Origins of skin care: prescription topical Vitamin A

05-23-2020    

One of the most important and basic skin care ingredients is Vitamin A.

Vitamin A belongs to a family of chemicals called retinoids – so called because of their close association with the chemistry of the eye (retina). Vitamin A is essential for the production of certain visual characteristics and almost all skin characteristics.

Vitamin A dates back to 1811 when carotene was isolated from carrots (what gives them their vibrant colour)

In the 1930s scientists realised that ageing skin wasn’t just due to just with chronologic factors but rather to the degradation of Vitamin A in sun exposed skin

They also found that Vitamin A levels in sun protected skin are higher and there is less wrinkling and damage than those in sun exposed skin. That means that UVA and UVB exposure depletes Vitamin A levels in the skin. On the flip side, If the skin is kept sufficiently rich in Vitamin A we prevent the signs of photodamage even when we go out in the sun. It is important to remember that Vitamin A levels can be diminished by UV exposure through windows and glass.

Prescription Vitamin A topicals

Vitamin A for skin care

Vitamin A, what is it and why is it always mentioned in skincare?  Vitamin A is a nutrient that helps support the skin in a myriad of ways. It can help speed up healing, has anti-aging properties, prevents breakouts, and support the skin's immune system.

Additionally, Vitamin A promotes natural moisturizing, meaning it can help to keep the skin hydrated and glowing (all of these benefits are what we search for in a skin care product). It is therefore essential for maintaining healthy skin overall. When you apply Vitamin A to your skin topically, it's readily absorbed because your skin is highly retinoid-responsive.

Why do you need a prescription for Vitamin A cream?

Not necessarily, as there are technically Vitamin A creams sold over the counter. If you are only looking for a moisturizer for example then you would not need a prescription.

However, if you are looking into Vitamin A creams as an option to help with anti aging effects or skin conditions such as acne or psoriasis then absolutely! Speak to a dermatologist for advice about if a prescription cream could help you.

Be careful with purchasing any skincare products over the counter if you have preexisting conditions to ensure that they won’t have any negative side effects.

How does Vitamin A cream work?

Vitamin A creams have been shown to be effective in reducing the appearance of fine lines and wrinkles (something many people turn to skincare products for as they age).

This is because it stimulates the production of collagen which keeps our skin strong and ‘youthful’. Additionally, retinoids like retinol can help improve skin elasticity and sagging by removing damaged elastin fibers and promoting angiogenesis, which is the formation of new blood vessels.

Retinoids promote skin cell turnover, which can help improve hyperpigmentation (dark spots), age spots, and sunspots. They can also lead to a more even skin tone overall. Many creams derived from Vitamin A can help improve acne. They remove dead skin cells and dirt from pores, as well as stimulate collagen and elastin production to reduce the appearance of pores and acne scars.

Topical retinoids can help treat psoriasis by reducing the formation of raised skin patches and inflammation. Tazarotene, a prescription retinoid, helps to slow the growth of skin cells, reduce thickness and scaling, and improve discolouration and swelling when used to treat psoriasis. When used appropriately, Vitamin A can be amazing for your skin to keep it looking healthy.

RETINOIC ACID

Retinoic acid is the active form that acts on the DNA of the cell in our skin.  But even though it's inherent in our skin, retinoid acid when applied to the skin is very often irritating. That's mostly because the skin is not ready to accept retinol if its deficient in vitamin A and its skin receptors. 

Over time with continued use, the skin rebuilds its receptors it will better tolerate retinoid acid in the skin. As doctors, we will often prescribe topical vitamin A in the form of tretinoin (.025% - .1%) and adapalene (.1%).  

It is best to start with the lowest possible dose and increase as tolerated. We would suggest mixing with a bland moisturiser initially to dilute it down and gradually reduce the amount of moisturizer. Another way would be to leave it on the skin for a few minutes and then wash it off.

Are prescription retinoic best? 

Not necessarily. Despite careful introduction, many skins will not tolerate prescription grade vitamin A and cosmeceutical grade would be recommended. 

Tretinoin .5% is available via our website if you have previously consulted our doctors.

What are retinoids?

Retinoids are a group of compounds that come from vitamin A. This means that they have some similarities to vitamin A in terms of structure or function. Retinoids can be natural or synthetic, and they come in many different forms, such as retinol, retinal, and retinyl esters. They are a common ingredient in many skincare products and cosmetics because they can have a positive effect on the skin.

Stronger retinoids are a powerful tool that dermatologists can use to treat a variety of skin conditions. These include common issues as well as more serious problems like certain types of cancer (they are super versatile). 

What are retinoids used for?

Retinol and tretinoin are two of the most common topical treatments for a variety of skin conditions, including: acne, melasma, clogged pores, sun spots and fine wrinkles. With safe and appropriate usage, both of these substances can literally transform your skin.

Prescription retinol cream vs over the counter

Retinol is an ingredient in many different types of skin care products that are available without a prescription (You can find products containing retinol at most major pharmacies). The amount of retinol in a product is usually listed as a percentage (such as 1% retinol). They are marketed for anti aging effects though over the counter products have only small traces of retinol in them. If you are wanting to use it to improve a skin condition then a higher prescription dose is needed to treat skin conditions safely.

What is the difference between retinol and retinoid?

Retinol and retinoid might sound like they should be completely different ingredients, but in actuality, retinol is a type of retinoid. The terms are used somewhat interchangeably, but retinoids are typically stronger and only available through a prescription, while retinol is weaker and some products can be found in over-the-counter skin care.

Tretinoin vs Retinol: Are They Different?

Retinol and tretinoin are both vital nutrients for your skin, but they differ greatly in terms of strength. Retinol is a weaker substance and is fat-soluble, which means it can stay in your body for a long time. Your liver can take this stored retinol and convert it into tretinoin. This is beneficial because our bodies can use the tretinoin for a variety of biological functions. Tretinoin is a more concentrated form of retinol, which makes it a stronger option for skin care. This means that tretinoin can be more effective than retinol for some people but also has a higher risk of side effects. You can buy some non-prescription retinol creams at the chemist as they tend to be more diluted though many retinol creams and all tretinoin creams are prescription only.

Do I Need a Prescription Retinol Cream?

If you are looking for treatments for mild acne, psoriasis, aging skin due to sun exposure or uneven colouring to the skin then retinol creams may be an option for you. If any of this sounds familiar then book an appointment to speak to a dermatologist or trusted General Practitioner. They will be able to speak to you about your experience and advise you on what treatment is best. 

Retinol creams are not suitable for everyone which is why they are often prescribed. If you experience; rosacea, eczema, skin allergies, dry skin, hormonal acne, moderate or severe acne scarring or are pregnant then other treatment options might be needed. 

Retinoid creams can have some nasty side effects for some, especially if used inappropriately! Such as skin dryness, redness, itching and scaling, increased sensitivity to UV light from the sun (also artificial UV light), and eczema flare-ups.

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