Vitamin A: Myth vs Facts Retinoic Acid & Natural Retinols

Vitamin A has become the go to source for most skin concerns. Wrinkles? Sagging skin? Apply some Retinols! Acne and breakouts? Tazorac! Indeed Vitamin A can be a very powerful active in improving skin health but many people have become a little unclear due to all the noise out there so this is a list of the most commonly asked questions I get.

Why all the different names?

The most common form of active Vitamin A for topical application is Retinoic Acid. It's what you're most likely to be prescribed by your dermatologist, although it might be branded as Retin-A, Renova, Tazorac, etc. For the most part this branding makes little difference and the formulas are pretty similar. Some skin types will take better to others, and most dermatologists (if they're not contracted with a specific brand) are happy to provide you with samples from different brands to try out. It's worthwhile to ask about insurance coverage as some will cover specific brands which can save you a lot of money in the long run.

What does it do?

Retinoic Acid is used to treat wrinkles, fine lines, age spots, sun damage, and acne, so this is why it's seen as a cure all for most skin concerns. Research has shown that retinoic acid restores elastin fibers, stimulates collagen growth, and increases cell turnover which help renew mature skin, making it firmer and more youthful. For acne, the acid helps breaks down dead skin cells and induce new skin cells which helps remove pore clogging debris and heal the marks that zits can leave behind. Stronger concentrations of retinoic acid can also deplete sebum levels which means acne is less likely to be triggered.

What are the side-effects?

Everyone will respond differently to everything. That's just the nature of the beast. Even with different brands of Retinoic Acid, people will respond differently and it has little to do the actual quality of the product. General side-effects of retinoic acid include photo-sensitivity, skin sensitivity, dry skin/flaking, redness, and some people might experience initial breakouts.

What form of retinoic acid should I use?

The ingredients list is only somewhat different and the active Retinoic Acid will be at most at a 5% concentration (though you will very likely start out on something way less concentrated). For dry and sensitive skin types, ask for a cream formula as they're less drying. For acne prone and oily skin, ask for a gel formula as they'll be lighter on your skin.

Start off on the retinoic acid every other night, applying only to the areas you'd like to treat.

Is it true that long term use will make my skin thinner?

This perception mainly comes from the fact that retinoic acid sloughs off dead skin cells, so people think it will just eat away at epidermal layers. This is incorrect. In fact, retinoic acid has been shown to boost collagen synthesis so if anything, you should notice thicker, stronger skin.

Can I use retinoic acid in the day time?

I wouldn't advise it, but if you do, you should absolutely apply a strong sunscreen and stay out of the sun. Retinoic Acid is instable in sunlight meaning at best it will be rendered ineffective, and at worst it will generate skin damage. The photo-sensitivity caused by retinols is attributed to this quality and also that the skin regenerative properties mean new skin is particularly vulnerable to exposure.

I am using products that contain natural retinols, is this different?

Yes and no. There are companies like Intelligent Nutrients, Pai, Ren, and Yuli who use naturally derived retinols. They have similar benefits as retinoic acid but structurally, these are different from Retinoic Acid which is a synthetic chemical. There are some key advantages to using these:

• More readily absorbed, meaning you won't experience the sensitivity/irritation with naturals as you would with Retinoic Acid because these synthetic chemicals are harsher for skin while the naturals are in a form that skin can break down and utilize. 
• More stable under sun light, meaning your skin will not be as prone to photo-sensitivity because the chemicals that cause Retinoic Acid to breakdown under sunlight and be instable are not present in natural retinols. Natural retinols are not only more stable and resist breakdown, but many are anti-oxidants which protect against sun damage and free radicals. 

Like synthetic retinols, these natural retinols have similar benefits for skin. So your skin will experience increased skin turnover which does mean that it will be more prone to exposure. However this is fairly minimal and is generally not the factor that causes discomfort. Applying a sunscreen of SPF 30+ should be enough to offset this. And in Yuli's case their formula also contains skin protecting ingredients such as avocado oil, so they covered their bases to the degree where I am comfortable recommending these products as suitable for day and night use. The minor setback for many of these naturals are that the trade-off to the irritation and sensitivity is that these naturals are not as concentrated as something like a 10% Retin-A Gel, but you will see gradual improvement that could be even more advantageous over long-term comparison since the natural retinols often carry other "phyto-nutrients" that science is only beginning to untap.

Having a natural version of retinols in a concentrated formula gives you the effective power of retinols that us dermatologists love, but in a safer and less irritating way as your skin can more efficiently utilize this stable form. This is one of the reasons why I am an advocate for doing things the natural way.