Interesting Article Re: Wound Healing Combo

[Guest guest]

> I found an interesting article in the December 2001 edition of

> Dermatology Times. Although it doesn't directly deal with rosacea,

> it does talk about how one form of Vitamin E can be absorbed by the

> skin and can be used successfully as an antioxidant.

Interesting article, but this one too reads like a press

release/promotional. Nothing against her at all, it's characteristic

of all research to be promoted to the general media as if it's a

great discovery. The reality is usually way less dramatic.

For example, one thing that's clearly being hyped: the only active

form of Vit E in humans is d-alpha-tocophenol, so of course that's

the only form that has any potential to do benefit, whether absorbed

or not. That's not her idea at all.

Keep us posted if you come across anything else. I'm still very

skeptical that topical anti-oxidants do anything. (Though if a

topical anti-oxidant is also anti-inflammatory, as Dr. Burke's work

seems to suggest, then it may help rosaceans from that perspective.

But anti-inflammatory agents don't protect the skin as anti-oxidants

are theorized to do.)

Marjorie

Marjorie Lazoff, MD

> Selenomethionine, vitamin E combo effective

>

> December 1, 2001

> By: Jane Schwanke

> Dermatology Times

>

> New York - With the number of laser abrasions being performed

today,

> it is no wonder that postprocedure wound healing is a hot topic.

>

> " Everybody is thinking about it, and everyone has their own

> protocol, " said E. Burke, M.D., Ph.D., dermatologist and

> attending physician, Cabrini Medical Center, New York.

>

> While lasers are delivering miraculous results on the face, the

> downside remains a difficult initial healing period, with redness,

> pain, and sometimes swelling, as well as the risk of infection.

>

> Dr. Burke's approach to wound healing is based on her more than 15

> years of research on selenium and vitamin E. Most recently she

> extended her studies to investigate how selenium delivered

topically

> as L-selenomethionine, coupled with vitamin E, can help the skin

> recover from laser abrasion procedures. " They're both good

> antioxidants and both are known to be anti-inflammatory, " she

> said. " It stood to reason that they would help in wound healing

too. "

>

> Selenium, a trace mineral that quenches free radicals, has earned

> acclaim for its cancer-preventive qualities among populations that

> naturally derive the nutrient through soil and water. People in the

> Southeast are often deficient, while those in the Great Plains

> regions consume higher levels.

>

> Vitamin E has 32 distinct molecular forms or isomers; these isomers

> are classified as D-, L-, or DL- and alpha, beta, gamma, or delta.

> When it comes to application on the skin, the form that is " by the

> far the most effective is D-alpha-tocopherol, " Dr. Burke said. What

> she found in her latest study convinced her of the combined healing

> properties of selenomethionine and vitamin E.

>

> Enhanced healing, less inflammation

>

> Using Yorkshire pigs, Dr. Burke performed both high-wattage and low-

> wattage laser abrasions. Immediately following the procedures, some

> of the pigs were treated with a moisturizing cream and some were

> treated with L-selenomethionine 0.05 percent and vitamin E in the

> form of 5 percent D-alpha tocopherol. Others were left untreated.

> Absorption status was verified by measuring skin, blood, and liver

> levels.

>

> The pigs that received topical applications of either

> selenomethionine or vitamin E experienced " markedly enhanced wound

> healing and markedly less inflammation, " Dr. Burke said, whereas

the

> other control groups improved only slightly.

>

> In addition, Dr. Burke found that the animals that received L-

> selenomethionine developed half as many skin cancers induced by

> ultraviolet irradiation as those that received no treatment. And

> these cancers developed later in the animals' lives - about five or

> 10 human equivalent years later. In human subjects, she found that

> the higher the concentration of topical L-selenomethionine applied,

> the greater the protection.

>

> " The most important thing is that selenium must be applied

topically

> in the form of selenomethionine, or it's not absorbed, " Dr. Burke

> said. " Unlike selenium sulfide - utilized in shampoos developed to

> treat seborrhea and dandruff, which results in no percutaneous

> absorption of selenium - L-selenomethionine is absorbed by the

skin.

> And secondly, form matters. You can't apply vitamin E from a

capsule

> since the capsule contains tocopheryl acetate, the ester form; the

> ester is not active on the skin because, unlike the stomach, the

skin

> does not have the enzymes to convert the ester to the active

> tocopherol form.

>

> " Only the D-alpha tocopherol form is active on the skin, and a

> minimum concentration of 2 to 5 percent is needed for efficacy.

> Almost all, if not all, vitamin E products commonly available

contain

> the mixture of 32 isomers, rather than the one active isomer, and

> contain the ester derivative, which is not active on the skin.

Also,

> the concentration is usually very low - less than 0.1 percent.

> Topical D-alpha-tocopherol 5 percent is truly different. "

>

> Silvadine burn treatment

>

> In other studies, Dr. Burke has also shown that Silvadine, a cream

> used to treat severe burns, significantly enhances postlaser

abrasion

> wound healing. Application should begin immediately after the

> procedure, she said, " particularly for the first week when the

wound

> is really open because of its anti-bacterial properties. After the

> initial healing, I favor 5 percent vitamin E. "

>

> Whichever topical treatment is used, Dr. Burke encourages open

> dressings. " Although closed dressings are easier for the patient,

> they also create more chance for infection, " she said. " Two things

> can cause scarring after laser abrasion: an uneven abrasion or too

> much overlap, and infection. "

>

> Despite improvements in laser techniques, the need for effective

> wound-healing products is not likely to diminish. " No matter what

> technique is used, to get more of an effect, you have to do more

> abrasion, which means more of a healing period, " said Dr.

Burke. " As

> I've shown in pig models, these products really do help.

>

> " Any person that undergoes laser abrasion should take steps to

> enhance wound healing, " she added. " I think every surgeon should at

> least try topical L-selenomethionine, vitamin E, and Silvadine and

> see if they don't agree. In my studies, all of them enhance wound

> healing significantly. In the clinic, I find them to be excellent. "

> DT