Photodynamic Skincare: A Prospective Single-Center Study

May 2024 | Volume 23 | Issue 5 | 332 | Copyright © May 2024


Published online April 22, 2024

Jade N. Young BSa, Katrina Yearwood BAb, Julia Scali BSc, Arlene Sanchez BSb, Margit Juhasz MDd, Ellen S. Marmur MDe

aOregon Health Science University, School of Medicine, Portland, OR
bMarmur Medical, New York, NY
cRowan University, School of Osteopathic Medicine, Camden, NJ
dCedars Sinai Medical Center, Department of Dermatology, Los Angeles, CA
eMt. Sinai Hospital, Department of Dermatology, New York, NY

Abstract
Background: Peer-reviewed, clinical studies measuring the efficacy and usability of skin care products enhance their integrity and may guide experts in the field in providing recommendations. A single-blind, prospective clinical study was designed to assess the subject satisfaction, clinical benefit, and safety of three photodynamic topical formulations referred to as MMSRepose (MMSRep), MMSRevive (MMSRev), and MMSBalance (MMSB). 
Methods: Thirteen male and female patients (mean age 49 +/- 17.8 years) applied one of the three topical serums twice daily over a period of 12 weeks. Subjects returned for photography, and blinded investigator evaluation of rhytides (fine lines) and dyspigmentation were measured on a 6- and 4-point scale, respectively. Patient-perceived efficacy of multiple clinical outcomes was measured on a 5-point scale. 
Results: 100% of subjects reported at least a 1-grade improvement in global aesthetic at the conclusion of the study. Investigator assessment revealed an overall 53.3% decrease in rhytides, correlating to a mean point reduction from 1.65 +/- 0.77 to 0.77 +/- 0.53 (P<0.001) from baseline to week 12. Investigator assessment of dyspigmentation revealed a 62.7% decrease, correlating to a mean point reduction of 1.85 +/- 0.68 from week 1 to 0.69 +/- 0.48 at week 12 (P<0.001).
Conclusion: Photodynamic serums demonstrate clinical efficacy in skin rejuvenation and high user satisfaction. There were no serious adverse events. This study is limited by the inability to randomize to placebo due to the small sample size, as subject retention was heavily impacted by the SARS-CoV-2 pandemic. Future studies may be indicated to undergo comparison with a larger cohort. 

J Drugs Dermatol. 2024;23(5):332-337. doi:10.36849/JDD.7167

INTRODUCTION

The cosmeceutical industry has produced countless new products to target signs of cutaneous aging, reduce acne, decrease hyperpigmentation, improve texture, and many other concerns. Peer-reviewed, clinical trials help inform the recommendations experts provide to their patients regarding these products. Multimodal skincare products are increasing in popularity. These contain many active ingredients targeting several mechanisms of clinical stigmata of cutaneous damage including fine lines, texture, and sallowness, acne formation, and notably, signs of aging. 

Perhaps the most pervasive and well-known factor that contributes to clinical signs of extrinsic aging and degradation of cutaneous integrity is photodamage. Exposure of human skin to ultraviolet radiation induces DNA damage that triggers photoaging, cell death, and carcinogenesis.1 Thus, many skincare products are designed with these mechanisms in mind. The inclusion of light-responsive ingredients, adaptogens, probiotics, and specialized peptides in skincare have enhanced the ability of products to respond to both environmental cues such as the ultraviolet (UV) and visible light spectrum, as well as encompass intrinsic cues such as cortisol-driven stress response, circadian rhythm, and commensal flora.2–5 For example, extrinsic DNA damage induced by UV radiation is repaired by photolyase enzymes. Growing evidence shows that when applied to the skin, topical liposomal formulations of these enzymes can contribute to DNA repair to reduce signs of photoaging as well as carcinogenesis.6 Taking this a step further, some topical photolyase enzymes are activated by UV radiation, making them light-responsive. Therefore, photolyases are augmented by the environment that generates DNA damage and are photodynamic.7

Circadian physiology is perhaps the meeting point of extrinsic and intrinsic cues, considering the extrinsic light cycles that govern our intrinsic circadian clock. A growing body of evidence