degree and duration of post-CO2 laser resurfacing erythema.
The application of topical L-ascorbic acid in an aqueous formulation resulted in a significant decrease in post-CO2 laser resurfacing erythema by the eighth postoperative week when compared with laser-irradiated skin that had not received topical vitamin C. The application of topical ascorbic acid in a cream formulation did not result in a significant reduction in post-CO2 laser resurfacing erythema.
Topical L-ascorbic acid, when used in an appropriate vehicle and when initiated at an appropriate postoperative period, may decrease the degree and duration of erythema after cutaneous CO2 laser resurfacing. It is presumed that the anti-inflammatory effect of vitamin C is responsible for the clinical changes observed in this study.
Editorial note: this study shows that vitamin C significantly decreases redness (erythema) after carbon dioxide laser resurfacing.