Vitamin A and Acne

The surface of our skin is lubricated by sebum an oil produced by the sebaceous glands. Sebum travels through the hair follicles, out of the pores and on to the surface of the skin. When excessive oil is produced due to various reasons, it combines with dirt and dead skin cells to block and inflame pores. This inflammatory condition is called acne and it appears as pimples, blackheads, whiteheads, pustules, papules or cysts on the skin’s surface. Acne can affect any part of the body although it is mostly seen on the face, back and trunk. Millions of people world over suffer from acne. While it is not a serious condition, severe forms can cause permanent scarring and psychological problems. 

Vitamin A

Vitamin A (retinol) is an essential vitamin that is needed for maintaining good health of the skin, intestines, lungs, urinary tract etc. it protects the body against infections. Vitamin A is available as retinol or retinoids got mainly from animal sources and carotenoids, including beta-carotene available from plant sources. 

Vitamin A and Acne

Prescription retinoids (synthetic version of vitamin A) as pills or creams is used to cure severe skin conditions such as acne and psoriasis. Retinoids are prescribed by dermatologists and are a staple acne treatment. Vitamin A helps with cellular turnover, which keeps pores clear and therefore helps in the treatment of acne. In fact, some nutrition reports suggest that one symptom of a deficiency of vitamin A is acne.

Medications that contain Vitamin A

Topical Retinoids that are used to treat acne contain vitamin A. Retinoids are comedolytic – help the skin shed easily so that pores do not get blocked. Retinoids can work in several ways to treat acne:

vitamin A and Acne

  • Prevent formation of comedones, therefore limiting creation of inflammatory lesions
  • Discourage the growth of P.acnes bacteria
  • Help in shedding skin so that other topical agents can reach the root of acne
  • Reduce enlarge pores by ‘plumping up’ skin

Most dermatologists recommend topical formulations as the first step in treating acne. These topical medications include:

  • Tretinoin or Retin-A
  • Adapalene or Differin
  • Tazarotene or Tazorac

These medications, which contain vitamin A unclog pores and reduce inflammation. They should be applied at night, and they must not used at the same time as benzoyl peroxide (apart from adapalene) 

Topical retinoids are available as creams, liquids or gels. They are more effective when combined with topical antibiotics and benzoyl peroxide. They can also reduce outbreaks of acne by stopping dead skin cells from obstructing pores. They are used to treat moderate or severe acne outbreaks. 

Adapalene causes the least side effects, while Tazarotene is said to be more effective in treating acne than either adapalene or tretinoin. 

When you apply topical retinoids, first wash and dry the affected area. Then take tiny pea-sized amounts and apply on the area. Apply on the acne and even acne-prone areas. Topical retinoids like Retin-A which degrades in sunlight, must be applied only at bedtime. Initially, the acne will look like it is getting worse before it begins to get better.

Isotretinoin is a vitamin A derivative and very effective in treating severe cystic acne. Only when cystic acne has not responded to other medications will isotretinoin be used. It is taken 1-2 times a day for 16-20 weeks. This is the most effecitive treatment for acne since it acts on all four caused of acne – P.acnes, clogged pores, excess oil production and inflammation. When isotretinoin is taken, severe acne goes into remission – often for years. Most patients require just one full course to be free of all factors that cause acne. However, vitamin A as isotretinoin causes serious side effects that are listed below.

Vitamin A Diet and Supplements

Since vitamin A is so critical for preventing various serious skin disorders like acne, it is important to consume the correct daily requirement. Up to 10,000 IU of vitamin A is said to successfully combat acne. 

There are many foods rich in vitamin A. Dark green leafy vegetables, carrots, pumpkins, sweet potatoes, peaches, mangoes and other orange / yellow fruits and vegetables contain rich sources of beta-carotene. Vitamin A as retinol is found in chicken, calf and beef liver, dairy products, eggs and fish liver oils.

Possible Side effects of Vitamin A medications

Excess of vitamin A causes side effects like hair loss, dry skin, weakened bones, cracked lips, headaches etc. When you suffer from such side effects stop your vitamin A medications or supplements and consult your doctor at once.  Side effects of topical vitamin A medications for acne include peeling of the skin, redness and photosensitivity – which can cause sunburn.   Tazarotene sometimes causes more irritation than adapalene or tretinoin.

Topical retinoids must not be used by pregnant women. Do not use a combination of retinoids for they can increase risk of toxicity.

Isotretionoin is very dangerous for pregnant women as it causes serious birth defects in the fetus. Hence, all women of child-bearing age must follow these precautions:

  • Take 2 pregnancy tests before taking isotretinoin treatment
  • Use 2 types of birth control one month before, during and one month after treatment
  • Breastfeeding women must not take isotretinoin

Apart from pregnant women, isotretinoin also cause side effects like:

  • Blurred vision
  • Severe headaches
  • Diarrhea
  • Vomiting and nausea
  • Pain in the abdomen or chest
  • Difficulty swallowing
  • Joint pain
  • Dry skin, nose, eyes
  • Hair fall

Contact your dermatologist if you experience any of these side effects for if you ignore them, it can lead to severe problems.

Summary

Vitamin A has proven to be very effective in treating severe acne conditions. Deficiency in this vitamin can cause acne. Hence, ensure you take a diet rich in vitamin A and a supplement if needed. When you use vitamin A-based medications, ensure you do so only if a doctor prescribes it and follow all required precautions.