EXPERT ANALYSIS FROM ODAC 2017
MIAMI (FRONTLINE MEDICAL NEWS) – Topical skin care products are evolving along with evidence in the literature supporting their efficacy; these products include serums, lotions, and cleansers with DNA repair enzymes or epidermal growth factor as active ingredients, according to Ron Moy, MD.
Importantly, some of these formulations not only show efficacy to reverse the signs of photodamage to skin and to promote rejuvenation, but may have a role in skin cancer prevention as well, said Dr. Moy, a dermatologist and facial plastic surgeon in private practice in Beverly Hills, Calif.
Some patients may question why they need to apply such agents when sunscreens offer much-touted protection. “Sunscreens can help you 15-20 years down the road, but they don’t repair past damage. We have a better way of repairing [existing] damage,” said Dr. Moy, who is also past president of the American Academy of Dermatology and the American Society for Dermatologic Surgery.
More investigators are assessing the mechanisms and potential advantages of DNA repair, Dr. Moy said at the Orlando Dermatology Aesthetic and Clinical Conference. In 2015, the Nobel Prize in Chemistry was awarded to scientists who discovered key mechanisms underlying DNA repair. “Since then, DNA repair has gotten a lot more attention,” he said.
Evidence suggests a person’s DNA repair capability can modulate colon cancer risk. Also, smokers with a low level of DNA repair enzymes carry a higher risk for lung cancer, and DNA repair genes can predict ovarian cancer and lung cancer survival, Dr. Moy said.
“It is still not entirely understood how everything ties together,” he said. “But the work on DNA repair is convincing, more convincing than work on antioxidants or retinoids.” Although antioxidants look favorable in experimental and animal studies, for example, “generally the published work on antioxidants does not give you good clinical results,” he said.
DNA repair enzymes have a beneficial effect on the proto-oncogene hyperexpression in human skin and ultraviolet light telomere shortening, according to an experimental pilot study in the Journal of Drugs in Dermatology ( 2013 Sep;12[9]:1017-21 ).
Also, a DNA repair enzyme derived from bacteria, T4 endonuclease V, showed promise in an older study of 30 patients with xeroderma pigmentosum ( Lancet. 2001 Mar 24;357[9260]:926-9 ). Those affected carry a higher risk overall for any skin cancer, compared with the general population. The DNA repair enzyme group had fewer new actinic keratoses and fewer new basal cell carcinoma, squamous cell carcinomas, and melanoma lesions at 1 year, compared with a vehicle-only group at 1 year.
Another class of DNA repair molecules, photolyases, is newer than T4 endonuclease V and “might work even better,” Dr. Moy said.
“There is evidence that DNA enzymes are very effective and helpful in preventing skin cancer,” he pointed out. One mechanism is the ability of exogenous DNA repair enzymes to bolster intrinsic DNA in the fight against carcinogenesis, according to a review article Dr. Moy and his colleagues published in the Journal of Drugs in Dermatology ( 2015 Mar;14[3]:297-303 ).
The role of human epidermal growth factor for improving skin appearance and tightening is another area of active research and promise.
“It basically thickens and tightens skin,” Dr. Moy explained. “It works better on thinner skin, including the eyelids and neck.” Ultrasound objectively demonstrates gains in skin thickness. Studies also show improvement in acne scars following application of epidermal growth factor.
In addition, epidermal growth factor can enhance the appearance of solar purpura. In fact, this is the dermatologic condition with the most convincing evidence supporting its use so far, Dr. Moy said. Clinical studies have shown that epidermal growth factor along with other active ingredients also can improve acne scars and eye bags.
During the question and answer session at the ODAC conference, moderator Susan Weinkle, MD, a dermatologist and Mohs surgeon in private practice in Bradenton, Fla., asked Dr. Moy which epidermal growth factor product he recommends.
“There are a lot of different growth factors. Epidermal growth factors are not all the same,” said Dr. Moy, who is the founder of DNA EGF Renewal, a company that manufactures skin care products containing epidermal growth factor and DNA repair enzymes.
When pressed for the name of his growth factor product by Dr. Weinkle and an uproar from the audience, Dr. Moy chose to stay noncommercial, pointing attendees to his website instead: www.dnaegfrenewal.com.
Dr. Moy is founder of DNA EGF Renewal in Beverly Hills, Calif.
