Last Updated on October 3rd, 2019
Vitamin A is among the most effective treatments for acne1, especially severe or cystic acne. Popular vitamin A acne treatments like Accutane, Retin-A, and Differin are actually “turbo charged” synthetic forms of this vitamin. But which forms of vitamin A work the best against acne? And how does it work exactly? This article will answer these questions and more.
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If you’ve done some of your own research on the effect of vitamin A on the skin, odds are you’ve found some conflicting information. Some research says that retinoids (synthetic forms of vitamin A commonly used to treat acne, which we’ll get to in a moment) slow down the desquamation process2, which is the process of shedding the outermost layer of skin. Supposedly, this decreases clogged pores by preventing the shedding of excess dead skin cells. But then, other research claims the exact opposite; they say retinoids actually encourage speedy creation of new skin cells3. These articles claim that the new skin cells push the old ones out of the way, also preventing clogged pores. So which is it? Actually, vitamin A does both.
It turns out that vitamin A doesn’t just stimulate or suppress skin cell production, it does something a little more complicated. It actually affects your genes and encourages skin cells to be produced and die at the most effective rate, which is known as skin cell differentiation4. We like to think of it as a pace car. If the skin cells are produced quickly but don’t die at the same pace, then living skin cells can cling to the edges of a pore, causing a clog. Then again, if skin cells die at a normal rate but are being produced too slowly, then they can die in the pore without new skin cells to replace them, which also causes clogs. The solution? A pace car. Vitamin A encourages the production of skin cells at a moderately quick pace, but it also makes sure the skin cells die and move on at the same pace.
While it’s true that vitamin A has the power to prevent clogged pores through skin cell differentiation, not all vitamin A is the same. Various kinds of vitamin A found in skincare products and in nutritional supplements have different effects on your skin. Here is an overview of many of the most popular kinds of vitamin A that appear in skincare products.
Retinoids are generally considered the best vitamin A products for treating acne, but which retinoids are best for your specific skin needs?
For Sensitive Skin and Blackheads/Whiteheads: Adapalene is a synthetic form of vitamin A that produces fewer side effects than other retinoids, making it the best option for those with sensitive skin. It is gentler, which means it’s also a bit weaker, so it isn’t the best choice for severe or cystic acne, but if you have mild to moderate acne, studies show it can make a significant difference. It’s commonly sold over-the-counter as Differin or ProactivMD.
For Resistant Skin and Moderate to Severe Acne: If your skin is a bit tougher and your acne more than just mild, then you might want to look into getting a prescription for tretinoin or tazarotene. Tazarotene a good option for those who typically experience post-inflammatory hyperpigmentation (dark spots) after acne heals5 and is commonly sold under the brand name Tazorac. Tretinoin, commonly known by brand-name Retin-A, significantly improves moderate to severe acne6, though its effects on post-inflammatory hyperpigmentation are less significant than that of tazarotene.
For Sensitive Skin and Moderate to Severe Acne: What if you have sensitive skin and bad acne? Don’t worry, there’s a retinoid for that too. Studies have found that combining low concentrations of various retinoids with other acne treatment products like benzoyl peroxide or antibiotics is a gentler way to get the same results7. These products also require a prescription, but they are typically more effective against moderate to severe acne than adapalene.
For Cystic, Treatment-Resistant Acne: If it feels like you’ve tried literally everything to get rid of your acne and nothing is working, you may want to try isotretinoin, commonly known as Accutane. Isotretinoin is different from other retinoids because it is taken orally rather than applied topically. Most people who use isotretinoin take the medication every day for approximately four months, and then their acne stays relatively clear for the foreseeable future8. A small percentage of people have a relapse of their severe acne, but this can usually be treated with another round of isotretinoin treatment. The only downside is that isotretinoin comes with many side effects, some severe. However, more and more studies are being done on low-dose isotretinoin therapy, with positive results and fewer side effects9.
As we’ve seen, vitamin A can be a very effective acne treatment, but it does come with some side effects. Some forms of vitamin A, like retinol and adapalene, come with fewer side effects, but others, like isotretinoin, come with very serious side effects.
The most common side effect of vitamin A treatment is skin burning, peeling, and scaling. Sometimes these effects are relatively mild, but other times they can be rather painful and frustrating. One way to reduce these effects is with a gentle treatment system. If your daily cleanser is harsh or if you don’t use a moisturizer every day, you could easily make the side effects of vitamin A treatment worse. We recommend using Exposed Skin Care along with vitamin A treatments because their products are designed specifically to combat acne without irritating the skin.
If you decide to try isotretinoin, you will likely face these same side effects, plus a few more. First, isotretinoin is highly teratogenic, meaning it is very likely to cause birth defects. In many countries, in order to take isotretinoin, you must sign an affidavit swearing to use two forms of birth control at all times in order to prevent birth defects. Some studies also report psychological side effects when taking isotretinoin, such as mood swings, increased anxiety, or even suicidal ideation. However, some research suggests that there is minimal evidence to support the reality of these side effects10.
So we’ve seen how vitamin A can successfully treat acne when applied to the skin if it’s in the right form, and we’ve seen an oral medication made from a synthetic derivative of vitamin A, but what about vitamin A supplements? Could they have the same effect? Unfortunately, research shows that supplements are not an effective acne treatment11.
Generally, vitamin supplements are only helpful in treating acne if you have acne due to a vitamin deficiency. In most Western countries, vitamin A deficiency is very rare which means that vitamin A supplements are unlikely to have any significant effect on your health. In other countries, however, vitamin A deficiency is more common and supplements could mildly improve your skin. However, if you have moderate to severe acne with a vitamin A deficiency, we still recommend a topical retinoid in addition to vitamin A supplements.
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