Ida is a certified aesthetician (graduate of Marvel School of Beauty), offering home-based services since 1994. Ida provides various holistic services; she graduated from Zanqara’s Holistica Skin Care’s Dermatician course in 1994, which required her to understand homeopathic remedies.
Move over, Vitamins C & E. There's a new "miracle" vitamin in town that has taken the skincare world by storm. Vitamin A! Chances are that you've probably heard of names such as Retinol, Retinal, or Retinoic Acid when it comes to skincare ingredients, but what you may not know is that these names all fall under the umbrella term called "Retinoids" that are derivatives of Vitamin A. What makes Vitamin A so miraculous and so popular today is because of its skin-regenerating benefits when it comes to anti-aging and fighting acne.
Trying to decipher the terminology of the various skincare forms of Vitamin A and their levels of potency and efficacy, since not all Retinoids are created equal - can be confusing for the average consumer trying to navigate what is best for their skincare regime. Fasten your seatbelt, as this in-depth post will not only give you the lowdown on the different synthetic forms of Vitamin A available on the market today but also give you some natural plant-based alternatives! As a Certified Holistic Aesthetician, I strongly recommend that to make the right choice when it comes to skincare products and their ingredients; consumers must have all the information necessary to make the best-informed decision and to help prioritize health and safety even in a skincare beauty routine!
Vitamin A: Health benefits & risks
Before delving into the different skincare forms of Vitamin A, let's talk about Vitamin A itself! Vitamin A is an essential, fat-soluble vitamin. This fat-soluble vitamin has fat globules that travel through the small intestine to be absorbed and, once converted, can be stored in the liver. Remember that vitamins listed in the micronutrient category represent organic molecules that we need in small amounts for essential metabolism and functioning; thereby, the health benefits of Vitamin A in terms of consumption are significant! Retinoids provide immunity, general body growth, organ health and development, support reproductive health, and the eye's retina requires Vitamin A for vision. To obtain natural Vitamin A, include wild-caught fish/fish oils and organic fruits and vegetables in your diet.
However, consumers in wealthy nations need to be aware that significant risks may result, such as toxicity in the over-consumption of synthetic Vitamin A, especially in fortified foods, high-dose Vitamin A supplements and prescription medications, since toxicity results as it accumulates in the body's fat. Toxicity can cause everything from severe headaches to issues with coordination and beyond. Pregnant women should avoid these high doses, as they can cause severe congenital disabilities in the baby. (You can read more about Vitamin A toxicity here):
High intakes of natural Vitamin A found in plants, fruits, and vegetables do not pose the same health risks or problems as synthetic forms in supplements. The body converts carotenoids (pigments found in plants, fruits, and vegetables that give them their colour) into Pro-vitamin A. Twelve units of beta-carotene, as found in carrots, is equivalent to one unit of retinol. Consumption of carotenoid-rich foods converts to pro-vitamin A, which the body may convert to vitamin A if required. The body slows this process when its stores are saturated, so toxicity does not result.
Health benefits of topical vitamin A include (results vary with potency, efficiency and type of Retinoid)
Gives the skin a stronger foundation in terms of cellular turnover
It evens skin tone and enhances skin texture.
Improving and reducing hyperpigmentation, acne scars, sun damage, and age spots
Reducing fine lines and wrinkles
Helping to give the face a more 'lifted' appearance by stimulating collagen production
Removing damaged elastin fibres (that help with skin elasticity) and promoting the production of new blood vessels
As previously mentioned, carotenoids are pigments from plants, fruits, and vegetables that the body converts into Pro-vitamin A. They help protect from skin pollution and UV radiation/damage, giving it a healthy and youthful glow.
It unclogs pores that may become acne by shedding surface skin cells and removing dirt, oil, and dead skin cells.
They have a gentler effect of interacting with specific nuclear receptors, Retinoic Acid Receptors (RARs), and Retinoic X Receptors (RXRs) to regulate genes and cellular processes
Potential risks can also occur when it comes to the topical application of Synthetic (lab-made) Retinoids derived from Vitamin A, such as those found in skincare products and prescriptions. Before discussing their risks, let's look at the production methods of Synthetic Retinoids and their different forms for skincare usage.
