Vitamin A and the “latest and greatest” in skin healing

In my previous article I described the healing properties of vitamin A on eyes and skin. Today I’ll share what I learned while digging deeper into the subject of cosmeceuticals, including how you can use and benefit from topical vitamin A ingredients.

First, let me see if can simplify the multitude of marketing claims about skin care products for you.

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What are cosmeceuticals?

I recently attended the 39^th Annual Hawaii Dermatology Seminar largely to satisfy my curiosity about the “latest and greatest” of skin treatments available today.

The scientific meetings got very technical, and would bore you… but when they started talking about cosmeceuticals I knew I wanted to share what they said with you.

Cosmeceutical ingredients are a cross between a cosmetic and a prescription (pharmaceutical) strength ingredient found is skin creams. Cosmeceuticals are powerful anti-aging and healing ingredients, yet the natural ones you can get without a prescription are only allowed to be evaluated and classified based on their ability to improve skin appearance, and skin structure and function, but not for curing or treating disease, as the prescription drugs are.

Cosmeceuticals have a huge presence in today’s marketing materials for high-priced creams, all of which make your skin smoother, softer, and younger-looking.

You’ll see ads claiming to be “…the ONLY wrinkle serum on the market to be formulated with 99% concentration of peptides … considering that the industry standard of peptide concentration for high-end wrinkle creams is ONLY 2-5%!”

Another one states it is the “best” contains 6 different peptides, 4 antioxidants, plus skin hydrators.

But what does any of that mean? It’s important to know how these ingredients work … and if they work.

Antioxidants

• Niacinamide (vitamin B3) 5% was shown to reduce hyperpigmentation (age spots and melasma), red blotchiness, and wrinkles in a double-blind placebo-controlled split face study of women ages 40 to 60 years old followed over twelve weeks. ^[1] Other studies repeatedly prove it has anti-itch, antimicrobial, photo-protective, anti-oil and color-lightening effects depending on its concentration. ^[2]
• L-Ascorbic acid (vitamin C) is a vital nutrient for skin growth and repair, and one of the strongest antioxidants for skin. It is proven to prevent and reduce skin aging, sun burns, hyperpigmentation and wrinkles. It is unstable to exposure to light and air and must be kept in air-tight brown or single-use bottles. It is expensive ($75-$200 for 2-3 month supply). The most effective formulation is 20% at a pH of 2 (very acid).
• Alpha tocopherol (one form of vitamin E) claims to protect skin softness, prevent sun damage and delay skin aging. Human studies showed it did not improve wound healing or reduce scaring after burns. Dermatologists instead often recommend Aquaphor® to protect and smooth skin which contains petrolatum, panthenol (derived from B-vitamin), glycerin, and bisabolol (from chamomile).
• Polyphenols: resveratrol, green tea, soy, and coffeeberry contain polyphenols shown to reduce skin cancer, sun damage, and skin aging. Resveratrol (from grapes, berries, nuts, etc.) is the most potent one when formulated correctly.
• CoEnzyme Q-10 reduced wrinkles in 27% of users over 6 weeks in one study
• Alpha lipoic acid 5% cream applied daily reduced sun damage (photo aging) in a study of 33 women average age 54 years in a twelve week placebo controlled study. ^[3]

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Hydroxy acids such as glycolic acid and salicylic acid are found in creams and also chemical peels to treat acne, hyperpigmentation, and wrinkles. They cause removal of dead surface skin cells from the outermost skin layer. They compare in effectiveness to Retin-A. Be aware of their risk of persistent redness, scarring, or cold sore flare-ups.

• Beauty spas and non-prescription creams contain 4 to 10% concentration for daily use, but be careful if you have very sensitive skin.
• Physicians can use 50-70% concentrations in their office for deeper chemical peels, typically as trichloroacetic acid (TCA) for acne, hyperpigmentation or fine wrinkle reduction. Repeat treatment every 2 to 4 weeks for optimal results.

Peptides induce cells in the skin to produce more collagen, the support structure behind firm and youthful skin. Originally these were marketed for healing stretch marks. Popular peptide creams include Regenerist (palmitoyl pentapeptide-3) by Olay and Strivectin-SD (palmitoyl Oligopeptide) by Klein Becker. Both promise firmer and more youthful skin in 4 to 12 weeks of daily use. The three main peptides are:

• Signal peptides increase collagen formation (e.g. Palmitoyl-pentapeptide, Peptamide-6)
• Carrier peptides activate enzymes to increase collagen and carry trace elements such as copper for wound healing (e.g. glycyl-l-histidyl-l-lysine)
• Enzyme-inhibiting peptides block collagen destruction and also relax muscles like Botox by blocking acetylcholine release (e.g. Argireline)

Growth factors and cytokines are vital molecules for skin repair and reversal of aging. They get depleted with age and current studies prove they increase dermal collagen.

Stem cells from plants, animal, and human fat cells have been proven to increase collagen, decrease wrinkles in just 2 weeks, and promote wound healing. They are found in many serums and creams on the market already.

Here are the cosmeceuticals that have vitamin A in them:

Vitamin A topical creams (retinoids) are natural and synthetic retinoids. Some retinoids are by prescription only.

• Natural retinoids are derived from Vitamin A and you don’t need a prescription to buy these. They are clinically proven to help visibly reduce both fine lines and deep wrinkles. They must be converted into pre-formed vitamin A by your body. From weaker to stronger, these ingredients are: retinyl palmitate, retinol, and then retinal aldehyde (a.k.a. “retinal”).
• Retinoic acid is the strongest natural retinoid. The prescription cream Tretinoin is retinoic acid in pharmaceutical form (Retin-A®, Renova®) and is dosed from 0.02% up to 0.1%. These treat acne and much more.

But now they are being prescribed for fine wrinkles, to lighten skin pigmentation, strengthen skin, and stimulate new skin growth. It also treats keratosis follicularis (small red rough bumps on the back of your upper arms), psoriasis and flat warts.

• Synthetic retinoids (a.k.a. retinoid analogues) are made in a laboratory and act like natural pre-formed vitamin A in your skin. These are by prescription only and (from weaker to stronger) are: Adapalene (Differin®) Gel 0.1% to 0.3%, Tazarotene (Tazorac®) cream 0.05% and 0.1%, and Isotretinoin (Accutane®) pills for severe acne.

Now that you know what these ingredients are, it will help you recognize, and sort out, the claims anti-aging companies make with their products, and advice from your doctor about what to take. This knowledge can also help you decide what might work for you, depending on what part of your skin appearance you want to improve.

In my next article I’ll share with you what I’ve learned about the new home device lasers being used with cosmeceuticals for optimal delivery to your skin. It’s as close as you can get to fillers and Botox injections at home and without needles!

To feeling good and looking good for health,

Michael Cutler, M.D.
Easy Health Options

[1] Bissett DL, Miyamoto K, Sun P, Li J, Berge CA. Topical niacinamide reduces yellowing, wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin.  Int J Cosmet Sci. 2004 Oct;26(5):231-8.
[2] Wohlrab J, Kreft D. Niacinamide – mechanisms of action and its topical use in dermatology. Skin Pharmacol Physiol. 2014;27(6):311-5.
[3] Beitner H. Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoageing of facial skin. Br J Dermatol. 2003 Oct;149(4):841-9.