To determine the efficacy of topical ascorbic acid application in treating mild to moderate photodamage of facial skin using an objective, computer-assisted image analysis of skin surface topography and subjective clinical, photographic, and patient self-appraisal questionnaires.A 3-month, randomized, double-blind, vehicle-controlled study.Facial plastic surgery private practice.Nineteen evaluable volunteer sample patients aged between 36 and 72 years with Fitzpatrick skin types I, II, and III who were in good physical and mental health with mild to moderately photodamaged facial skin were considered for analysis.Coded, unmarked medications were randomly assigned to the left and right sides of each subject's face, one containing the active agent, topical ascorbic acid (Cellex-C high-potency serum; Cellex-C International, Toronto, Ontario), the other, the vehicle serum (Cellex-C International). Three drops (0.5 mL) of each formulation were applied daily to the randomly assigned hemifaces over the 3-month study period.
Treatment assignments were not disclosed to subjects, clinicians, or personnel involved in analyzing skin replicas.Specific clinical parameters were evaluated and graded on a 0- to 9-point scale (0, none; 1-3, mild; 4-6, moderate; and 7-9, severe). Reference photographs were used to standardize grading criteria. Overall investigator scores were compared with baseline and graded as excellent (much improved), good (improved), fair (slightly improved), no change, or worse. Patient self-appraisal questionnaires rated the degree of improvement (much improved, improved, slightly improved, no change, or worse) and reported adverse effects (burning, stinging, redness, peeling, dryness, discoloration, itching, and rash). Standard photographs were taken at baseline, including anteroposterior and left and right oblique views to facilitate subsequent clinical evaluations, and at the end of therapy for comparison. Optical profilometry analysis was performed on the skin surface replicas of the lateral canthal (crow's feet) region, comparing baseline to end-of-study specimens.
Using this computer-based system, the resulting image was digitally analyzed, and numeric values were assigned to reflect surface features. The parameters obtained included Rz, Ra, and shadows. These values provided objective data that document pretreatment and posttreatment texture changes proportional to the degree of wrinkling, roughness, and other surface irregularities.Optical profilometry image analysis demonstrated a statistically significant 73.7% improvement in the Ra and shadows north-south facial axis values with active treatment greater than vehicle control, as well as a trend for improvement in the Rz north-south facial axis parameter, showing a 68.4% greater improvement of active treatment vs vehicle control. Clinical assessment demonstrated significant improvement with active treatment greater than control for fine wrinkling, tactile roughness, coarse rhytids, skin laxity/tone, sallowness/yellowing, and overall features. Patient questionnaire results demonstrated statistically significant improvement overall, active treatment 84.2% greater than control.
Photographic assessment demonstrated significant improvement, active treatment 57.9% greater than control.A 3-month daily regimen of topical ascorbic acid provided objective and subjective improvement in photodamaged facial skin. Skin replica optical profilometry is an objective method for quantification of the skin surface texture changes.Topical vitamin C treatments can definitely help make your skin better. Does that mean you should start using a vitamin C product? The short answer is yes, but only if your skin can handle it. Keep reading for more information about the skin benefits of vitamin C and why you should use it if you can. Vitamin C is one of the most powerful antioxidants in skin care. It helps slow down the aging process by preventing free radical damage. Long-term topical use has been clinically shown to regenerate collagen and improve the appearance of wrinkles. Vitamin C also lightens pigmentation and brightens over all skin tone. Therefore, it is used in a lot of anti-aging and whitening products (especially in Asia), as well as fade creams.
Topically, vitamin C also provides a small amount of UV protection. Though this is not comparable to well-formulated sunscreens, C serum use during daytime can give your sunscreen an extra boost. This is partly why many people recommend using vitamin C during the day instead of at night. It usually takes around 6 months of consistent vitamin C use to start seeing results. Not all vitamin C is the same. There are different types of vitamin C actives and these include l-ascorbic acid, ester C (magnesium ascorbyl phosphate), ascorbyl palmitate, and tetrahexyldecyl ascorbate. L-ascorbic acid is the most powerful one out of all of them, but it is also the one that destabilizes the easiest. Ester C, ascorbyl palmitate, and tetrahexyldecyl ascorbate are all pretty stable, but they are not as potent or effective as l-ascorbic acid. If you make your own vitamin C product with l-ascorbic acid, it is essential that you make a new batch every day so the vitamin C stays fresh. Some people, like my grandmother, think rubbing a lemon on your skin (or on dark knees or other pigmented spots) is a cheap way of getting vitamin C.
However, vitamin C straight from a lemon probably isn't as easily absorbed and utilized by your skin as well-formulated C actives. Besides, other ingredients and acids in a fresh lemon can really irritate your skin. If you are going to use a vitamin C product, it's best to use one in a form your skin can use with the least amount of irritation. One of the bad things about Vitamin C is that it oxidizes very easily. When a C serum oxidizes, it turns yellow or orange and looses its effectiveness. Proper product formulation can extend the stability of a C serum (which is partly why vitamin C products are so expensive), but you also have to take good care of your product by storing it in a cool, dark place and re-sealing it tightly after each application. Sunlight, heat, air, water, and even time (watch those expiration dates!) can all destabilize and render ineffective even the best-formulated vitamin C product. Also, look for C serums packaged in dark glass bottles or metal tubes.
This type of packaging will help extend its stability and keep it fresh. Besides having good stability, a C serum will only be effective if it is at the proper concentration and pH. Many skin care products advertise themselves as vitamin C treatments, but a lot of times they barely have enough vitamin C in them to do anything. Before you spend big bucks on a vitamin C product, make sure you're getting your money's worth. Most vitamin C products on the market range from 5% (considered fairly weak) to 20%. 20% is the highest amount you should put on your skin because if you go any higher, your skin will not be able to absorb as much of the antioxidant. If a product doesn't have the concentration of vitamin C listed, you can always contact the company for more information. The pH of a vitamin C product will also determine its effectiveness. Vitamin C has to be formulated around a pH of 3 for it to be able to pass through your skin barrier and be used by your skin. Most C serums don't publicize their pH levels, but you can always ask the manufacturer for clarification.
Despite all the raves and glowing reviews, vitamin C products don't work for everyone. For some people, vitamin C can cause redness and stinging upon application. Usually your skin gets used to the treatment and this kind of irritation will subside. However, sometimes you have to downgrade to a less potent C serum to make it more tolerable. Others even experience allergic reactions, such as itchy red bumps, and cannot use vitamin C at all. It all depends on your skin and how it handles the antioxidant. Besides vitamin C induced irritation, some people breakout from vitamin C products because of their base. Some C serums have silicones or other inactive ingredients (to help keep the vitamin C stable longer) that can be problematic for acne-prone or sensitive skin. To minimize irritation, it's important to start using vitamin C at the lowest concentration you can tolerate because once you apply the treatment to your skin, the vitamin C is immediately absorbed (even if you wash it off right away) and stays in your skin until it gets all used up (around 3 days).