Synthetic retinoids
Some synthetic retinoids are derived from natural vitamin A in labs, mimicking Vitamin A's natural molecular structure, and some are not. In the lab, they can also produce varying levels, from weak to strong, depending on the consumer's various and individual skincare needs.
There are four main categories of Synthetic Natural Retinoids: Retinol Esters, Retinol, Retinaldehyde, and Retinoic Acid. The first three are available in over-the-counter skin care products, except for prescription Retinoic Acid and Isotretinoin. They aim to bind to and stimulate the skin’s Retinoic Acid receptors, which affect the skin’s DNA, and change its look and feel to promote varying skin benefits, as previously mentioned.
However, no matter what type of Retinoid you apply topically, your skin can only use its most biologically active form, Retinoic Acid. Retinol Esters, Retinol, and Retinaldehyde all need to first convert to Retinoic Acid directly on the skin's surface, and the more steps it takes to transform, the weaker (and therefore gentler) it will be.
Over-the-counter (OTC) synthetic retinoids
Starting on the scale from the least irritating/potent to the most irritating/potent to the skin, here are some of the most popularly known OTC Retinoids:
Retinol esters
When applied to the skin, Retinol Esters, the least potent form of retinoids, take three steps to transform into Retinoic Acid. First, they convert to retinol and then retinaldehyde before becoming the active form of retinoic acid.
The three main Retinol Esters, from the least effective to the most effective, are as follows:
Retinyl acetate is the smallest form of these Retinol Esters and the least effective one.
Recommended use: Ideal for first-time Retinoid users or people with sensitive skin should start with retinol esters, and with consistent use, they can help with premature aging skin concerns, uneven skin tone, and milder forms of acne.
Retinyl palmitate (although a lot of products contain this; a study revealed that it thins the skin and predisposes one to skin cancer. Its micellar water-soluble version is significantly more toxic than the oil-soluble version – more on that later under the heading of “Risks & Precautions When Using Synthetic Retinoids")
Retinyl propionate (found in a lot of different over-the-counter products)
Retinol
It is the most popular form of Retinoid for overall skin health and its anti-aging benefits (after sun protection products). Retinol regulates cell turnover, promotes effective exfoliation, prevents acne, evens skin discoloration, controls oil, smooths fine lines and wrinkles, and unclogs pores.
Conversion process: It takes two steps to convert into Retinoic Acid. It is approximately 10 to 20 times less potent than Retinoic Acid. Still, consistency is vital because, over time, it can build up to be as effective as Retinoic Acid with consistent use.
Side effects: It can irritate and dry (causing even skin to peel) for people with more sensitive skin. Dermatologists recommend slowly building up tolerance by mixing it with a moisturizer or starting to use it one or two nights a week.
Retinaldehyde (Retinal)
The strongest over-the-counter Retinoid, not to be confused with retinol. It regulates cell turnover, promotes exfoliation, prevents acne, evens skin discoloration, controls oil, smooths fine lines and wrinkles, unclogs pores, and is gentler than pure Retinoic Acid.
Conversion process: It takes one step to convert into Retinoic Acid, which makes it more potent than Retinol Esters and Retinol.
Side effects: Similar to Retinol, it can cause irritation and dryness.
OTC synthetic retinoids to consider
Retinoic acid esters
Relatively new form of Retinoids, which fall somewhere between Retinol and Retinoic Acid on the irritation/potency scale from least to most. They are effective for a wide range of skin concerns and are reasonably gentle. Studies show they increase cell turnover, stimulate collagen, control acne, soften fine lines and wrinkles, fade pigmentation, and produce glowing, youthful skin.
Examples:
Retinyl retinoate: When it interacts with the skin, it converts into retinoic acid and retinol. It offers immediate and delayed benefits as the retinol converts to retinaldehyde and then retinoic acid.
Hydroxypinacolone retinoate (HPR) (granactive retinoid): Binds directly to Retinoid receptors without conversion to Retinoic Acid.
Side effects: Retinoic acid esters demonstrate the promise of being more active than retinol without irritation (although they list side effects such as flaking, skin irritation, and redness).
Adapalene
Adapalene is derived from Napthoic Acid and is not converted to Retinoic Acid before it becomes active.
