Dr Marita Kosmadaki

Co-founder of “Athens Dermoiatriki” Clinic in Greece and a visiting lecturer in Dermatology at Boston University, USA


With a passion for skin biology and skincare science, Marita tells us about the current scientific evidence on Nutraceuticals and Skin Health.

Behind The Business Woman


About your career and the people who inspired you

I was very lucky to spend several years with Dr Barbara Gilchrest in Boston University. She has inspired me with her multiple achievements and maybe more importantly with her personality. Kind, generous and firm, she has taught me the importance of perseverance; and that it is a skill we should have regardless of our age or our success. I work in Athens, Greece for over 13 years now and I chair a group practice where we deal with the whole spectrum of dermatology. Dr Gilchrest has affected the way I react to different situations, especially the difficult ones.

The growing interest in skin and nutrition



Over the past few years, I have noticed a growing interest in nutrition. Patients ask how it may affect their skin conditions/disease, if it has a preventive, causative or curative effect. They are more interested about what they eat, they exercise more, they look for anti-stress solutions and they smoke less. I think that this trend is indicative of a more holistic approach to medicine.


Are there any new evidence regarding the role of nutrition on skin health and/or on some specific skin conditions?


We have long known that nutritional deficiencies result in skin symptoms, like eczema, cheilitis, hypopigmentation, petechie. For patients who present for cosmetic treatment of aging skin, we typically review lifestyle factors that impact this process. While smoking and sun protection are commonly addressed, dietary factors should be as well. UNFORTUNATELY they are LESS WELL STUDIED.

Can you clarify what are the Nutraceuticals?


The word “nutraceutical” is derived from the combination of “nutrition” and “pharmaceutical” and was coined by Stephen DeFelice in 1989. They aim to improve health, delay the aging process, prevent chronic diseases and increase life expectancy.


Are Prebiotics and Probiotics part of the Nutraceutical group? What are their effects on skin?

The term nutraceuticals has evolved to include three main segments: herbal/natural products, dietary supplements and functional foods (food added more of or new ingredients to promote health). Thus, under this broader definition probiotics and prebiotics are considered part of the nutraceutical family.

I’d like to clarify that probiotics are living microorganisms that when consumed in adequate amounts offer health benefits to the host. We find them in foods like yoghurt or we can take them in supplements. Prebiotics are compounds that promote the growth of beneficial microorganisms. In other words: prebiotics provide the food for the probiotics. We take prebiotics by consuming fiber in certain plant based foods or in supplements. Probiotics and prebiotics modulate the gut microbiome and may affect the immune system. Although many more studies are needed to clarify this field, it appears that there is a communication between the gut microbiome and the skin (the skin-gut axis). Modulations in gut microbiome may affect skin diseases like atopic dermatitis, rosacea or psoriasis. Further, topical products with pro/prebiotics are available in the skin care market. So far a beneficial effect of topical products with prebiotics is shown for atopic dermatitis and acne.

What are your recommendations for getting back to an healthy Skin State after the Winter Season – which is very often associated with some excess of food?


Sleep well, cut down on alcohol, remember your antioxidants, exercise and of course no smoking.



What is your approach for incorporating Nutraceuticals in your patients treatment options?


A good strategy for enhancing skin protection from oxidative damage is to support the endogenous antioxidant system with diet rich in antioxidants or with nutraceuticals containing antioxidants. I usually incorporate nutraceuticals in my treatment regimen during summer months, aiming to enhance skin defense mechanism and prevent sun damage.

What is your favorite nutraceutical for Healthy Skin and slowing skin aging?


I cannot name one – but I like vitamins, flavonoids, carotenoids and tocopherols for their antioxidant and/or photoprotective properties. Studies have shown that their use is associated with improved measures of skin elasticity, facial wrinkling, roughness and color.


Your View on Skincare Education

What about the scientific evidence behind the role of Nutraceuticals in Cosmetic Dermatology?


Though there is some data available on the benefits nutraceuticals have on the skin, there are many questions that remain to be answered and industry may help with more research. We need more data to prove the role of specific ingredients in nutraceuticals in real life conditions.  What is the optimal concentration they should to be consumed, for how long and at what combinations? We need well designed randomized controlled trials examining the effect of nutraceuticals on skin health and disease. These are not easy to do since many variables need to be taken into consideration, but medicine has dealt with harder problems than that…

I am optimistic that in time we shall have all the answers!

1. RYAN, Anna Sarno et GOLDSMITH, Lowell A. Nutrition and the skin. Clinics in dermatology, 1996, vol. 14, no 4, p. 389-406.
2. KALRA, Ekta K. Nutraceutical-definition and introduction. Aaps Pharmsci, 2003, vol. 5, no 3, p. 27-28.
3. DAS, Lipi, BHAUMIK, Eshani, RAYCHAUDHURI, Utpal, et al. Role of nutraceuticals in human health. Journal of food science and technology, 2012, vol. 49, no 2, p. 173-183.
4. AL-GHAZZEWI, F. H. et TESTER, R. F. Impact of prebiotics and probiotics on skin health. Beneficial microbes, 2014, vol. 5, no 2, p. 99-107.
5. Liu-Walsh F, et al. Fermentation of colloidal oatmeal by cutaneous bacteria results in enhanced production of lactic acid and short chain fatty acids. American Academy of Dermatology (AAD) Poster 6639: February 26-28, 2018;San Diego, CA, USA. Publication submitted