1. Kim Johnson
Study of the effectiveness of L ascorbic acid and vitamin a in the
treatment of skin.
Kim Johnson
Gray Clay Medical Aesthetics Education
Abstract
The effects of free radicals caused by frequent
sun exposure and lifestyle choices is a topical
issue. Antioxidants, L ascorbic acid and
Vitamin A have been tested in this clinical trial
as to their ability to combat damage to the skin.
A clinical trial of 45 participants was conducted
using a number of criteria to test the usefulness
of each antioxidant, the results showed that L
ascorbic acid was useful in the treatment of
pigmentation while vitamin A showed improved
moisture content. Neither antioxidant repaired
the skin completely and removed fine lines and
wrinkles but showed to improve them slightly
by improving hydration.
The clinical trial also supported the views that
the effects of sun damage on the skin are
permanent and highlighted the need for a more
intensive trial.
Introduction
Our increasing love affair with the sun and daily
lifestyle habits have caused a change in the
number and severity of damaged skin cases
seen by dermal therapists in Australia and
throughout the world.
In more recent years this issue has been
further compounded by poor diet choices and
incorrect care of the skin which has resulted in
a growing need for clinical trials like this trial
which focuses on the usefulness of
antioxidants to assist with the effects of sun
damage, like fine lines, dry and over aging skin,
pigmentation and the neutralising of free
radicals caused by excessive sun exposure
and lifestyle choices.
The underlying issue stems from free radicals
which are oxygen atoms that attack the living
cells within the body causing cell decay in the
skin, this is supported by Bourgeois, c.f.
(2003,p4) who states that “free radicals are
very aggressive, able to react with all kinds of
biological molecules (lipids, proteins, DNA) in the
vicinity and denature them”.
Key to free radicals ability to cause damage is
‘denaturing’ which causes cell lysis from
oxidative stress. Antioxidants play the vital role
in neutralising and reversing the denaturing
effect by donating electrons to the body and to
bring balance and health to the skin.
The two primary types of antioxidants used in
many topical and oral treatments found on the
market today are L ascorbic acid, commonly
known as vitamin C and retinol known as
Vitamin A.
L ascorbic acid is an important nutrient and an
essential component in the body’s production of
collagen which thickens the skin and stimulates
ground substance in the deeper layers of the
dermis while, topical application of retinol has
been found to enhance the skins photo
protection against damaging UV rays. As stated
by Espejo, R, (2010 p165) retinol can inhibit the
enzyme responsible for the synthesis of melanin
to prevent pigmentation.

2. Kim Johnson
Retinol also plays a significant role in the
production of collagen and has simular effects
to L ascorbic acid, however, retinol is also able
to convert to retinoic acid and repair DNA from
the receptors found in epidermal and dermal
cells.
This repair within the DNA facilitates increased
activity within the dermis and helps to stimulate
fibroblast activity in ground substance. This
results in increased water retention, less lines
and wrinkles.
Finally, each of these antioxidants play a
significant role in the production of collagen
and GAG activity, improving hydration and
bringing balance to the skin.
As demonstrated above, L ascorbic acid and
retinol are useful in combating the effects of
free radicals that cause skin damage, however
prior clinical trials have sort to establish which
antioxidant is more useful for certain desired
results.
A study by Jenny, K. entitled, “Vitamins and
photo aging do scientific data support their use"
found there was significant data to establish
that prescription topical retinoids were effective
in reducing fine wrinkles (like those caused by
sun damage), and that vitamin C may reduce
the negative effects of UV radiation on the
skin… but because of the bodies deficiencies
to convert the ascorbic acid it was difficult to
determine its true effect”
Meanwhile, dissimilar to Jenny, K.’s findings,
Fitzpatrick, R.E. (2002) was able to determine
that that topical application of vitamin C
increased collagen formation in the skin which
facilitates the rebuilding process.
This study seeks to further analyse the
usefulness of using either L ascorbic acid or
retinol to treat three of the effects of excessive
sun damage, these being:
 Reducing the pigmentation of the skin
 Increase the skin’s moisture content;
and
 Reducing fine lines.
Methods
45 female students aged 20-50 years old were
selected. The students were asked to apply L
ascorbic acid to the right side of face and retinol
on the left every morning and evening over a 6
week period. The students were also asked to
stop applying any other active ingredients.
Throughout the trial students were learning
about free radicals, antioxidants and discussions
on their personal experience were also
documented for the trial. Other criteria was also
was also tested, which has not been used for the
purpose of this study.
Results
For the purpose of the trial the students were
asked to rate their observations as either no
change, slight improvement or significant
improvement. The outcomes in the areas of
pigmentation, skin moisture content & fine lines
have been discussed below:
Effects on Pigmentation
The results reflect that L ascorbic acid more
effectively treated pigmentation of the skin with
7% showing significant improvement and a
further 67% showing slight improvement. This is
compared with Retinol which had results of 80%
showing no change.
27%
67%
7%
80%
20%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
L-Ascorbic Acid Vitamin A
Effects of L-Ascorbic Acid & Vitamin A on Pigmentation
No change Slight Improvement Significant Improvement

