Potentials and limitations of the natural antioxidants RRR-alpha-tocopherol, l-ascorbic acid and β-carotene in cutaneous photoprotection

Sun exposure has been linked to several types of skin damage including sun burn, photoimmunosuppression, photoaging and photocarcinogenesis. In view of the increasing awareness of the potentially detrimental long term side effects of chronic solar irradiation there is a general need for safe and effective photoprotectants. One likely hypothesis for the genesis of skin pathologies due to solar radiation is the increased formation of reactive oxidants and impairment of the cutaneous antioxidant system. Consequently, oral antioxidants that scavenge reactive oxidants and modulate the cellular redox status may be useful; systemic photoprotection overcomes some of the problems associated with the topical use of sunscreens. Preclinical studies amply illustrate the photoprotective properties of supplemented antioxidants, particularly RRR-alpha-tocopherol, L-ascorbate and β-carotene. However, clinical evidence that these antioxidants prevent, retard or slow down solar skin damage is not yet convincing. The purpose of this review is to provide the reader with current information on cutaneous pathophysiology of photoxidative stress, to review the literature on antioxidant photoprotection and to discuss the caveats of the photo-oxidative stress hypothesis.