Polypodium

What is Polypodium?

Polypodium is a naturally occurring extract of fern leaves found in South America. It has been used extensively in dermatology for the past two decades, including melasma & other pigmentation disorders.

This ingredient is considered as a safe adjunct to medically prescribed pigment correctors, with added benefits of photoprotection against UV, HEV blue light & IsR light. It is taken as an oral supplement (works better than creams) in the form of tablets.

Polypodium extract has shown promise in reducing melasma pigment, including relapse.

How good is it as a pigment corrector?

Polypodium is a poor pigment corrector (as a stand-alone). It is best combined with medical therapy. It works by preventing damage to cells & reducing skin inflammation. It has a mild, but scientifically proven role in reducing UV, blue light & infrared damage to underlying cells.

How to initiate polypodium for melasma?

Polypodium can be used as –
1. Adjunctive therapy for melasma (as part of a bespoke pigment reduction program).
2. During rotational therapy of melasma.
3. As part of an anti-aging program to reduce photodamage & possibly reduce the incidence of skin cancer.
4. As a topical within sunscreen- Heliocare sunscreen.

What polypodium supplement brands do we prescribe?

For melasma the dose is 7mg/kg, ideally twice a day. It is best taken in the morning, & midday. The two best known brands are Fernblock & Heliocare. The dose is 480 mg twice daily.

What are the side effects of polypodium?

Side effects are extremely uncommon, occurring in less than 2% of cases. The most common side effect is gastrointestinal irritation. Side effects can be mitigated by taking polypodium with food.

It is safe in pregnancy & compatible with breast feeding.

How soon can I see results?

Initial results (as monotherapy or standalone supplementation) with sunscreen may take 12 to 16 weeks, however the overall effect in decreasing pigment (to a point whereby most patients are happy) is not clinically profound. It is thus used as an adjunct to medical therapy, lasers or chemical peels.

It is unlikely that melasma will go away with polypodium alone, however it can add to increased rates of clearance, especially if combined with medical therapies & lasers.

What other treatments do we combine with polypodium?

Our team at The Melasma Clinic combines polypodium with –

• Laser therapy: Picosure Pro, QRas, Fraxel, LaseMD Ultra.
• Chemical peels: Dermamelan, Cosmelan, Vi Peels.
• Pigment correctors: Vitamin C, arbutin, HQ, kojic acid, bearberry & liquorice.
• Vascular modifiers & plasminogen modifiers: oral, intradermal & topical
• Oral glutathione supplementation daily, 500 mg.

*Polypodium supplementation works best as adjunctive therapy, not monotherapy.

What other supplements can help with melasma?

The two main supplements we recommend are polypodium & glutathione.

Glutathione acts as an antioxidant & skin lightening agent. The recommended dose we prescribe in our clinics is 500 mg daily. Other supplements that have limited or no data include-

• Vitamin C (as antioxidants)
• Vitamin E & fish oil (antioxidants)
• Green tea (taste good, acts as overall antioxidant for the body & skin)

How does polypodium work?

Polypodium extract counteracts oxidative stress caused by solar radiation & aging, It also reduces inflammation, melanogenesis and cellular damage.

It also has photoprotective roles in reducing damage from UV, HEV or blue light as well as IR radiation, however in the scheme of photoprotection, the overall effects are much less than sunscreen- hence it’s use as an adjunct.

What is better, sunscreen or polypodium?

Rhetorical question with an obvious answer in the context of melasma treatment. Both. Sunscreens protect against UV & in some cases visible light radiation (tinted) to a greater degree than oral polypodium supplementation.

Polypodium offers a second layer of defence against UV, HEV & some attenuation of IR via its antioxidant & anti-inflammatory roles. As stated, polypodium is an adjunct to mainstream melasma management.

What does a simple skin care routine that is frequently combined with
polypodium?

AM: Polypodium, vitamin C, E, ferulic acid serum, SPF tinted, make up. Glutathione
supplement.

