Outer beauty from the inside?

In the 1930s when Revlon founder Charles Revson uttered the now infamous slogan “hope in a jar,” he probably didn’t imagine that those seeking a beauty panacea in 2007 would also buy the notion of hope in a pill.

In Southern California and across the nation, doctors, major skin-care brands and medi-spas are offering oral supplements to treat skin from the inside out. The idea that ingesting what some are calling “nutri-cosmetics” can reverse sun damage, alleviate acne or even improve skin elasticity relies on the premise that healthy skin is beautiful skin.

A strong body of scientific evidence supports use of the topical application of vitamins such as C and A and antioxidants such as green tea to help rejuvenate the skin by scavenging free radicals and aiding in collagen production. But when it comes to taking the same supplements (and others) orally, the marketing potential appears to be ahead of the science.

“Theoretically, it makes sense that taking supplements could help improve skin health and appearance or even reverse [sun] damage,” says Dr. Jenny Kim, an assistant professor of dermatology at the David Geffen School of Medicine at UCLA who also conducts research on vitamins and aging. “But we still don’t really know exactly what oral supplements do for our skin and we don’t know when we take something orally how much, if any of it, gets to the skin via the bloodstream.”

Olay Effects Beautiful Skin and Wellness Pack, for example, which sells for about $15 for a 30-day supply, boasts ingredients such as coenzyme Q10, vitamin E and alpha lipoic acid with green tea. The product says it helps support collagen, prevent puffiness and smooth skin texture.

Jan Marini C-Estamins promises to increase skin moisture, reduce wrinkles and improve sun-damaged skin with coenzyme Q10, vitamins C and E, alpha lipoic acid and even hyaluronic acid, the same ingredient found in the popular filler Restylane. It retails for about $80 for a 30-day supply.

Proponents of oral supplementation for beautiful skin are buoyed by a handful of small, sometimes inconclusive, studies -- and swift sales.

According to a report published in August 2006 by independent market research firm Datamonitor, the “beauty from within” trend grew 17% from 2000 to 2005, with beauty supplement sales reaching more than $740 million in 2005.

Also telling is the slew of oral beauty supplements that have recently flooded the market from other familiar cosmetic brands such as Boscia, L’Oreal and Kinerase and from physician-developed lines such as Murad and N.V. Perricone.

Kate Somerville, whose Melrose Place medi-spa is a destination for celebrities and others who want the latest in noninvasive skincare technology, said she sells skin care supplements because 85% of her clients are interested in taking oral supplements for their skin and their overall health.

This is especially true for those who have acne and are desperate to stop breakouts without taking prescription antibiotics or stronger medicine such as Accutane. “It’s really common sense,” Somerville said.

“Our skin is our largest organ, so if there is a problem internally, we will definitely see it in the skin. A perfect example is smokers. They have terrible skin and that’s a direct result of what they put in their body.”

Somerville first became interested in supplementation more than a decade ago when she worked in plastic surgery offices. Some plastic surgeons have advised their patients to take supplements such as Arnica montana (to decrease swelling and bruising), bromelain (for its anti-inflammatory properties) and vitamins A, C, beta carotene and zinc (to minimize free radical damage, speed healing and minimize the risk of infection).

A 2004 study published in the journal Plastic and Reconstructive Surgery backed what many plastic surgeons had seen anecdotally: A small placebo-controlled, randomized study (26 patients) concluded that an herbal cocktail containing bromelain (an anti-inflammatory enzyme found in pineapple plants), vitamin C, rutin (a plant nutrient believed to prevent bruising and boost vitamin C) and grape seed extract (an anti-oxidant known for wound-healing benefits) could help patients heal 17% faster after an invasive procedure such as a face lift.

Certainly wound healing after plastic surgery and skin rejuvenation through supplementation are two very different circumstances but Torrance-based Dr. Christine Petti said that many of her patients have stayed on the supplements well after their surgery has healed because they said they noticed an improvement in their skin.

“The aging process is a series of continuous events,” said Petti, who takes supplements every day -- including vitamins A, C and E -- for her skin. “Cells lose their ability to regenerate and repair themselves so anything we can do to enhance rejuvenation and delay degeneration is beneficial. Supplementation is just one more tool in our arsenal of noninvasive ways to accelerate healing and prevent aging.”

Among the skeptics are Paul M. Coates, director of the Office of Dietary Supplements at the National Institutes of Health. “There is no question that there are diseases of the skin associated with deficiencies in vitamins and minerals, but it’s a leap to think that supplements can help prevent the natural decline in normal healthy skin,” he said.

One reason there have not been rigorous studies of these products is that the Food and Drug Administration only requires dietary supplements to be tested for safety, not efficacy. That means manufacturers don’t have to conduct double-blind controlled clinical studies to back their claims.

Dr. Howard Murad, an El Segundo-based dermatologist who has his own line of oral supplements to combat wrinkles, blemishes and stretch marks, has conducted small studies that support the claims on his products. He says his Youth Builder Collagen Supplement (glucosamine, amino acids, vitamins A, C and E, grape seed extract and other minerals) is proven to reduce wrinkles by 34%.

He also says that his Wet Suit Cell Hydrating Dietary Supplement strengthens skin cell membranes and locks in cellular water by supplying phosphatidylcholine and anti-inflammatory ingredients such as gamma linoleic acid and essential fatty acids.

He says his Pure Skin Clarifying Dietary supplement reduces blemishes by 55% with ingredients such as vitamins A, C, E, beta carotene, zinc and herbs such as burdock root.

“I agree that a double-blind controlled study is the gold standard, but in order for me to do that, it would cost hundreds of thousands of dollars and for me that’s a very high road to climb,” he says.

Dr. David Rahm, an anesthesiologist who founded Vita Medica, a Long Beach-based company that has been manufacturing pharmaceutical-grade oral supplements for plastic surgeons and other physicians for 20 years, acknowledged that creating oral supplements for skin care health and beauty is an imperfect science.

Rahm manufactures multivitamin and mineral products including products for aging skin, dry skin and acne-prone skin that include ingredients such as vitamins A, C and E, B-complex vitamins, carotenoids, green tea extract, bromelain, pine tree bark and coenzyme Q10.

“Much of what we’re doing has not been proven in clinical trials, it’s been proven in practical realities using evidence-based medicine,” Rahm said. “Will these supplements help some? Yes. Will they help a lot? Well, that might be an exaggeration.

“But what we’re doing is providing the convenience of a product formulated with supplements that do have some research to back them up. We’re just really an adjunct to other age-management therapies.”