August 2003
Dear Paula,
Thanks for a great book that is also very helpful to a naturopath! I would like some clarification on your entry in the Cosmetics Dictionary section of your book Don't Go to the Cosmetics Counter Without Me. You state that there is no evidence that vitamin E can help scars and that topical application can actually impede the healing process. You do not seem to differentiate between d-alpha tocopherol (natural form) and dl-alpha tocopherol (synthetic form). Within the body, the natural form of vitamin E is known to be hundreds of times more absorbable. The synthetic form is derived from petrochemicals and as such may produce irritation in sensitive skin. The natural form of vitamin E does not exhibit this. In fact, natural vitamin E is used in several serious burn units in the USA.

I doubt that anyone would use a skin cream to treat scarring--burns are another matter. Burning, whether by the sun or other means (and scarring) produces significant oxidative damage. As a premium antioxidant, vitamin E would certainly help to minimize this. I have used this therapy within my practice on numerous occasions quite successfully.

Chris, via email

Dear Chris,
I appreciate that my information has been helpful for you, despite your concerns about vitamin E. The research I quoted about vitamin E on wound healing did not indicate which type of vitamin E was used, so I can't confirm or deny your belief that the "natural" form of vitamin E would perform better than the synthetic form. Concerning the use of vitamin E in burn units, there is no research demonstrating it is being used for this purpose, and a call to the local burn center here in Seattle (the University of Washington Burn Center at Harborview Hospital is one of the largest in the United States) confirmed that they are in fact not using it.

I understand the drive to believe that all things natural are good and all things "unnatural" are bad but there is research showing synthetic vitamin E to have certain health benefits when taken orally (Source: Cancer Cell International, March 12, 2003, www.cancerci.com/content/3/1/3/abstract and Journal of Nutrition, January 2001, pages 161S-163S). Also, synthetic vitamin E is not derived from petrochemicals, though it is synthesized in the lab.

When it comes to any form of vitamin E applied topically, the following information from www.healthnotes.com might be of interest to you and my readers: "Antioxidants may protect the skin from sunburn due to free radical?producing ultraviolet rays. Combinations of 1,000 to 2,000 IU per day of vitamin E and 2,000 to 3,000 mg per day of vitamin C, but neither given alone, have a significant protective effect against ultraviolet rays, according to double-blind studies. Oral synthetic beta-carotene alone was not found to provide effective protection in a recent double-blind study, it may be effective in combination with topical sunscreen.... However, other carotenoids such as lycopene may be more important for ultraviolet protection. One recent uncontrolled trial found 40 grams per day of tomato paste providing 16 mg per day lycopene for 10 weeks protected against burning by ultraviolet rays. Another uncontrolled trial found 25 mg/day of natural mixed carotenoids also protected against ultraviolet radiation, especially when combined with 500 IU per day of vitamin E. Double-blind research has also shown that topical application of antioxidants protects against sunburn if used before, but not after, exposure.

"Despite a lack of research on the subject [and some research showing no benefit], using vitamin E topically on minor burns is a popular remedy. This makes sense, because some of the damage done to the skin is oxidative, and vitamin E is an antioxidant. Some doctors suggest simply breaking open a capsule of vitamin E and applying it to the affected area two or three times per day. Vitamin E forms are listed as either 'tocopherol' or 'tocopheryl' followed by the name of what is attached to it, as in 'tocopheryl acetate.' While both forms are active when taken by mouth, the skin utilizes the tocopheryl forms very slowly. Therefore, those planning to apply vitamin E to the skin should buy the tocopherol form."