The truth about vitamin A skincare

Vitamin A has long been a hot ingredient in the cosmeceutical skincare industry, with many professional brands using it as one of their main weapons for fighting the signs of ageing. “Vitamin A has been clinically proven to stimulate the fibroblast cells, which are responsible for collagen, elastin, hydration and cellular turnover – returning skin to a more youthful state,” claims Victoria Hiscock, product and education specialist for Alumier Labs UK.

Despite the pro brands singing the praises of retinoids (which are derived from vitamin A), many consumers are unsure if the ingredient is their friend of foe, because of the reaction it can cause in the skin. Known as the retinoid effect, it can leave skin red, flaky and extremely irritated. “There’s a market of people out there who are nervous about using retinoids because they’ve heard that they are irritating,” says Elliot Issacs, founder of skincare brand Medik8. But with new formulations promising to be just as effective but with less irritation, are we welcoming in a new era of vitamin A skincare?

The different forms

There are many forms of vitamin A but the ones most commonly used in skincare are retinol (alcohol form), retinoic acid (active form), retinaldehyde (aldehyde form), and retinyl palmitate and retinyl acetate (ester forms). “Every retinoid works to give the same effect on the skin but they have their own personalities, if you like. So some are more effective while others have fewer side effects or require less conversion,” explains Issacs.

The most popular form is retinol – “the entire vitamin A molecule, which is known as the ‘gold standard’ in professional skincare,” according to Hiscock. It has been proven to increase natural cell turnover rate, exfoliating the skin in the process, which can cause inflammation and swelling.

“It’s one of the most useable forms. It’s relatively stable but needs to be converted inside the skin cell into retinoic acid – the only form of retinol the body can use,” says Issacs. “Retinoic acid is biologically active, so it gets transported into the cell nucleus and, from there, proteins are manufactured that effect all the changes in the skin.”

Because it’s the strongest form of vitamin A, retinoic acid, in its own form, is only available as prescription medicine. “Less and less Tretinoin (the pharmaceutical form of retinoic acid) is being prescribed because dermatologists and cosmetic doctors are finding there are forms of retinol, or combination treatments with retinol and other ingredients, that are as effective as prescription-only forms of retinoic acid but without the side effects,” explains Lorna Bowes, managing director of Aesthetic Source, the distributor of professional skincare brands Exuviance and Neostrata.

Retinaldehyde is the transitional form of vitamin A – when retinol is converted into retinoic acid – and is typically used in skincare because it’s “only one metabolic step away from retinoic acid,” says Issacs. “But it has limitations; it’s hard to stabilise in a product formula, so by the time a client gets to use it, there’s less retinol in the product than would perhaps be desired.”

Esters retinyl palmitate and retinyl acetate are the most stable forms of vitamin A and are generally easier for the skin to tolerate, “resurfacing and benefitting the skin greatly but with no real side effects,” says Jacqui Faucitt, chief executive of RégimA Global, which manufactures a skin rejuvenation and treatment range for doctors and skincare professionals.

“The ester forms are much gentler because they have a fat attached to them, which makes them far less irritating,” adds Tracy Tamaris, director of the International Institute for Anti-Ageing (iiaa), which distributes skincare brand Environ. “Retinyl palmitate also specifically acts as a powerful natural sunscreen by absorbing UV rays and protecting DNA from damage.” However, Bowes believes the esters’ gentler nature means they’re not as effective: “Although you don’t get the side effects, more often than not you also don’t get the clinical results.”

Retinoids’ reputation

One of the biggest concerns about vitamin A is that it can cause irritation to the skin. However, Hiscock explains that if the skin has been gradually conditioned to it, the retinoid effect is less likely to occur. “If somebody’s skin isn’t well acclimatised to retinoids then the body may find it traumatic, sending a lot of blood to the area in order to cope with what’s happening. This brings with it heat to the skin, and because lots of white platelets and natural antibodies start fighting the inflammation, you tend to get swelling.”

There’s also the argument that the more damaged a client’s skin is the more reactive it’s going to be “because there are no vitamin A receptors in the cells, so it’s like giving the skin an overdose,” says Tamaris. “The whole reason our skin becomes wrinkled, pigmented, old, thick and dull is because we have no vitamin A in it – it’s been depleted through years of sun exposure and abuse. That’s why we recommend client’s start on a low level and build up their tolerance.”

Medik8 recommends clients start at 0.1% of retinol “and use that every other night until the client is comfortable, then gradually increase the frequency,” says Issacs, while Hiscock says she uses 0.5% as a baseline, which she asks clients to fluctuate above and below. “So, if I have somebody who has bad acne or very photo-damaged skin, I’ll ask them to begin on the 0.5% to start getting results. Then, when I see them, I drop them back down to a 0.25%,” she says.

Most of the pro brands offer a step-up programme that can range from 0.25% to 1%, but Faucitt believes “the main thing people need to know is that you don’t need a high concentration to get the action. Start low and work your way up.”

Game-changing formulations

The industry has seen a lot of new formulations launch this year that promise to tackle common skin conditions such as acne, ageing and pigmentation without triggering the dreaded retinoid effect. “The current vitamin A holy grail is to produce a retinol that actually gets through the skin barrier and into the cells where it’s going to create its function, without damaging on the way,” says Bowes.

As a result, one of the biggest trends at the moment is microencapsulated retinol. “Rather than the retinol being loose in the bottle and delivered into the skin in one go, it’s drip-fed,” explains Hiscock. “You don’t get such a big dump of retinol in one, which reduces irritation, and there’s also a much higher metabolic uptake because the body can actually use all that vitamin A, so drip feeding actually makes it more effective.”

Another game-changer is a new class of retinoids called “retinoics” – where retinoic acid is used in combination with another molecule. For the past two years Medik8 has been working on an ingredient called retinyl retinoate – a new molecule that’s a hybrid of retinol and retinoic acid, which it launched this year in its r-Retinoate product.

“It’s biologically active just like retinoic acid so it doesn’t need to convert – it works directly on the cell nucleus,” explains Issacs. “It’s the interesting aspect of the molecule and why we think, in low doses, it doesn’t cause any irritation – it’s all being used up by the cell nucleus so there’s none left over to cause a reaction.”

How vitamin A works for...

Acne – “It stimulates the function of stem cells and improves skin tissue, helping to heal lesions,” explains Hiscock.
Lines and wrinkles –
“It increases cell turnover and the speed that the cells at the bottom of the epidermis travel to the top, resulting in younger looking skin,” says Bowes.
Pigmentation –
“It works by removing dead skin cells from the surface that might be pigmented,” adds Hiscock.