Many uses: Since Adapalene regulates cell turnover and decreases inflammation, it has become the new "wonder" ingredient for treating acne. It prevents new acne formation and evens skin texture and tone. It's used in anti-aging topicals to prevent and treat dark spots, fine lines, and wrinkles.
Adapalene is considered the first OTC treatment to contain a prescription-strength Retinoid that fights acne; it is also considered the weakest (and, therefore, gentlest) for anyone with sensitive or acne-prone skin.
Side effects: These include a burning sensation or stinging of the skin, dryness, peeling, and redness. A dermatologist will consider prescription options with higher doses.
Availability: It is a reasonably priced OTC and is also available in prescription form.
Tazarotene (Tazorac)
The most potent topical Retinoid. It is used for skin concerns such as acne and psoriasis by slowing skin cell overgrowth and decreasing skin cell inflammation.
Uses: It improves photo-damaged skin, tightens and evens out skin pigmentation, and smooths fine lines.
Forms: It is available in formulations such as creams, foams, and gels - with gels being the most irritating.
Side effects: Tazarotene can be incredibly drying, even more so than Tretinoin.
Prescription synthetic retinoids
Prescription Retinoids are the most potent, with more significant side effects due to their greater potency and efficacy. Vitamin A toxicity can even result from medications.
Tretinoin
Tretinoin the topical form of Retinoic Acid, the active form required on the skin. It begins to work on cellular renewal and repair right away, but that also means that it has more potent side effects than its weaker counterparts.
Side effects: Expect dry patches, irritation, flaking, mild redness, and possibly an acne purge.
Use: Start slowly with two to three applications per week. Combining it with an oil-free moisturizer can help the skin adapt.
Availability: Retinoic acid can only be obtained via prescription (usually given when gentler over-the-counter treatments have failed).
Again, a study revealed that it can predispose one to skin cancer (more on that later under the heading of "Risks & Precautions When Using Synthetic Retinoids").
Retinoic Acid treatments can address more severe skin conditions like cystic acne and signs of aging, hyperpigmentation, and melasma. They increase collagen production, which improves skin tone and reduces fine lines and wrinkles by producing new blood vessels in the skin. They also fade age spots and soften rough patches of the skin.
Isotretinoin (Accutane)
It is a potent ingestible Retinoic Acid capsule reserved for severe and resistant forms of acne.
Side effects include dry skin of the eyes, nose, and lips, muscle aches, joint pain, calcification of tendons, and disorder with connective tissues between bones, tendons, or ligaments, among other numerous issues.
Monitoring: Monthly monitoring of the patient's bloodwork ensures that the patient can tolerate this medication.
Trifarotene is a newer, relatively gentle prescription retinoid for acne treatment. It is the next step up from Adapalene and one step below Tretinoin. It sheds dead skin cells, unclogs pores, and helps prevent new acne formation with less irritation.
Use: It is also great for chest, shoulders and back acne.
Precautions: Use an oil-free moisturizer to reduce dryness, redness, peeling, burning, or stinging when needed. Protect your skin from extreme weather elements, even on cloudy days, as your skin will be more prone to sunburn, dryness, or irritation.
Risks & precautions when using synthetic retinoids
We know there are potential side effects with each form of synthetic Retinoid. Dermatologists state that Prescription Synthetic Retinoids should only be used at night because sunlight affects these forms and breaks them up, rendering them ineffective and inactive. However, some dermatologists also recommend that OTC Synthetic Retinoids that can be used both in the morning and evening should still be used only at night -this is because it not only simplifies their patients' skincare routines and keeps them consistent, but the motto "less is more" ensures that there is less risk of any detrimental side effects to their patient's skin. Dermatologists also state that ALL Synthetic Retinoids (not just the prescription ones) should not be used during pregnancy or when breastfeeding. Yet, Synthetic Retinoids can also pose other more significant risks and precautions, including those from other regulatory professionals:
General guidelines
Avoid using on irritated, burned, or injured skin.
Do not apply to premature skin, mucous membranes, or under a dressing.
Avoid using it too close to the eye or on damp skin.
Do not use it if you are prone to dry eyes.
Avoid using at the same time as aggressive ingredients, such as Vitamin C, Glycolic Acid, Lactic Acid, Salicylic Acid, and Benzoyl Peroxide.
