SYSTEMIC BETA-CAROTENE PLUS TOPICAL UV-SUNSCREEN ARE AN OPTIMAL PROTECTION AGAINST HARMFUL EFFECTS OF NATURAL UV-SUNLIGHT - RESULTS OF THE BERLIN-EILATH STUDY

Increasing numbers of patients with different kinds of UV-induced derm atoses and skin cancer, are presenting at medical care institutions in many countries. If social and cultural behaviour does not change, low ering the risk of harmful effects of UV radiation, for example by the use of topical and systemic preventive agents acting as sunscreens and antoxidants, is going to have to be a priority. We conducted a random ized, placebo controlled, double blind study in 20 healthy young femal e students (skin type II + III, body mass index 18-22) to evaluate the efficacy of a moderate dose of 30 mg/d beta carotene (BC) after 10 we eks presupplementation and over 13 days, of time and intensity control led sunlight exposure at sea level (30 degrees latitude, Red Sea, Eila th, Israel) with regard to development skin erythema assessed by chrom ametry at selected skin sites with and without topical UVA/B sunscreen cream. In addition, BC blood levels, were regularly checked before an d after UV-exposure as well as epidermal Langerhans cell (LHC) density by biopsy, delayed type hypersensitivity by recall antigens and lymph ocyte counts by flowcytometry-analysis of the peripheral blood. A 10-w eek BC-supplementation did not lead to a visible carotenodermia. Devel opment of erythema in selected skin areas exposed to natural sunlight was lower in the group supplemented with BC. Body areas in the verum g roup protected with sunscreen cream plus systemic BC showed lower medi an degrees of erythema. Serum levels of BC did not fall during sun exp osure in the verum group under the normal value, whereas in the placeb o group the levels decreased significantly to sub-physiological levels . Langerhans cells increased significantly (p < 0.01) in density per s qmm/epidermis after presupplementation with BC. After UV-exposure, LHC -density decreased in both groups, however, compared to baseline level s this was significant (p < 0.05) in the temporary exposed skin region only for the placebo group. The lymphocyte counts and recall antigen profile did not change significantly. Presupplementation with moderate doses of beta carotene before and during natural sunlight exposure co mbined with topical sunscreens are more effective than sunscreen cream alone. From our results the use of such a combination for the general health of populations at risk e.g., before UV-exposure during vacatio n would seem advisable.