Avoid the Damage, Not the Outdoors

Spring is just around the corner in South Georgia: Azaleas are blooming, temperatures are rising, and the sun is shining. Our days are getting longer, leaving us more time to enjoy the outdoors — and get sunburned. We have long known that year-round daily application of a broad spectrum (UVA- and UVB-blocking) sunscreen and nightly topical retinoids are the two most cost-effective tools for mitigating sun-induced DNA and photodamage. While I continue to use these products religiously, three products have caught my attention, and I now feel like there is enough research and clinical data to support recommending their use.

Heliocare® is an over-the-counter oral supplement that contains leaf extracts from the Central and South American fern Polypodium leucotomas. It has been shown in both human and animal studies to decrease UV-mediated oxidative damage and has anti-inflammatory activity. Placebo controlled studies have shown that Heliocare® increases the amount of sun-exposure needed to cause a sunburn and decreases the amount of DNA damage that occurs in response to a given amount of UV-exposure. These effects are probably mediated through increased p53 expression, which functions as a tumor suppressor gene (a good thing) and inhibition of matrix metalloproteinases, which normally degrade proteins like collagen. There are no known drug interactions, and one may safely take four or more pills daily. Children may even take one pill daily, typically dissolved in a beverage. The effects last for about six hours. I take one pill each day, but on days that I’m out fishing or hitting the pool/courts/beach, I’ll take two about 30 minutes before I go outside and then two more pills about three hours later.

I am also using topical antioxidants with vitamin C, vitamin E (alpha tocopherol), and ferulic acid like SkinCeuticals CE Ferulic® or Phloretin CF®. When applied each morning, these products increase your skin’s natural UVA/UVB protection eight-fold and help improve fine lines, firmness, and discoloration. I apply four to six drops to the back of my hand and then dab it onto a clean face, neck, and chest in a thin, uniform layer. Whatever is left on the back of my hand gets rubbed onto the back of my other hand, and presto, I’ve gotten a free hand treatment as well. At a minimum, I finish with some formulation of sunscreen with zinc oxide or titanium dioxide that has an SPF of 30 or higher. My favorites are Tizo, Thacker Dermatology Simply Sheer, and SkinCeuticals Physical Fusion UV Defense. I may not have on makeup, but you can rest assured that I have on my CE Ferulic® and sunscreen whenever you see me.

At night, prescription topical retinoids (tretinoin, adapalene, tazarotene) and defensins help repair the damage that each day brings. They help with fine lines, wrinkles, and dyspigmentation (brown spots). Defensins are naturally-occurring anti-microbial peptides that also trigger keratinocyte (skin cell) turnover and differentiation, optimizing skin barrier function. DefenAge® is a fourth generation skin care line that contains synthetic messenger peptides called Age-Repair Defensins®. Using high resolution photography, ultrasound skin thickness, skin biopsies, and UV-cameras, patients enrolled in clinical trials had visible improvement in up to 16 signs of skin aging in just six weeks. I am using these twice daily (after my HA Intensifier and before my sunscreen in the morning and after my topical retinoid/NeoCutis Biocream® mixture at night) and am loving the results.

These products do not replace sunscreens and other sun-avoidance measures such as long-sleeves, hats, and sunglasses. They are meant to supplement that protection and help fill in the gaps so that we don’t get burned or even tanned. A tan is a sign of DNA damage, and DNA damage can lead to cancer. We keep the skin that we are born with for our entire lives. Make it last.

All products mentioned can be found at Thacker Dermatology.

Written by: Dr. Betsy Perry Thacker

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