INTRODUCTION
Facial redness can occur in association with a large number of medical problems. The most common causes of facial redness include inflammatory dermatoses, such as rosacea, perioral oral/ocular dermatitis, contact, seborrheic and atopic dermatoses and chronic sun damage. While redness is the final clinical manifestation, the biologic pathway leading to the redness may be quite varied. We refer to the common denominator in all of these as inflammation, and we now understand many molecules are involved in the inflammatory process. Many of the pathways of inflammation involve reactive oxygen species (ROS). Therefore one may conclude that molecules quenching ROS should be considered anti-inflammatory agents.
There are a number of topical formulations that include antioxidants to improve the antioxidant capability of the skin.1,2,3,4 Two antioxidants, green tea polyphenols and caffeine, have been shown in the laboratory5,6,7 to be very effective and have been used in a commercially available product that has been well tolerated. A third compound that has received considerable attention is resveratrol (3,5,4’-trihydroxystilbene), a polyphenolic phytoalexin found in red wines, colored berries, and peanuts.8 Resveratrol has also been shown in the laboratory9 to be a potent antioxidant. The myriad of clinical benefits of resveratrol led to the hypothesis that the addition of this agent to a topical preparation containing green tea polyphenols and caffeine (both of which protect skin from UV injury10,11) might create an even more effective skin care product. The present study demonstrates that this combination of GTP, caffeine, and resveratrol reduces facial redness.
METHODS
Stage 1
In a preliminary split-face study, volunteers applied topical antioxidant product containing green tea polyphenols and caffeine to one side of the face and the same product with resveratrol added to the other side of the face. Product was applied twice daily for 8-12 weeks. Both products were well tolerated. Facial redness was reduced on the side treated with resveratrol-enriched product (data not shown). These results led to the present study in which subjects presenting with facial redness applied resveratrol-enriched product to the entire face to evaluate the consistency of the clinically apparent reduction in redness.
Stage 2
Subjects (n = 16) presenting with facial redness applied the resveratrol-enriched product twice daily to the entire face. Reduction in redness was evaluated and photographed at 2-week intervals for up to 12 weeks. Photography was obtained by Canfield Visia Software Version 5.2.0 2010-0503a. This unit has a mode that spectrally separates the red portion of the image allowing enhanced ability to see changes in skin redness. Improvement was evaluated by nine trained staff members and 21 dermatology residents on a scale of 1 to 9. The baseline score was assigned a value of 5 for each subject. Post treatment scores lower than 5 denoted redness reduction while scores above 5 indicated an increase in redness. Evaluators compared photographs taken before treatment and at 2-week intervals for up to12 weeks. All subjects provided signed informed consent to treatment and photography.
