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Are Antioxidants Worth the Hype?

Ahmed Abdullah, MD November 2010 issue of Skin Inc. magazine
hands full of strawberries

In the never-ending quest for the fountain of youth, antioxidants are the “it” ingredient of the decade. A nutrient that is manufactured by the human body, naturally found within many beans, grains, fruits and vegetables, and even produced synthetically, antioxidants are now added to everything from soft drinks to, of course, skin care products. And sales of antioxidant products are on the rise. In fact, according to Nutrition Business Journal, in 2008, antioxidant supplement sales totaled $4.6 billion, a strong increase of 6% from just two years earlier.

When it comes to skin care, the presence of antioxidants is nearly expected. Those who work in the esthetic industry recommend antioxidant-rich products to clients daily, citing the science that proves their ability to protect skin health and its appearance. But let’s take a step back for a moment. When all known factors are considered, are antioxidants worth it?

The science of antioxidants

First, a bit about the scenario that necessitates antioxidants. Although oxygen is essential to the human body because it enables cells to harness energy from food, it also has the potential to cause harm. When molecules within cells encounter oxygen, a reaction occurs and a free radical is produced. This process is called oxidation, and it can stem from endogenous factors, that is, factors within the body, such as breathing and metabolism, as well as exogenous factors outside the body, most notably excessive sun exposure, pollution, cigarette smoke and more. Another mechanism for forming free radicals is the natural aging process.

Free radicals are unstable atoms or molecules characterized by at least one unpaired electron. Thus, the free radical steals electrons from nearby molecules within the cell, turning them also into a free radical. It’s a chain reaction that causes increasing damage to the cells of the body. As this free radical cascade continues, it can lead to disease. For example, free radicals are a suggested cause of heart disease,1 Parkinson’s disease2 and even cancer.3 They’re also implicated as a leading cause of aging.4, 5 In skin, free radicals lead to the breakdown of collagen and elastin, resulting in the development of fine lines and wrinkles.

Luckily, antioxidants are like soldiers for the cells. They neutralize endogenous and exogenous factors by providing electrons to free radicals, thereby disabling them and preventing cell damage. There are thousands of known antioxidants—such as vitamins A, C and E, and beta carotene—that fall into several antioxidant categories, including carotenoids, flavonoids and polyphenols. Obviously, the goal must be to keep more antioxidants than free radicals in the body. However, as people age, the body produces more free radicals and fewer antioxidants, which aren’t stored in the body, resulting in the need for regular replenishment. Therefore, it’s necessary to augment the body’s production of antioxidants with those from outside sources, including foods and supplements. Antioxidant benefits are just one reason why the Centers for Disease Control has promoted its “Fruits & Veggies—More Matters” campaign.

Antioxidants and the body

In fact, only 33% of adults are getting the recommended allowance of fruit and only 27% are getting the recommended allowance of vegetables.6 To determine the number of antioxidants in a food, supplement or skin care product, most look to the Oxygen Radical Absorbance Capacity (ORAC) scale. According to this scale, the top five foods for antioxidant content are ground cloves, sumac, ground cinnamon, sorghum and dried oregano. This is in addition to the many foods that have become trendy for their antioxidant capacity, including acai berry, pomegranate and goji berry. (Editor’s note: To find the ORAC values of various foods, log on to

The concern, however, is that use of the ORAC scale has led to competition among manufacturers to develop product formulations with the highest antioxidant content. Although that hardly seems like a negative at face value, consider that a study demonstrated that ingestion of too-high levels of certain antioxidants might have a negative impact on health. Vitamin C, for example, has exhibited pro-oxidant characteristics, actually inducing oxidation when ingested at quantities greater than 500 mg.7 Keep in mind that this is a single study and, therefore, doesn’t prove anything. After all, vitamin C is water-soluble and excessive amounts in the body are excreted. Additionally, high dosages have been found beneficial in reducing the frequency and severity of colds.8

What the vitamin C study demonstrates is that there is indeed more that must be learned regarding how high levels of antioxidants behave in the body. In fact, just recently at the 2010 Annual Meeting of The American Academy of Dermatology (AAD), the Coppertone Solar Research Center released the results of a study that showed the use of certain topical antioxidants in sunscreen reduced the formation of free radicals by 74% in the skin’s outer layers exposed to UV. However, that research also showed that some topical antioxidants, including some plant extracts, transformed into pro-oxidants when exposed to UV light.9

Perhaps the biggest unknown when it comes to the use of topical antioxidants is the antioxidant-absorption capacity of the skin. It is not yet concretely known how many of the antioxidants that are topically applied are absorbed into the deeper layers of the skin. And, of those that are absorbed, does the skin actually utilize them? Answers to these questions may vary depending on the antioxidant being applied.