Please do not use it on infants and young children.
Apply moisturizers or Hyaluronic Acid before applying, and wash them off at night.
Follow the manufacturer's recommendations to avoid toxicity.
Manufacturer and regulatory guidelines
Manufacturers recommend the cautious use of strong Retinoid creams in fine print. Health Canada limits cosmetic manufacturers to producing a maximum dilution of 1% Retinol (Synthetic Vitamin A) and its Esters and .05% Retinal—retinaldehyde (Synthetic Vitamin A). Health Canada has also scrutinized Retinoic Acid and its salts, including Hydroxypinacolone Retinoate.
Global retinoid production & sales
Some manufacturers have discontinued production of Tretinoin products in .1%, .05%, and .025% dilutions globally. Other countries have also restricted the use of certain Retinoids.
Environmental Working Group (EWG)
The EWG realizes that excessive topical application of fat-soluble synthetic Vitamin A products penetrates the skin and can over-accumulate in the body's fat cells. EWG recommends that North American consumers avoid cleansers, toners, sunscreens, moisturizers, and lip products that contain Synthetic Vitamin A, Retinyl Acetate, Retinyl Palmitate, Retinol, Retinyl Linoleate, and Retinoic Acid. Retinol crosses the placenta barrier and is transferred from mother to child during pregnancy and nursing. The EWG, dermatologists, and doctors recommend discontinuing synthetically produced Vitamin A during pregnancy and nursing.
Cosmetic Ingredient Review and the Environmental Working Group
They have data-based information on the safety of ingredients in commercial products. Their links are below for you to review:
According to the EWG, synthetic retinol & its derivatives are linked to
Sped-up development of skin tumours
Cell mutations and cell death
Reproductive issues (which is also, especially why pregnant women should avoid using)
Specific forms of Synthetic Retinoids can also pose health concerns and are carcinogens. The National Toxicology Program of the US National Institutes of Health conducted a 2012 Retinol Photocarcinognic Study and found that skin creams containing Retinoic Acid or Retinyl Palmitate can elevate the appearance of cancerous tumours when exposed to sunlight.
While retinyl palmitate is in the weakest category of retinoids, its "micellar" water-soluble version is significantly more toxic than its oil-soluble counterpart.
Transretinoic acids (commonly known as Tretinoin) are banned in the European Union for cosmetic use and are on a restricted use list in Canada.
EWG's Skin Deep Database is an excellent source for tracking the safety of ingredients and products. Synthetic retinol and its derivatives, Retinyl Palmitate and Retinyl Acetate, register as a 9 in their database (with ten being one of the worst/most toxic scores an ingredient can receive).
In aesthetic practices
As an experienced Holistic Aesthetician, I have observed my clients' challenges when using Synthetic Vitamin A - the skin rips or bruises during waxing sessions. There are limitations with performing Intense Pulsed Light (IPL/Laser), which uses light-based technology on clients who use Synthetic Retinoids. Have you had an experience with a Synthetic Retinoid product that has irritated your skin, especially during similar treatments and wondered why?
Impact of retinoic acid on healthy skin
In healthy skin, Retinoic Acids bind to nuclear receptors such as Retinoic Acid Receptors (RAR) and Retinoic X Receptors (RXR) to control the expression of various genes critical to interacting with different body parts and, in this case, maintaining healthy skin. Synthetic Retinoids such as Retinol or Retinal are more stable and aggressively target RAR and RXR nuclear receptors. The body does not recognize these stripped chemicals, as they take longer to assimilate, so they accumulate.
Since these products have a longer shelf life, excessive use of Synthetic Retinoids can cause Vitamin A toxicity.