Midday: Polypodium supplement, reapplication of sunscreen

PM: Pigment corrector of choice (retinol, niacinamide, kojic acid, arbutin, cysteamine)

Weekends: AHA serum as a chemical exfoliator

The exact formulations, timings, & application frequency is modified according to your skin sensitives. For more information on the ideal skin care formulations, book a consultation with our dermal therapists at The Melasma Clinic.

What is the scientific data on polypodium for melasma?

The most amount of evidence was published by Professor Goh’s group in Singapore at the NSC. This study hypothesized that combination of PL with HQ & SPF50 would be more than effect than the combination of HQ & sunscreen alone.

The subjects were all darker Asian skin type. After randomization, subjects received two capsules of oral PLE 480mg or placebo twice daily. The mean baseline melasma area severity index for the control group was 6, whilst the polypodium group was higher, at 6.8. However, at the end of the study the PLE group demonstrated a greater reduction in the MASI score compared with placebo, which reached statistical significance. 31.3 percent of the subjects in the polypodium group achieved 75 percent or greater improvement in MASI score, while only 6.3 percent did in the placebo group (p=0.07).

The study concluded that PL is a useful adjunctive for treatment of melasma. As of 2024, the dermatologists trained at the National Skin Centre in Singapore will frequently recommend polypodium extract supplementation as adjunct to medical & laser therapy for melasma. The specialists at The Melasma Clinic mirrors this recommendation.

Goh CL, et al. Double-blind, placebo-controlled trial to evaluate the effectiveness of extract in the treatment of melasma in Asian skin: A pilot study. J Clin Aesthet Dermatol. 2018;11(3):14–19.

What other pigmentation conditions can be treated with polypodium
extract?

Though researched in melasma, polypodium has been extensively used by dermatologists for well over two decades in the treatment of –

• Photosensitive disorders such a polymorphous light eruption, solar urticaria, idiopathic photodermatoses, drug induced photosensitivity, lupus & porphyrias.
• Skin cancer prevention.
• Photoaging as part of an antiaging skin care program.
• Vitiligo treatment.

How long should I take polypodium leucotomos for?

Two ways to take it, firstly as part of rotational therapy (e.g. 4 months on, 2 months off, then back again). This can be useful if you are on the de-pigmentation phase of your melasma treatment, as oral supplements can be combined with medical therapy, anti- pigment creams & lasers-chemical peels.

Secondly as part of an anti-aging program aimed at senescence mitigation (the science of growing older). This means daily supplementation of polypodium, NMN, resveratrol, topical rapamycin & if indicated metformin.

What are other natural skin care ingredients that can treat melasma?

You are reading the wrong website if you are after natural treatments as The Melasma Clinic is a specialist dermatologist institution that initiates therapy based upon peer reviewed scientific data. Having said that, if you would like to consider a natural remedy, try the following before seeing a dermatologist.

1. Sunscreen. Ideally organic. Zinc or titanium dioxide, remembering your chemistry that these elements are on the periodic table, hence ‘natural’. In fact, all chemicals are derived from elements of the table, so the definition of ‘natural’ is blurred on the addition of chemical bonds. If you don’t want a manufactured sunscreen, rub raw, refined iron oxide combined with mud on your face. This offers a very high SPF factor, without the addition of nanoparticles or reef bleaching chemicals.
2. Polypodium leucotomos extract is as organic & natural as it comes. Used by South Americans for centuries for its anti-inflammatory properties, the effects on melasma can be statically significant.
3. Other plant extracts include liquorice root, bearberries, beta arbutin & azelaic acid.
4. Skin vitamins include vitamin C, vitamin E & ferulic acid.
5. Skin acids include glycolic, lactic, & mandelic acids.
6. Glutathione tablets/capsules

What is better- glutathione tablets or polypodium for pigmentation?

There are no head-to-head comparisons, as these tablets work on different pathways, we recommend both as supplementation for pigmentation and skin lightening.