In 2009, a team of fellow researchers, including the author of this article, implemented a study to determine the effects of skin moisturizers containing antioxidants on total antioxidant capacity (TAC) of human skin.10 The team found that it is indeed beneficial to use a topical skin care product that includes antioxidants, because they increase antioxidant levels within the skin. Furthermore, another study demonstrated that, when applied topically in proper form, antioxidants such as vitamins C and E and selenium “arm the skin with a reservoir of antioxidants that cannot be washed or rubbed off, a protection which stays in the skin for several days after application.”11


How then, given all the research—some of which is preliminary—should antioxidants be utilized by clients to optimize the body’s ability to fight disease, and the skin’s ability to combat the signs of aging and environmental influences? The following recommendations work together to safely optimize antioxidant levels.

Consume a healthy diet. Consider that the very best, undisputed method for obtaining antioxidants is by eating a diet rich in whole grains, beans, fruits and vegetables. According to biochemist Barry Halliwell, PhD, of the National University of Singapore, a leading antioxidant researcher, “Because polyphenols, carotenoids and vitamins in fruits and vegetables are bound into tough, fibrous material, they hang around in the stomach and colon, where they can neutralize free radicals.”12 He adds, “Supplements may not replicate this effect because they are digested too quickly.”

This is certainly a point that spa chefs should keep in mind when developing their menus. And by counseling clients to look for brightly colored berries, fruits and vegetables, they’re increasing their antioxidant levels, which is better not only for their health, but for their appearance, as well.

Limit exposure to oxidative stressors. Environmental toxins, such as pollution and cigarette smoke—both firsthand and secondhand—are huge contributors to oxidative stress. Therefore, their presence must be limited as much as possible. Most importantly, clients must be continuously counseled to avoid excessive sun exposure and to protect their skin when outdoors through the daily use of sunscreen and protective clothing, because UV exposure is one of the main producers of free radicals.

Supplement wisely. Research has shown that people who take a combination of antioxidants in supplement form and at a low dosage were able to successfully reduce oxidation in their bodies without the risk of considerable pro-oxidant production.13 Additionally, the combination of multiple antioxidants has a synergistic effect and helps ensure that skin is better protected.14, 15 Given these findings, the use of a daily multivitamin that includes multiple antioxidants, such as vitamins A, C and E, as well as selenium, is recommended.

Use effective topical antioxidant formulations. Research has shown that combining oral antioxidant supplements with topical antioxidant formulations is beneficial to ensuring the optimal protection of skin from photoaging and oxidative stress.16, 17 However, it’s important that the antioxidant skin care products you make available to your clients utilize formulations that optimize the delivery of antioxidants to the skin. Therefore, ensure that the product is formulated with a base that can be absorbed by the skin. If the base ingredient is water, for example, the ability of the product to take the antioxidants to the deeper layers of the skin is compromised since skin cannot absorb water. The delivery system is also important to ensuring the stability of the antioxidant in the finished formulation.

Prevent future damage

Regardless of the protocol that is utilized, it’s essential to be realistic about what can be expected from antioxidants. Skin damage that has already occurred is irreversible. Antioxidants are incapable of affecting existing wrinkles; their real benefit is in preventing future damage. It’s also important to take factors, such as ORAC values, with a grain of salt. After all, performance in a test tube means nothing really, unless the same benefits can be achieved when a food or product is ingested or placed on the skin.

There’s very promising research relative to antioxidants but, rather than putting a great deal of energy into optimizing antioxidant intake via outside sources, simply living a healthy lifestyle can be the very best medicine.


