Can vitamins and supplements lead to healthier skin? Plus online reviews drive cosmetic procedures; and rituximab for pemphigus vulgaris

Thursday, October 24, 2019

Skin appearance is a sign of internal health, and patients who have appropriate vitamin levels naturally have healthier skin. Dr. Vincent DeLeo talks with Dr. Gary Goldenberg about the data on vitamins and supplements that have been shown to improve the skin’s appearance and health. Dr. Goldenberg discusses the controversies surrounding the quality of products and the need for dermatologists to remain up-to-date on products their patients may be taking already. “A discussion of nutrition and supplements really is a part of any dermatologic evaluation, just like skin care should be part of every dermatologic evaluation,” advises Dr. Goldenberg.

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We bring you the latest in dermatology news and research:

1. Rituximab bests mycophenolate in pemphigus vulgaris

Rituximab showed a superior overall benefit/risk profile, compared with mycophenolate mofetil.

2. Once-daily oral JAK inhibitor for atopic dermatitis effective in phase 3 study

Abrocitinib may have taken a step closer to becoming the first once-daily oral Janus kinase 1 inhibitor to be approved for atopic dermatitis.

3. Online resources influencing cosmetic treatment choices

Rate and review websites affect almost 70% of consumers seeking providers for cosmetic procedures.

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Things you will learn in this episode:

  • Patients who have good nutrition also will have appropriate vitamin levels, which contributes to having healthier skin. Dr. Goldberg explains, “Patients who have really low vitamin D levels will not be as healthy and cannot have as healthy skin as those who have more normal vitamin D levels.”
  • Studies have shown that internal vitamin C levels reduce oxidative stress and help with the appearance of fine wrinkles, lines, and pigmentation. “As far as topical vitamin C goes, I think that there [are] good data showing that vitamin C improves the appearance of skin. But the issue with vitamin C is the delivery of the product into the skin,” advises Dr. Goldenberg. Vitamin E is one of the best antioxidants, according to Dr. Goldenberg, and is especially helpful for UV-induced oxidative stress.
  • Carotenoids, which are derived from vitamin A, can help reduce oxidative stress associated with UV-induced radiation and UV-induced erythema. “We also know that carotenoids actually improve UV-damaged cells such as for patients with a history of skin cancer,” says Dr. Goldenberg.
  • Studies have reported that oral collagen supplements can improve skin health and appearance. However, Dr. Goldenberg remains skeptical: “It’s still unclear to me if the improvement is due to the actual collagen or to the water that patients may be taking the collagen in, especially if it’s a powder.” Hydration is very important for skin appearance and health, he adds.
  • Imedeen supplementation has some data that show antioxidant properties. Although it’s too early to say that Imedeen is completely effective, studies report efficacy for skin appearance and health.
  • In terms of side effects associated with vitamins and supplements, Dr. Goldenberg advises that not all supplements have the same quality, and patients should consult a nutritionist for advice on which vitamins and supplements are needed. “Not all supplements are going to have the same quality. So if you’re going with the least expensive ones, they may have the least absorption. Now the most expensive ones may have the prettiest packaging and not necessarily be the highest quality of the vitamin.”
  • Dermatologists, as skin experts, need to be aware of the data on vitamins and supplements because diet or nutrition is a common question among patients. For example, patients with acne, psoriasis, eczema, or rosacea may inquire if their condition is caused by a supplement they take or by the lack of supplements. “[We] have to be aware of all of the positive and negative data that’s out there and what I call ‘pseudo’ data, which is blogging, Instagram influencers, etc.,” Dr. Goldenberg says.

Guests: Gary Goldenberg, MD (Icahn School of Medicine at Mount Sinai, New York, and Goldenberg Dermatology, PC, New York)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: podcasts@mdedge.com

Interact with us on Twitter: @MDedgeDerm

Gary Goldenberg on Twitter: @Goldenberg_Derm

Podcast Participants

Vincent A. DeLeo, MD
Vincent A. DeLeo, MD, is from the Keck School of Medicine of the University of Southern California, Los Angeles, and the Icahn School of Medicine at Mount Sinai, New York, New York. He also is the editor in chief of Cutis and the author of more than 200 publications. He is a leading expert on contact dermatitis, sunscreens, and photosensitivity.