Assessing the Potential Role for Topical Melatonin in an Antiaging Skin Regimen
September 2018 | Volume 17 | Issue 9 | Original Article | 966 | Copyright © September 2018
Doris Day MD,a Cheryl M. Burgess MD,b Leon H. Kircik MDc
aNYU Langone Medical Center, New York, NY bCenter for Dermatology and Dermatologic Surgery; George Washington University School of Medicine and Health Sciences; Department of Internal Medicine/Dermatology, Georgetown University Medical Hospital, Washington, DC cIcahn School of Medicine at Mount Sinai, New York, NY; Indiana Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY
Background: Melatonin is an endogenous hormone commonly associated with regulation of sleep. However, over the last two decades, research has elucidated a range of effects associated with the compound, including anti-inflammatory, both direct and indirect antioxidant activity, tissue regenerative benefits, and preservation of mitochondrial function. Melatonin’s anti-inflammatory and antioxidant support, coupled with its mitochondrial support, make it an intriguing target for use to support skin health. Human skin and hair follicles express functional melatonin receptors. They also engage in substantial melatonin synthesis. By supporting cutaneous homeostasis, melatonin and its metabolites are thought to attenuate carcinogenesis and possibly other pathological processes, including hyperproliferative/inflammatory conditions. The primary extrinsic driver of aging has been considered to be exposure to ultraviolet (UV) light, which is well-established to contribute to sunburn, immunosuppression, skin aging, and carcinogenesis. Topically applied melatonin has been shown to reduce markers of reactive oxygen species formation and to reverse signs of skin aging. As the global population continues to age, photo-damage remains a significant cutaneous concern. While use of sunscreens and UV avoidance strategies are essential to mitigate skin cancer risks, the potential to protect the skin and improve the appearance of photo-damage through the use of topical antioxidant support is appealing. The evidence suggests that melatonin deserves consideration for topical use as an anti-aging and skin protective agent. It is shown to be both safe and effective when topically applied. J Drugs Dermatol. 2018;17(8):966-969.
Melatonin, the main neuroendocrine product of the pineal gland, is an endogenous hormone commonly associated with regulation of the sleep cycle. Exogenous melatonin, in the form of oral supplements, has been used for many years to help regulate the sleep cycle. Research over the last two decades supports a range of additional benefits as- sociated with melatonin, including anti-inflammatory and both direct and indirect antioxidant activity. Melatonin also has been shown to induce tissue regeneration.1 Specifically, research has elucidated regenerative effects of melatonin on tissues of the nervous system, liver, bone, kidney, bladder, muscle, and skin.1 The combined antioxidant, anti-inflammatory, and regenerative effects of melatonin are sufficiently potent that melatonin has been investigated as a protective agent for ischemia-reperfu- sion (IR) injury in brain, heart, and liver.2 The degree of myo- cardial protection from melatonin following myocardial IR has been characterized as “substantial.”3 One area of research has focused on the use of melatonin systemically for its anti-aging benefits via preservation of mito- chondrial function. As mitochondrial function declines with age, impairment leads to damage to mitochondrial proteins, lipids, and DNA. One way that melatonin may preserve mitochondrial physiopathology and prevent aging is by preserving cardiolipin, a phospholipid that plays an important role in several biochemical processes of the mitochondrial function, from ROS mediated oxidation.4 Of particular interest, melatonin and its metabolites have been identified as integral to physiological skin functions.5 Such functions are known to decrease with age and cumulative skin damage. In the skin, melatonin functions largely as a direct and an indirect antioxidant. The range of potential cutaneous benefits associated with melatonin extend beyond signs of skin aging. By supporting cu- taneous homeostasis, melatonin and its metabolites are thought