Understanding Topical Vitamin A

Vitamin A is a key ingredient to correct any skin issue. It acts on the dermis  to encourage the maturation and correct the defects of new cells creating healthy looking skin.

Some benefits of topical Vitamin A:

  • increases cell turnover
  • stimulates collagen/elastin/GAG production
  • reduces fine lines/signs of aging
  • improves skin texture and color
  • anti-acne/antibacterial/anti-sebum
  • discourages melanocyte grouping

In the right form and dosage , topical Vitamin A offers incredible results in the treatment of acne, rosacea, hyperpigmentation, loss of skin tone, wrinkles, and virtually any skin condition.

The effects of topical Vitamin A do not last long after you stop applying it topically. Vitamin A is available in many forms.The following chart shows the most commonly used forms, with retinoic acid on the right hand side being the form that is active and produces results in the skin:

Retinyl palmitate <=> Retinol <=> Retinaldehyde => Retinoic acid

Retinoic Acid

This is the acidified form of Vitamin A. Retinoic acid is the only form that produces the results in the skin, however retinoic acid will remain in that state and is incapable of reverting back to the other inert forms. This makes retinoic acid the most powerful and most irritating form of topical Vitamin A. There is a limit to how much retinoic acid the skin can use and whatever retinoic acid is left over simply hangs out on the surface of the skin causing irritation in the form of a little red bumpy rash often called a “Vitamin A” rash. Long term compliance is often low with retinoic acid due to the side effects. The following are some common prescription topicals:

Retin A
Indicated for Acne
Generic Name: Tretinoin Strengths:0.01% Gel; 0.025% Gel; 0.025% Cream; 0.05% Liquid; 0.05% Cream; 0.1% Cream; 0.1% Micro Gel

Avita
Indicated for Acne. As it’s generic is tretinoin, similar skin rejuvenation use considered appropriate
Generic Name:
Strengths:

Differin
Indicated for Acne
Generic Name: Adapalene
Strengths: 0.1% Gel; 0.1% Solution

Tazorac
Indicated for Psoriasis and Acne. Good for those with chronically oily skin or severe blackhead form of acne. Pending indication for skin rejuvenation.
Generic Name:Tazarotene
Strengths: 0.1% Cream; 0.1% Gel; 0.05% Cream; 0.05% Gel

Renova
Generic Name: Tretinoin
Strengths: 0.05% Cream; 0.025% Cream

Retinaldehyde (Retinal)

This is the vitamin A form that is found on the retina of the human eye. Retinaldehyde is an aldehyde that readily converts to retinoic acid via oxidation. A usable amount of retinoic acid is converted from the retinaldehyde and the rest converts to retinyl ester form that is less irritating to the skin. Thus retinaldehyde is less drying and irritating  than pure retinoic acid, but more so than retinol. Retinaldehyde is also less potent than retinoic acid and more potent than retinol. A beginning dose is 0.05% Retinaldehyde, maintenance 0.1%, and a short term aggressive dose 0.2%.

Retinol

This is the next form of Vitamin A down the line and is an alcohol. Again providing less irritation but also less impact than the first two forms. This is the most common over the counter version of topical Vitamin A. A beginning dose of retinol in a serum or cream is 2%, maintenance is 4%, and short term aggressive dose is 8%.

Retinyl Palmitate (and Retinyl Acetate)

This is an ester form of Vitamin A and the most abundant form found in the human body. It is the least irritating but also the slowest acting of the topical Vitamin A choices.

What should I use?

From a holistic point of view, the most effective intervention is the one that gives you the most positive results with the least negative results. The severity of the condition, the sensitivity of the skin, lifestyle, and the mindset of the individual are all important factors in making the right choice. Keep in mind that irritation is aging and will thin the skin and aggravate inflammatory conditions such as acne and rosacea. It is important to build on one thing without destroying another. It is my opinion that amazing results can be obtained from milder forms of Vitamin A, only it might take a little longer to achieve those same results. Severe scarring acne may require a strong intervention such as Accutane, halting the scarring. However, after the course is over, extra effort must be placed in cleansing the liver and balancing the skin so that the acne doesn’t return with a vengeance later on.

Cautions

With any form of topical Vitamin A, the product should be introduced slowly, either every 2nd or 3rd night. As the skin becomes more active and accustomed to Vitamin A, it can handle more frequent use.

Topical Vitamin A increases sun sensitivity and is more safely used at night. Always wear sun protection of at least an spf 15, or ideally spf 30, while on a Vitamin A regimen.

Avoid during pregnancy. Though there are no studies linking birth defects to the use of topical Vitamin A, excessive amounts of internal Vitamin A does cause severe birth defects as is the case with taking medications such as Accutane. The Department of Health recommends that pregnant women or those seeking to get pregnant should not take more than 800ug of vitamin A daily (internally). This does not apply to Vitamin A found in beta carotene.

Just because Vitamin A is listed in the ingredients doesn’t mean that there is a sufficient quantity to be therapeutic or that it is in a form that is deliverable to the cells.

References

http://www.smartskincare.com/treatments/topical/retinol.html

http://www.dermadoctor.com/article_Retin-A-Vitamin-A-Creams_63.html

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