Concerning Remodeling Collagen (the main structural protein found in skin and other connective tissues that lasts twenty years) and Elastin (a protein forming the main constituent of elastic connective tissues, especially in the dermis of the skin that lasts seventy years), Matrix metalloproteinases (MMPs) enzymes recycle old or damaged Collagen and Elastin Fibres to make new Collagen and Elastin Fibres. They are also responsible for cell growth, movement, differentiation, blood vessel formation, programmed cell death, and immune defence. Matrix Metalloproteinases MMP enzyme's activity in healthy connective tissue remodelling is low and high in unhealthy conditions. Again, Synthetic Retinoids are more aggressive and, with excessive use, can have the following effects:
Disrupt the MMP enzymes, reducing necessary Collagen breakdown and causing the accumulation of old Collagen fibres, which contributes to skin thinning, aging, and fibrosis, especially in aged or sunburned skin
Excessive Synthetic Retinoids slow wound healing by inhibiting MMP involvement in skin repairs and altering cell growth patterns
Increased cell turnover can cause complications
Increased cell turnover results in Photosensitivity because it indirectly loosens the connection between the skin's dermis and epithelial layer. As the Keratinocytes (epidural cells that produce Keratin, a fibrous protein) move up to the top of the epidermis, they do not mature to UV-protecting Corneocytes on the outer skin, resulting in skin that is sensitive to light.
Transitioning clients to Zanqara, the skincare line I use in my profession, which uses plant-based natural Vitamin A instead of synthetic versions, improves skincare experiences, making waxing and Intense Pulsed Light IPL (Laser) more effective.
To set up a Zanqara account and make purchases, visit here
or here and email info@zanqara.com
Use Promo Code IDA10 to get 10 % off your first purchase.
NB. The Food and Drug Administration requires me to state that cosmetic products do not diagnose, treat, cure, or prevent disease.
Natural plant-based retinoid alternatives: Retin-Alts
Natural Plant-Based Retinoid Alternatives (Retin-Alts) offer similar benefits to Synthetic Retinoids without the associated risks and side effects.
If reading all these potential side effects, risks, and precautions concerning Synthetic Retinoids leaves you feeling concerned and skin-weary, then keep reading! Your first course of action should be to jump into a natural skincare routine by swapping out those Synthetic Retinoids for natural, plant-based forms of Vitamin A, which provide all the fantastic benefits because they contain antioxidants, enzymes, coenzymes, minerals, and phytochemicals that enhance its metabolism and are significantly gentler on your skin!
Natural plant-based Retinoid Alternatives, aka "Retin-Alts," do not have photosensitive issues with daytime use. In most cases, you can feel safe using them during pregnancy (but please confirm with your doctor first!).
No documentation states that natural vitamin A for skincare affects wound healing or increases cell turnover complications. Carotenoids are beneficial for the skin and health issues when used in the correct proportions.
Factors affecting vitamin A
Natural Vitamin A is less stable and has a shorter shelf life, so there is no risk of accumulation or Vitamin A toxicity. Vitamin D counteracts vitamin A. Sunlight initially stimulates the breakdown of natural vitamin A, which eventually becomes the active form of retinoic acid utilized in the skin and body.
Ingredients to look for
Bakuchiol is taken from the Indian Babchi plant, a traditional Ayurvedic and Chinese medicine used throughout history. It has anti-inflammatory properties that soothe redness and acneic skin. A research trial compared 0.5% Bakuchiol and 0.5% Retinol, dermatologists could not tell the difference with their wrinkle smoothing. The best news? Those who used Bakuchiol reported fewer adverse side effects, which is also considered safe during pregnancy or breastfeeding.
Pure rosehip oil has Vitamin A. It reduces the formation of wrinkles, treats acne, and reverses sun damage.
Pumpkin oil or powder both contain vitamin A in the form of Beta-carotene and Vitamins B, D, and E. Natural skin care products use it for its high Zinc content.
Apricot kernel seed oil is a carrier oil containing large amounts of Vitamins E and A. It helps the skin's protective barrier, increases cell production, and diminishes fine lines and wrinkles.
Buriti. This tree, nicknamed the "tree of life," is native to the Amazonian forests." It contains a great deal of Vitamin A and rehydrates dry skin.
Carrot oil is a carrier oil rich in Vitamin A and promotes youthful skin. (Do not to be confused with Carrot seed oil)
Camellia oleifera seed oil. This amazing dry oil contains Vitamins A, C, D, and E. It also includes a high amount of Oleic Acid, which replenishes moisture.
Cranberry seed oil has a high amount of Vitamin A and greatly relieves dry, itchy skin.
Sunflower oil has high Vitamins A, B, D, and E content. It nourishes dry skin and is helpful for Psoriasis and Eczema.
