Purpose of Review Systemic photoprotection is an attractive concept; however, its use has been limited by a lack of robust evidence. We performed a review to evaluate the evidence for systemic photoprotection and skin cancer prevention in humans by vitamins C, D and E, carotenoids, nicotinamide, retinoids, polyphenols, Polypodium leucotomos extract, NSAIDs and afamelanotide. Recent Findings In a randomized controlled trial, compared with placebo, a 13% reduction in actinic keratoses and a 23% reduction in keratinocyte carcinoma were found with continued nicotinamide use over 12 months, although the result should be interpreted with caution. A synthetic melanotropin, Nle4-D-Phe7-a-MSH, showed promising results in photoprotection but was limited by its side effect profile. Summary Various photoprotective agents have shown promise in the reduction of the acute response to UV radiation, but there is insufficient evidence for their mainstream use presently. There is evidence for keratinocyte skin cancer prevention with the use of retinoids and nicotinamide in certain populations.
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