1. JJ Belch, AB Bridges, N Scott, M Chopra, Oxygen free radicals and congestive heart failure, Br Heart J 65 245–248 (1991)

2. JD Adams Jr, IN Odunze, Oxygen free radicals and Parkinson’s disease, Free Radical Biology and Medicine 10 2 161–169 (1991)

3. D Dreher, AF Junod, Role of oxygen free radicals in cancer development, Eur J of Cancer 32 1 30–38 (1996)

4. O Pansarasa, L Bertorelli, J Vecchiet, et al, Age-dependent changes of antioxidant activities and markers of free radical damage in human skeletal muscle, Free Radical Bio and Med 27 5–6 617–622 (1999)

5. T Finkel, NJ Holbrook, Oxidants, oxidative stress and the biology of ageing, Nature 408 239–247 (2000)

6. (Accessed Sep 1, 2010)

7. ID Podmore, HR Griffiths, KE Herert, et al, Vitamin C exhibits pro-oxidant properties, Nature 392 559 (1998)

8. TW Anderson, DBW Reid, GH Beaton, Vitamin C And the common cold: a double-blind trial, Can Med Assoc J 107 6 503–508 (1972)

9. (Accessed Sep 1, 2010)

10. AT Grazul-Bilska, JJ Bilski, DA Redmer, LP Reynolds, KM Abdullah, A Abdullah, Antioxidant capacity of 3D human skin EpiDerm. model: effects of skin moisturizers, Int J of Cos Sci 31 3 201–208 (2009)

11. KE Burke, Photodamage of the skin: protection and reversal with topical antioxidants, J Cos Derm 3 3 149–155 (2004)

12. L Melton, The antioxidant myth: a medical fairy tale, New Scientist (2006)

13. U Cornelli, R Terranova, S Luca, et al, Bioavailability and antioxidant activity of some food supplements in men and women using the d-roms test as a marker of oxidative stress, J Nutrition 131 3208–3211 (2001)

14. HS Cho, MH Lee, JW Lee, et al., Anti-wrinkling effects of the mixture of vitamin C, vitamin E, pycnogenol and evening primrose oil, and molecular mechanisms on hairless mouse skin caused by chronic ultraviolet B irradiation, Photodermatol Photoimmunol Photomed 23 5 155–162 (2007)

15. FH Lin, JY Lin, RD Gupta, et al, Ferulic acid stabilizes a solution of vitamins A and E and doubles its photoprotection of skin, J Invest Dermatol 125 4 826–832 (2005)

16. AK Greul, JU Grundmann, F Heinrich, et al, Photoprotection of UV-irradiated human skin: an antioxidative combination of vitamins E and C, carotenoids, selenium and proanthocyanidins Skin Pharmacol Appl Skin Physiol 15 5 307–315 (2002)

17. S Passi, O De Pita, M Grandinetti, et al, The combined use of oral and topical lipophilic antioxidants increases their levels both in sebum and stratum corneum, Biofactors 18 1–4 289–297 (2003)

Ahmed Abdullah, MD, a board-certified plastic and cosmetic surgeon, is CEO, co-founder and formulator of Lexli International, Inc. He is a member of the International Aloe Science Council (IASC) based in Dallas, and has served on its board of directors. Abdullah is a clinical associate professor of plastic surgery at the University of North Dakota School of Medicine in Grand Forks, North Dakota, and owns and practices at Plastic Surgery Institute PC and the Lexli Skin Care Center, both of which are based in Fargo, North Dakota.

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Retail Tips: Are Antioxidants Worth the Hype?

The most important step in encouraging the use of antioxidant products at home is to promote the science that demonstrates their benefits. Provide clients with a fact sheet that outlines the basic information about what antioxidants do and why they’re important, while quoting studies and highlighting their findings. This sheet should also offer recommendations for how to increase antioxidant levels, including the consumption of antioxidant-rich foods and using skin care products that feature added antioxidants, preferably those that you retail in your spa.

Clients are going to be more likely to utilize these products at home if they experience them within your spa services. It helps clients to become familiar with them while offering an endorsement of their safety and efficacy. That’s why it’s important to include antioxidant products in facials and pre- and post-procedure care routines for treatments such as microdermabrasion, chemical peels, dermabrading, lasers and even waxing.

Antioxidant-rich Foods

A healthy diet is vital to ensuring the body is armed with damage-fighting antioxidants. Foods rich in antioxidants include:

  • Berries (various antioxidants)
  • Broccoli (vitamin A)
  • Carrots (vitamin A)
  • Citrus fruit (vitamin C)
  • Fish and shellfish (selenium)
  • Green peppers (vitamin C)
  • Leafy Greens (lutein)
  • Nuts and seeds (vitamin E)
  • Red wine (polyphenol)
  • Tomatoes (lycopene)
  • Watermelon (lycopene)
  • Whole grains (lignan)

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