Interview with Nicholas Perricone, MD on aging skin and ALA - alpha lipoic acid - Interview

Townsend Letter for Doctors and Patients, Feb-March, 2002 by Lily G. Casura

Dr. Perricone claims that your whole body, including your skin, can benefit from taking ALA internally (50-100 mg. a day for a generally healthy adult is a safe dosage, he says). Apparently, ALA has no known toxicity. Larger amounts are permissible for people suffering from diabetes and heart disease, but only under the supervision of a physician. (There's also a suggestion in the literature that it interacts poorly with thyroid hormone, so caution here is indicated). To maximize benefits, you may want to apply ALA topically as well, in a cream or lotion containing at least 1% ALA. (Creams containing 5% are available only through a dermatologist). Topical application of alpha lipoic lotion to the skin also boosts the levels of vitamin C, vitamin E and glutathione within the skin, giving further protection from mediators of inflammatory reactions. According to Dr. Perricone, the skin's appearance should take on a healthy glow almost immediately after use: just three to four days after treatment with a lotion containing 1-5% ALA. (His personal preference is a combination ALA and vitamin C ester in a cream or lotion.)

Fascinating theories of aging

On an abstract level, ALA may be involved in slowing down the aging process, or at least tempering its visible effects. Many theories of aging swirl about, but one of the most common ones about why we age has to do with free radical damage. Free radicals (the "oxidants" we fight with anti-oxidants) have been implicated in as many as 80 age-related diseases, including heart disease, arthritis, Alzheimer's, Parkinson's disease, and cancer. Spent oxygen molecules and the like which become "free radicals" are unavoidable, basic byproducts of the metabolic process; however, they can cause an inordinate amount of damage, and the damage seems to be both cumulative (over our lifetimes) and extensive, since other diet and lifestyle factors add to it.

Attention to diet and exercise may slow down the effects of aging and limit the incidence of disease, but judicious use of powerful anti-oxidants seems wise as well. And ALA might be particularly well-suited for the job. Since ALA is part of an enzyme complex within the mitochondria that controls energy production, it's possible that by supplementing the cell with additional lipoic acid, aging cells can increase their energy production -- which in turn allows them to repair cellular damage and to expel cellular waste products more efficiently, thereby forestalling the signs of aging, according to Dr. Perricone. Says Perricone, "Use of topical anti-oxidants in the prevention and treatment of skin disease and aging has just begun. All of our current data supports the free radical theory of aging, and invention using ALA, among others, looks extremely promising."

Cautions

As one author cautions, "Research on [ALA] in humans has been limited, so not much is known about its action in specific diseases. In Germany, where it is used to treat nerve damage in diabetics, it is sold only by prescription--and its potency is monitored by the government. In the United States, such is not the case, so there is no way of knowing for certain what's in the bottles now being sold." (1)