The A-B-C's of vitamin A: which version works best

Dr Hannah Sweilam

Vitamin A is a ‘must have’ in your anti-aging skincare arsenal but there are a lot of different types and they aren’t all born equal. Dr Hannah Sweilam explains.

There’s a lot of talk about vitamin A or retinoid creams in anti-aging these days and for good reasons. Retinoid creams are scientifically proven to reduce fine lines and wrinkles. But buyer beware, the retinoid family is a large one. It includes tretinoin (Retin-A), the prescription only version, and its over-the-counter-cousins, retinol (pure vitamin A) and retinyl palmitate, to name a few.

And to complicate things further, they all vary in their effectiveness, so knowing what to look for in a product can be tricky.  But fear not, help is at hand.


Retinoic acid is the key

Vitamin A in the form of retinol is found in the diet (particularly in meat, fish and dairy), and is broken down in the body to form retinoic acid. Retinoic acid is the only form of vitamin A that can act on skin cells to produce anti-ageing effects; any other form must be converted in the body to retinoic acid in order to exert it’s effect.


Retinoic acid stimulates skin cells to produce more collagen and less collagenase (an enzyme that breaks down collagen). This results in skin that is thicker, firmer and more supple.  It also signals to skin cells to grow at a faster rate, bringing new, more youthful skin to the surface more quickly which helps to reduce wrinkles and even skin tone.


So which Retinoid does what?


Tretinoin, the prescription-only retinoid, is considered the gold standard for treating aged skin. It is basically retinoic acid.  When put onto skin, this retinoic acid is able to travel into the deeper layers of the skin and bind directly to cells, which makes it highly effective. It is usually prescribed for as a treatment for acne.


The next best thing is retinol and many skin care companies use this in their products  as it is a non-prescription alternative to tretinoin. Retinol has to be converted to retinoic acid in the body which makes it less potent than tretinoin.  This doesn’t mean that retinol isn’t effective; it means that a higher concentration of retinol is required to produce a similar effect.

Retinol is generally considered to be ten times less potent than tretinoin and in line with this, one study showed that retinol concentrations of 0.25% and 0.5% were as effective as the commonly prescribed tretinoin concentrations of 0.025% and 0.05%, respectively.


On the downside, however, retinol may cause skin irritation and peeling and not everyone can tolerate a higher concentration of retinoid.  But, it’s useful to know that a lower concentration of 0.1% retinol has been shown to improve wrinkles, pigmentation (dark spots) and firmness when applied once daily for eight weeks.  Likewise, another study reports that after one year, 0.1% retinol improved crow’s feet fine lines by  44% and pigmentation by 84%.

So, retinol concentration is important in determining whether a retinol product will be effective, and a 0.1% retinol product can produce beneficial results.  The thing is, not all brands disclose the percentage of retinol in their product on their packaging.  One tactic you can employ is to compare labels to see how high it is on the list of ingredients -the higher on the list means more retinol – or contact the manufacturer and ask.

Another important factor is that retinol is a very unstable ingredient and is easily broken down into inactive substances on exposure to light and air.  This means that the overall formulation of a retinol product, and the way it is packaged, play an important role.

The retinol used in studies is likely to have been well ‘stabilised’, and the same can’t automatically be said of the retinol in every retinol product on the on the market. In terms of packaging, retinol products should be packaged in an opaque container that minimises exposure to air and light (i.e. in a tube or bottle with a pump dispenser; not in a jar or bottle that opens).


Retinyl Palmitate

This is a combination of retinyl and palmitic acid.  After its absorption into skin, retinyl palmitate is converted to retinol, and ultimately to retinoic acid. Since the conversion of retinyl palmitate is longer and more complex compared with that of retinol, the process is less efficient. This means that compared with retinol, even more retinyl palmitate is needed to produce the same amount of retinoic acid.  So an even higher concentration of retinyl palmitate is required for it to be effective.

It’s likely that a lot of products containing retinyl palmitate don’t contain enough for it to be particularly effective.  If it appears far down the list of ingredients, it’s even less likely to have a noticeable effect.


So, where does that leave us?

All in all, prescription tretinoin offers the best chance of reducing signs of skin ageing as it is the most potent and it’s effect does not depend on conversion rates and other factors. But if you’re looking for a non-prescription alternative, a well-designed retinol product, more so than a retinyl palmitate product, is likely to be effective.

When using retinoids, it’s important to exercise particular caution if you have sensitive skin and to remember to protect your skin from UV light. Only use at night and always wear a sunscreen with a minimum SPF30. Also, if you are pregnant of breastfeeding it is best to avoid these products. Always consult your doctor to be sure.


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