As an Amazon affiliate member, I have included a short list of some of the natural sources of Vitamin A skincare alternatives found on Amazon:
Conclusion
Retinoids can be manufactured in laboratories as synthetic forms of Vitamin A or found in nature. Synthetic Retinoids were invented in 1971 to address acne concerns, but today, medical professionals prescribe Synthetic Retinoid-based skincare products for fast and easy skincare results such as anti-aging, acne prevention, scar reduction, pigmentation lightening, stretch mark reduction, psoriasis, and for some forms of cancer. It has become the go-to shortcut. Manufacturers in wealthy nations like North America prefer synthetic retinoids due to their long shelf life. Fortified convenience foods, affordable vitamins, and skin care make claims to achieve the fountain of youth.
As consumers, we should recognize that there is a global trend towards reducing specifically available concentrations of Synthetic Retinoids and that in our country, Health Canada is doing this with good reason. Consumers can choose to substitute Synthetic Retinoids that can contribute to Vitamin A toxicity if not used with knowledge, within reason, and good judgment. Suppose consumers educate themselves and opt for natural plant-based retinoid alternatives, aka retin-alts that can give similar results. In that case, they can also influence manufacturers' decisions about the availability of retinoid alternatives due to consumer needs.
When it comes to choosing Synthetic Retinoids over natural plant-based alternatives, consumers only need to ask themselves one important question: In the long run, is purchasing a skincare product or medication that gives you a youthful appearance but is toxic and that could eventually cost you your health worth the risk when other options are available that are just as effective? Related Article you may enjoy: Exfoliation – A Guide To AHAs, BHAs, And Enzymes For Youthful, Healthy Skin
Ida Fanelli, Aesthetician, Reflexologist, IPL Technician
Ida is a certified aesthetician (graduate of Marvel School of Beauty), offering home-based services since 1994. Ida provides various holistic services; she graduated from Zanqara’s Holistica Skin Care’s Dermatician course in 1994, which required her to understand homeopathic remedies. Ida has been a certified reflexologist since 1993 (graduate of D’Arcy Lane Institute). She has also been practicing Healing Energy since 1998 and has added the Ion Cleanse Foot Detox to her therapies. In 2012, Ida became a certified Sharplight Laser (IPL) Technician. She enjoys learning new techniques which can benefit her clients. In 2019, she received certification from the Center for Pain and Stress Research (CPSR.) She can now speed up the healing of scars and help with pain caused by surgical scars to her list of specialties.
She enjoys continuing her education in the complementary health field. Many can testify that Ida is committed to ensuring her clients access adequate and affordable quality service and treatment.
Beyond her many years of experience as a holistic practitioner, Ida draws on her 12 years of experience as a hospital laboratory technologist in Microbiology and Biochemistry.
References:
https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/carotenoids
https://www.westonaprice.org/health-topics/cod-liver-oil/cod-liver-oil-manufacturing/#gsc.tab=0
https://www.ewg.org/skindeep/ingredients/705544-RETINYL_LINOLEATE/
https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/
https://www.who.int/tools/elena/interventions/vitamina-pregnancy
https://www.womenshealthmag.com/uk/beauty/skin/a45201814/retinol-around-eyes/
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/604850
https://skinwellness.com/learn/the-ultimate-guide-to-understanding-the-hierarchy-of-retinoids/
https://www.shoppersdrugmart.ca/en/health-and-wellness/resources/drug-database/drug/961
https://www.drugshortagescanada.ca/ingredient/346?shortage_page=5
https://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=16448&lang=eng
https://globalnews.ca/news/9538843/skin-lightening-products-health-risks
https://www.frontiersin.org/articles/10.3389/fcell.2020.573230/full
https://www.healthline.com/health/best-form-of-vitamins-for-absorption#faq
(glooshi.) (INCI Decoder) (Stratia) Skin Wellness Dermatology, Stratia
(Wikipedia) (Pediaa.Com). Paula’sChoice | Shop Paula's Choice) (Pediaa.Com).
(Pediaa.Com). Paula’sChoice.
https://www.completefoodsnutrition.com/blog/the-differences-between-synthetic-and-natural-vitamins
The Root Cause of Fatigue with Morley Robbins: Episode 2 The Myths Around Vitamins C and A
Comments