What is the difference between Vitamin A, Retinol, and Retinoids, and which should I use for my skin?
Retinol and retinoids are both forms of topical vitamin A. Retinols are found in over-the-counter products and are less strong than retinoids. The powerful retinoids such as tretinoin and tazarotene are only available with a prescription, but adapalene (Differin®) is now available over-the-counter.
“In terms of which one to use for your skin, it depends on how sensitive your skin is, and what your goals of treatment are. The biggest side effect of retinoids and retinols is dryness. No matter which one you use, you should start by applying it only two or three nights per week. If your skin is tolerating it and not getting too dry or irritated, you can gradually increase to every night.”
For acne, the prescription retinoids work best. But if your skin is too sensitive, you may want to start with a retinol and work your way up. For fine lines, wrinkles, pigmentation, and texture abnormalities, retinols and retinoids both work, but the retinoids are stronger and will work better if your skin can tolerate it.
As with many treatments, it takes at least 2 months to notice a significant effect. Retinols and retinoids will make your skin more sensitive to the sun, so sun protection is a must.
One of the most common vitamins in skincare products is vitamin C. What does Vitamin C do for the skin?
“Vitamin C (L-ascorbic acid) is an antioxidant, both when ingested in our diet and when applied topically to our skin. The optimal concentration is 10-20%. Anything higher than that does not increase its effects and will likely cause irritation.”
Vitamin C helps prevent damage from free radicals (which can happen from things like pollution or sun damage). It also is anti-aging because it serves as a building block for collagen and it helps to prevent and fade brown spots by suppressing melanin production.
These benefits are maximized when used with daily sunscreen.
What are the benefits of vitamin E? Do you recommend vitamin E in a capsule or as an oil?
Vitamin E is a fat-soluble vitamin. Similar to vitamin C, vitamin E is an antioxidant and anti-inflammatory agent, so these two work very well together.
“Vitamin E is found in our sebum (skin oil) in our skin, thus it is found in higher levels in people with oily skin. For people with oily skin, topical vitamin E may make things worse. As we age, our sebum levels naturally decline, as does our vitamin E level in our skin.”
Vitamin E is consumed in our diet through foods such as sunflower seeds, nuts, avocado, and fish. If your diet does not incorporate foods with adequate levels, it can be taken as an oral supplement. Since it is fat-soluble, avoid consuming in excess of the recommended daily amount (15 milligrams).
Research on its benefits is ongoing. It alone will not magically make wrinkles disappear or prevent sunburn, but when combined as part of your skincare regimen, it can help to minimize damage to your cells, and make your moisturizers work better.
For patients looking to minimize and improve scars or stretch marks, I often recommend the brand Bio-Oil® which is a topical oil with vitamins A and E.
How does Vitamin D impact our skin and should we take a supplement?
Many people in our area are low on Vitamin D, especially in the winter.
Vitamin D is a fat-soluble vitamin that is obtained from our diet and is also synthesized in our skin. There are 3 ways to obtain vitamin D: through sunlight, diet, and supplements.
It is well known that the sun is a carcinogen and causes skin cancer. Therefore, it is not recommended to get your vitamin D from sunlight or tanning beds. Instead, we recommend obtaining it through a healthy balanced diet, and supplementation with oral vitamin D pills if needed. The recommended daily total doses are as follows:
- 0 to 12 months of age: 400 IU/day
- 1-70 years of age: 600 IU/day
- older than 70 years: 800 IU/day.
“If you do slip up with the sun protection and are worried you have an impending sunburn, taking high dose (200,000 IU) vitamin D3 as soon as possible after the sun exposure has been shown to help suppress the inflammation and activate skin repair.”
Are there certain vitamins or supplements that are helpful for hair and nails, too?
“There are some studies that support low vitamin D or iron levels can lead to hair loss. If you are not vitamin deficient (which a doctor can tell you), supplementation with these is unnecessary and will likely be of any benefit for your hair or nails.”
There is one particular supplement, Nutrafol®, that I do recommend for hair and nail growth. It has ingredients such as saw palmetto and Sensoril® Ashwagandha that help naturally balance hormone levels, as well as antioxidants and marine collagen to promote healthy hair growth.
What are some vitamins that are sold for skin, hair and nails that are NOT effective?
“One of the most recommended vitamins for hair, skin, and nails is biotin (vitamin B7). However, there is not sufficient research to actually support this (sorry). Biotin can be helpful if someone is truly biotin deficient, however this is rare in a healthy patient with a decently balanced diet because bacteria in our gut produce biotin in excess of the body’s daily requirements, and biotin is consumed from a wide range of food sources. If a patient has hair loss, a dermatologist will perform a thorough history to determine if biotin level testing is indicated.”
It is worth noting that excess biotin can cause issues. It can lead to falsely abnormal test results. For example, troponin (a test ordered when there is concern for a heart attack) can sometimes be falsely normal if someone is taking biotin supplements. It can also lead to false levels of thyroid hormone testing.
Other than vitamins, what do you recommend to improve overall skin health?
Sunscreen is the most important external thing you can do every single day to protect your skin and improve skin health long term. You should apply SPF 30 or higher every morning to the face and if you will be outdoors, to your body as well, and reapply every 2 hours. There are several clothing brands that now contain built-in sun protection. Rather than SPF, when it is in clothing it is called UPF. You should look for anything UPF 50 or higher.
“The most important internal factor is a healthy, balanced diet. We know that things like chocolate and a high glycemic index diet (sugar and processed foods) worsens acne, but those types of food also lead to inflammation and damage to the skin in general. High fat is also associated with skin inflammation. Alcohol degrades the skin barrier function and can lead to facial volume loss. Water is vital, and the skin is no exception, and the appearance of dry skin or dry lips can reflect the body’s internal moisture status.”
Finally, minimizing stress levels is beneficial for the entire body, including the skin and hair. Stress hormone signals hair to go from active state to resting state, preventing it from growing. Stress can also make several skin conditions worse, or even appear.
Overall, vitamins certainly can help your skin as an added benefit of a healthy lifestyle, but they’ll never be a replacement for healing and curing skin conditions in the long-term. We always recommend seeing a dermatologist in order to understand how best to treat your skin.