Their role in dermatology practice

Journal of Drugs in Dermatology, Oct, 2003 by Neil S Sadick

Coenzyme [Q.sub.10] (Ubiquinone-10)

Coenzyme [Q.sub.10] (CoQ10), also called ubiquinone-10, is a fat-soluble vitamin-like antioxidant present in every cell of the body serum as a coenzyme for several key enzymatic steps involving the production of energy within the cell. It is naturally present in a wide variety of forms and organ meats such as hearts, livers, kidneys, beef, soy oil, sardines, mackerel, and peanuts (52). Oral supplements have been used in the management of and protection from cardiovascular disease, diabetes, neurodegenerative diseases, and cancer. CoQ10 is also necessary for production of adenosine-5-triphosphate, and levels decrease with age and with UV exposure (53-56).

Topical formulations have been utilized in cosmeceutical preparations based upon studies which show that application of this agent prior to UVR exposure protects cell-cultured keratinocytes from UVAinduced oxidative stress and DNA damage. In addition, use of this agent in vitro has been shown to reduce fibroblast expression of UVA-induced mRNA collagenase, which may have a protective effect upon the dermal matrix in protecting from UVR damage. Two clinical trials employing 0.05% Co[Q.sub.12] (a similar antioxidant) applied nightly at four weeks showed a 42% reduction in fine rhytids in the periorbital zone compared to placebo. These anti-aging benefits were received by patients without irritation or other side effects (56-58).

Dimethy laminoethanol (DMAE)

DMAE utilized in the past as a dietary supplement

has been associated with improvement in anti-aging performance and function, including improved mental awareness and enhanced physical performance, These effects are due to a combination of its effect in increasing synthesis of acetylcholine as well as its anti-oxidant and anti-inflammatory effect (59-60).

Topical preparations of DMAE have been used for skin tightening and the rejuvenation of sagging skin. Industry-sponsored studies have confirmed that DMAE has both immediate and long-term effects; one open-label trial applying a DMAE facial moisturizer containing DMAE significantly improved skin firmness and lifting in the eye area, cheek, and jaw line after four weeks. An 18 week double-blind placebo-controlled study evaluated the long-term efficacy of a facial gel containing 3% DMAE, and documented improvement of overall appearance of aging skin and forehead and periorbital frown lines and neck sagging. Further studies are necessary to further document the role of this agent in the photoaging therapeutic armamentarium (61-62).

Copper Peptides

Copper peptide-containing products have gained increasing popularity in the healing of diabetic ulcers and post surgical wounds, and most recently in the healing of post-follicular unit hair transplantation patients. These agents have been shown to increase collagen synthesis and upregulation of lysyl oxidase, the enzyme responsible for cross-linking elastic and collagen. In previously reported studies, it also has been shown to stimulate angiogenesis and glycosaminoglycan synthesis, explaining its potential effect on skin firming (63).