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J. Cosmet. Sci., 74.6, 315–334 (November/December 2023)
*Address all correspondence to Shangyi Fu, shangyi.fu@bcm.edu
Cosmetic Trends in Dermatology: A Systematic Review of
Topical Apple Derivatives in Treating Dermatologic Conditions
SHANGYI FU, CRISY ABRAHAM, ANUSHA MACNOJIA, ARUSA MACNOJIA, PIYA
MALHAN, JENNIFER ONWUKWE, SOPHIA FU, AMNA BASHIR, DANNY HUYNH
AND CARLY DUNN
School of Medicine, Baylor College of Medicine, Houston, TX (C.A., An.M., Ar.M., P.M., A.B.)
Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX (Sh.F.)
John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX (J.O.)
Glenda Dawson High School, Pearland, TX (So.F.)
Embedded Systems Engineering, Teal Systems, Houston, TX (D.H.)
Department of Dermatology, Baylor College of Medicine, Houston, TX (C.D.)
Accepted for publication October 02, 2023.
Synopsis
The apple has been used as traditional medicine throughout human history to treat different medical
conditions, including cardiovascular, diabetic, cancer, and inflammatory diseases. Recently, apple extracts
and derivatives have been increasingly used in commercial skincare products, touting their properties for
enhancing cosmetic effects on the skin. In this review, we systematically searched PubMed, analyzed for
inclusion and exclusion criteria, and found 14 articles that described the topical use of apple derivatives
on dermatological conditions. It was found that anthocyanin, a compound from apples, as well as apple
extract, were found to reduce transepidermal water loss. Procyanidin B-2 and AnnurtriComplex could prevent
androgenic alopecia in men and mice, and AnnurtriComplex was effective against chemotherapy-induced
alopecia. Phloretin 3’,3-disulfonate can attenuate ultraviolet (UV)-induced inflammation, and Annurca
polyphenolic extract was found to have a wrinkle smoothing and hydrating effect. However, apple cider
vinegar was found to be ineffective in treating atopic dermatitis and caused chemical burns, and apple extract
can also induce urticaria and dermatitis. These findings show promise in using apple derivatives for certain
skin conditions. However, testing and regulations are needed to prevent adverse effects.
INTRODUCTION
“An apple a day keeps the doctor away” is a centuries-old proverb that is used to encourage
health and prosperity by both medical and lay people. It highlights the extensive use of
apples, otherwise known as the genus Malus, in not only maintaining a healthy lifestyle
but also in treating various medical symptoms, including those commonly associated
with dermatological disorders.1 Lately, the use of apple derivatives has increased in the
commercial skincare market, prompting a high demand for more information about this
product to elucidate whether it has potentially beneficial dermatological effects.

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For many years, apples have been linked to cardiovascular, diabetic, cancer, and inflammatory
disease prevention. In particular, apples contain a plethora of antioxidants and bioactive
substances that reduce inflammation and cell proliferation in organs such as the liver, lungs,
colon, and intestines.2 Historically, apples, especially in the form of apple cider vinegar,
have been used to treat a myriad of ailments including asthma, kidney stones, and even
arthritis. The bioactive compounds of apples include fatty acids, polysaccharides, terpenes,
carotenoids, polyphenols, and organic acids. These compounds play an important role in
establishing the antimicrobial, anti-cancer, antioxidant, and anti-inflammatory potential of
apples.3 In the realm of dermatology, apples and their associated derivatives have been used
extensively for stimulating hair growth and for skin regeneration.4 Polyphenolic extracts
are an increasingly popular topic of research for dermatology specialists due to their link to
hair growth and keratin production.3
Polyphenolic compounds are known to play a regulatory role in many metabolic synthesis
processes, particularly those that involve amino acid oxidation. Polyphenols can inhibit
certain anabolic processes, such as nucleotide synthesis, to conserve amino acids for keratin
synthesis.3 Paired with a variety of moisturizing and cosmetic products, such as foams and
creams, polyphenol extracts can stimulate growth and metabolic activity in hair follicle
cells.4 In terms of apple anatomy, polyphenols are highly concentrated in apple peels.
This can be problematic because apple peels are much more susceptible to environmental
pollutants when compared to apple pulp. Therefore, the isolation of polyphenols may
reduce experimental efficiency and contribute to organic waste and overuse.4 Nonetheless,
the pharmaceutical capacity and benefits that apple polyphenols can provide for patients
with different dermatological conditions warrant its further study in medical use and
development.5
Other apple derivatives, such as their stem cells, have also demonstrated anti-aging and
skin regeneration properties. Apple stem cells, used in the form of cosmetic serums, can
stimulate anti-wrinkle effects and skin rejuvenation through the metabolic optimization of
senescent human fibroblast cells. In other words, the stem cells promote tissue production
in aging and otherwise inactive skin cells.1 The large-scale effectiveness of apple-derived
topical serums is still being researched but holds the potential to grow as a lucrative subset
of the cosmetic industry, like products containing activated charcoal.
The most marketed form of apple-derived products is apple cider vinegar. Whether for
its experimentally supported antimicrobial properties or its association with fad diets on
social media, apple cider vinegar is a household name both inside and outside of academia.1
In dermatology research, apple cider vinegar is speculated to alter skin barrier integrity
by acidifying skin and promoting microbial diversification during the healing process.6
If effective, this treatment could immensely improve the skin barrier of patients with
atopic dermatitis and protect them from common bacterial infections, such as those
from Staphylococcus aureus.4 With all these potentially beneficial effects, a review of the
dermatological treatment of apple derivatives is important both for treatment and in
dispelling hearsay.1 Apple products, though more commonly promoted for their nutritional
benefits, are playing a larger role in the cosmetic and medical branches of dermatology.
For example, apple bioactive products such as phytosterols are being curated as preventive
treatments for squamous cell carcinoma, while also being incorporated into topical products
for their moisturization capacity.2
Apple products make up a significant percentage of the commercial skincare industry and
are among the “trendy” products gaining traction in stores and on social media.1 According