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Received: 10 July 2017 / Revised: 7 August 2017 / Accepted: 9 August 2017 / Published: 12 August 2017

The skin’s primary function is to act as a barrier against insults from the environment, and its unique structure reflects this. The skin is composed of two layers: The outer epidermis layer is highly cellular and provides the barrier function, and the inner dermal layer ensures strength and elasticity and provides nutritional support to the epidermis. Normal skin contains high concentrations of vitamin C, which supports important and well-known functions, stimulates collagen synthesis and helps with antioxidant protection against UV-induced photodamage. This knowledge is often used as a rationale for adding vitamin C to topical applications, but the efficacy of such treatment, as opposed to optimizing dietary vitamin C intake, is poorly understood. This review discusses the potential roles of vitamin C in skin health and summarizes the in vitro and in vivo research to date. We compare the effectiveness of dietary intake of vitamin C versus topical application, identify the areas where a lack of evidence limits our understanding of the potential benefits of vitamin C on skin health, and suggest which skin characteristics are most likely to benefit of improved nutritional vitamin C intake.

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The skin is a multifunctional organ, the largest in the body, and its appearance generally reflects the health and efficiency of its underlying structures. It has many functions, but its basic role is to provide a protective interface between the external environment and an individual’s tissues, providing shielding against mechanical and chemical threats, pathogens, ultraviolet radiation, and even dehydration (functions reviewed in [1]). Being in constant contact with the external environment, the skin is exposed to more insults than most of our other organs, and this is where the first visible signs of aging appear.

The skin is composed of two main layers with quite different underlying structures – the outermost epidermis and the deeper dermis (Figure 1). The epidermis fulfills most of the skin’s barrier functions and consists predominantly of cells, mostly keratinocytes [2]. The keratinocytes are arranged in layers throughout the epidermis; as these cells divide and multiply away from the basal layer, which is closest to the dermis, they begin to differentiate. This process is called keratinization and involves the production of specialized structural proteins, the secretion of lipids, and the formation of a cellular envelope of cross-linked proteins. During differentiation, virtually all of the subcellular organelles, including the nucleus, disappear [3, 4]. The cytoplasm is also removed, although there is evidence that some enzymes remain [4]. Thus, the upper layer of the epidermis that interacts with the external environment is composed of flattened metabolically ‘dead’ cells (the terminally differentiated keratinocytes). These cells are sealed together with lipid-rich domains that form a water-impermeable barrier. This layer is known as the stratum corneum (Figure 1) and fulfills the primary barrier function of the epidermis, although the lower epidermal layers also contribute [5].

In contrast, the dermal skin layer provides strength and elasticity and includes the vascular, lymphatic and neuronal systems. It is relatively acellular and consists primarily of complex extracellular matrix proteins [6] that are particularly rich in collagen fibers, which make up ~75% of the dry weight of the dermis (Figure 1). The main cell type present in the dermis are fibroblasts, which are heavily involved in the synthesis of many of the extracellular matrix components. Blood vessels that supply nutrients to both skin layers are also present in the dermis [1, 2]. Between the two main layers is the dermal-epidermal junction, a specialized basement membrane structure that fixes the epidermis to the dermis below.

It is accepted that nutritional status in terms of both macronutrients and micronutrients is important for skin health and appearance [7]. Proof of this is the many vitamin deficiency diseases that result in significant skin disorders [8]. Dermatological signs of B vitamin deficiency include, for example, a patchy red rash, seborrheic dermatitis, and fungal infections of the skin and nails [9, 10]. The vitamin C deficiency disease scurvy is characterized by skin fragility, bleeding gums and corkscrew hair as well as reduced wound healing [11, 12, 13, 14, 15, 16, 17, 18].

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Nutritional status is essential to maintain normal function of the skin during collagen synthesis and keratinocyte differentiation [7]. In addition, many of the components of our antioxidant defenses such as vitamins C and E and selenium come from the diet, and these are likely to be important for protection against UV-induced damage [ 19 , 20 , 21 , 22 , 23 ].

The epidermis is a challenged environment for the supply of nutrients, as it lacks the blood vessels that normally supply nutrients to the cells. Supply of nutrients is dependent on diffusion from the vascularized dermis [24], and this may be particularly limited for the outermost layers of the epidermis (Figure 2). Delivery is further enhanced by the chemical nature of these outer epidermal layers, in which there is little movement of extracellular fluid between cells due to the complex lipid/protein crosslinking structure that forms the skin barrier. All of this makes it likely that dietary nutrients are not easily able to reach the cells in the outermost layers of the epidermis, and these cells receive little nutrient support.

The skin can be targeted for delivery of nutrients through topical application (Figure 2). In this case, however, the delivery vehicle is influential, as the stratum corneum acts as an effective aqueous barrier and prevents the passage of many substances [1]. Although some uncharged and lipid-soluble molecules can pass through the surface layer, nutrients delivered via topical application are unlikely to readily penetrate the lower layers of the dermis [22]. The dermal layer functions are therefore best supported by nutrients delivered through the bloodstream.

Normal skin contains high concentrations of vitamin C, with levels comparable to other body tissues and well above plasma concentrations, suggesting active accumulation from the circulation. Most of the vitamin C in the skin appears to be in intracellular compartments, with concentrations likely to be in the millimolar range [25, 26, 27]. It is transported into the cells from the blood vessels in the skin layer. Skin vitamin C levels have not been frequently reported, and there is considerable variation in the published levels with a 10-fold range across a number of independent studies (Table 1). Levels are similar to those found in several other body organs. The variation in reported levels most likely reflects the difficulty of handling skin tissue, which is highly resistant to degradation and solubilization, but may also be due to the location of the skin sample and the age of the donor.

Reasons Why Vitamin C Is Good For Your Skin

Several reports have indicated that vitamin C levels are lower in aged or photodamaged skin [25, 26, 27]. Whether this association reflects cause or effect is unknown, but it has also been reported that excessive exposure to oxidant stress via pollutants or UV irradiation is associated with depleted vitamin C levels in the epidermal layer [33, 34]. In fact, more vitamin C is found in the epidermal layer than in the dermis, with 2–5-fold differences between the two layers being consistently reported (Table 1 and [25, 26]). Levels of vitamin C in the skin correspond to

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