Background:
Sunscreen use and dietary antioxidants are advocated as preventives of skin aging, but supporting evidence is lacking.
Objective:
To determine whether regular use of sunscreen compared with discretionary use or β-carotene supplements compared with placebo retard skin aging, measured by degree of photoaging.
Design:
Randomized, controlled, community-based intervention. (australian new zealand clinical trials registry: actrn12610000086066).
Setting:
Nambour, australia (latitude 26° s).
Patients:
903 adults younger than 55 years out of 1621 adults randomly selected from a community register.
Intervention:
Random assignment into 4 groups: daily use of broad-spectrum sunscreen and 30 mg of β-carotene, daily use of sunscreen and placebo, discretionary use of sunscreen and 30 mg of β-carotene, and discretionary use of sunscreen and placebo.
Measurements:
Change in microtopography between 1992 and 1996 in the sunscreen and β-carotene groups compared with controls, graded by assessors blinded to treatment allocation.
Results:
The daily sunscreen group showed no detectable increase in skin aging after 4.5 years. skin aging from baseline to the end of the trial was 24% less in the daily sunscreen group than in the discretionary sunscreen group (relative odds, 0.76 [95% ci, 0.59 to 0.98]). β-carotene supplementation had no overall effect on skin aging, although contrasting associations were seen in subgroups with different severity of aging at baseline.
Limitation:
Some outcome data were missing, and power to detect moderate treatment effects was modest.
Conclusion:
Regular sunscreen use retards skin aging in healthy, middle-aged men and women. no overall effect of β-carotene on skin aging was identified, and further study is required to definitively exclude potential benefit or potential harm.
Primary funding source:
National health and medical research council of australia.