3. Kim Johnson
Effects on fine lines
The results indicated that retinol was better in
combating fine lines with 7% showing
significant improvement, compared to 2% using
L ascorbic acid, Over 50% of participants under
both antioxidant reported no change in the
effects on fine lines.
67%
31%
2%
58%
36%
7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
L-Ascorbic Acid Vitamin A
Effects of L-Ascorbic Acid & Vitamin A on fine lines
Nochange Slight Improvement Significant Improvement
Effects on skin moisture content
The results indicate that retinol is clearly more
effective in increasing moisture content with
22% showing significant improvement
compared to 4% using Lascorbic acid.
33%
62%
4%
18%
60%
22%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
L-Ascorbic Acid Vitamin A
Effects of L-Ascorbic Acid & Vitamin A on skin moisture content
No change Slight Improvement Significant Improvement
Discussion
The results of the clinical trial support the
findings in the study by Fitzpatrick, R.E., but
were inconsistent with the findings of Jenny, K.
as the trial indicated that neither antioxidant had
significant effects on minimising fine lines, with
note that non-prescription retanoids were used
for the purpose of this trial, in contrast to the
study conducted by Jenny, K who used
prescription based retinoids
The results of the trial support the importance of
consumers gaining an understanding that once
damage to the skin has occurred there are often
regretful and permanent consequences. The
above results show that over 50% of the
participants had no improvement on the severity
and number of fine lines to either side of their
face and without ablative procedures or
injections, these ‘fine lines’ are likely to remain
indefinitely.
However it is not all bad news as luckily we are
able to maintain the skin and prevent further
damage by using antioxidants like the topical
creams used in this trial. This is evidenced in the
skin moisture content increasing in 82% of
participants after topical use of Retinol and 66%
with L ascorbic acid which show how both
antioxidants stimulate cell renewal resulting in
fibroblast activity for the production of collagen &
ground substance.
An interesting area of the trial was found in the
effects of pigmentation, with 73% of participants
using L ascorbic acid showing improvement after
topical use, compared to minor improvements
using retinol, indicating L ascorbic acid is a more
effective option to stop the enzyme that
synthesises melanin and also acts as a skin
lightening agent.
This trial supports that either of these
antioxidants will play a role in treating the skin
concerns of consumers, however it is also up to
the consumer to sufficiently educate themselves
on the signs of skin damage and to seek the
advice of a licensed therapist on the correct care
of their skin and which of these two ingredients

4. Kim Johnson
they need to apply to help minimise the effects
free radicals have on the body.
Consumers knowledge of how and when to
apply the antioxidants is also equally important,
for example knowing to maintain an adequate
routine of cleansing and stimulating of the
basal cell turnover resulting will result in an
increase in skin moisture and cells being at a
more organised state.
Therefore the results of this study gave a clear
indication that each antioxidant was useful to
treat and maintain the skin, but were ineffective
in treating the permanent effects of sun
damage. As this trial was susceptible to
manipulation through the varying skin types of
candidates, the differences in their personal
area of concern and the lack of controls, it is
recommended that a wide and more intensive
clinical study be conducted on the
effectiveness of antioxidants to treat skin
damage.
References
1. Fitzpatrick RE, et al. (2002) Double-blind,
half-face study comparing topical vitamin C
and vehicle for rejuvenation of photo
damage. Dermatol Surg 2002
2. Jenny, K, MD, PhD, (2010) Vitamins and
photoaging: Do scientific data support their
use?”, published online in the Journal of the
American Academy of Dermatology,
3. Bourgeois, F. (2003), Antioxidant Vitamins &
Health, Cardiovascular Disease & Cancer,
cataracts & aging, HNB Publishing, New
York.
4. Espejo, R. (2010), The culture of Beauty,
opposing views, Green Haven Press, Detroit.
5. Antioxidants (2013) retrieved 7 October
2013, from http://www.nlm.nih.gov/
medlineplus/antioxidants.html
6. Goldfaden, G. MD. (2009), Revitalize Aging
Skin with Topical Vitamin C, retrieved from
http://www.lef.org/magazine/mag2009/may20
09_Revitalizing-Aging-Skin-with-Topical-
Vitamin-C_01.htm