Does Vitamin A Help Acne?

What is Vitamin A?

Vitamin A refers to a group of related compounds. This group includes one fat-soluble compound, retinol, and four carotenes (alpha, beta, gamma and beta-cryproxanthin).

Retinol is essential for the ability of the eyes to accommodate light. It forms the light-absorbing metabolite, retinal, which is responsible for color vision and low-light vision.

Because retinol is unstable outside the body, it is found in nature as retinyl palmitate. Most dietary sources of vitamin A obtained from animals contain this ester. Once ingested, retinyl palmitate is converted to retinol in the small intestine.

Retinol is the form in which vitamin A is stored in the body. It is, however, converted to retinal and retinoic acid.

Retinal is responsible for the activity of vitamin A in the retina of the eye. Retinoic acid, on the other hand, produces no such effect and only has a partial vitamin A activity.

There are many carotenes in nature but only the alpha, beta and gamma forms have any vitamin A activity. This activity is due to the presence of the beta-ionone ring and at least one retinyl group in the molecular structures of these compounds.

Retinol is a yellow, fat-soluble substance. Of the vitamin A sources, it is the only one with some degree of toxicity. Therefore, the recommended daily intake and upper limit values of the vitamin refers to retinol doses.

The recommended daily intake value of vitamin A for adolescents and adults is 600 – 900 micrograms per day. Breastfeeding women may need as much as 1300 micrograms per day. The upper limit for the vitamin is 3000 micrograms per day.

While retinol is obtained from animal sources, the carotenes are usually found in plants.

Vitamin A: Dietary Sources, Toxicity, Deficiency and Uses

Vitamin A toxicity is possible because it is a fat-soluble vitamin. However, only very high doses of the vitamin (25,000 IU per kg of body weight) can cause acute toxicity.

Chronic toxicity can occur from ingesting smaller doses (4,000 IU per kg) of the vitamin but it usually takes more than 6 months of continual use to develop.

Some of the symptoms of vitamin A toxicity include nausea, vomiting, depressed appetite, irritability, lethargy, mental confusion, blurry vision, headaches, abdominal pain and hair loss.

In severe cases, vitamin A toxicity can cause dry skin and the drying of mucosal membranes, fever, sleeplessness, weight loss, anemia and bone fractures.

These symptoms are sometimes observed with Accutane (isotretinoin), an acne medication containing retinoids.

However, the toxicity of high doses vitamin A is not actually due to the fact that the fat-soluble vitamin is accumulated in fat deposits in the body. In fact, water-soluble forms of vitamin A are ten times more toxic than regular vitamin A.

Vitamin A deficiency is very common. There are two forms of this deficiency: primary deficiency which is caused by inadequate ingestion of carotenes from plants or retinol from animal sources or vitamin A supplements; and secondary deficiency which is caused by reduced absorption of fat or vitamin A into the body.

Zinc is also absolutely important to the absorption, transport and usage of vitamin A in the body. Therefore, zinc deficiency eventually causes vitamin A deficiency.

Symptoms of vitamin A deficiency include night blindness, impaired immune function and increased formation of keratin on the skin, at the hair roots and even in the lining of the bladder and respiratory passage.

Vitamin A supplements are essential for preventing and treating vitamin A deficiency especially in children. However, there are other medical uses for these supplements.

Besides its importance in vision and gene expression, vitamin A is also essential for maintaining normal skin health. It does this by turning on certain genes and by nurturing immature skin cells to maturity.

Vitamin A in Acne Treatment

Although the exact details by which vitamin A provides dermatological benefits are still unknown, its usefulness in acne therapy is proven by the effectiveness of retinoids such as isotretinoin or Accutane.

However, while isotretinoin is a synthetic analog with known side effects (for example, it is a teratogen and should be avoided by pregnant women), the natural forms of vitamin A are safe and provide the same benefits for acne sufferers.

Exfoliation and Rejuvenation

Vitamin A increases the skin turnover by two complimentary mechanisms.

First, it is an exfoliant that gently sloughs off the dead skin cells shed from the upper layer of the skin. By removing these dead cells, it prevents them from clogging skin pores and forming comedones such as whiteheads and blackheads.

Secondly, vitamin A rejuvenates the skin by stimulating the maturation of epithelial cells. This means that it causes an increase the number of immature skin cells that quickly matures to cover the skin.

Furthermore, vitamin A activates the appropriate genes to stimulate new collagen synthesis. Since collagen is the fibrous protein that gives the skin its structure and appearance, vitamin A helps heal the skin by removing the old blemished layer and replacing it with a new top layer.

A rapid turnover of the skin is essential for restoring the skin especially after acne attack. Not only will this prevent the formation of acne lesions, it will also fade away acne scars.

Regulator of Hormonal Balance and Immune Function

Vitamin A can also promote skin health by regulating the immune system and, therefore, reducing the effect of hormones and inflammatory responses on the skin.

The effect of this vitamin on the immune system is largely responsible for the anti-acne properties of its analog, isotretinoin.

Therefore, like the synthetic analog, vitamin A can reduce the effect of male sex hormones on the sebaceous glands. Androgens such as testosterone and its metabolites cause the enlargement of the sebaceous gland and the excessive secretion of sebum.

Since sebum is nutrient for bacteria, androgens indirectly set the stage for the colonization of the skin by acne-causing bacteria.

Therefore, vitamin A can improve hormonal balance by reducing the synthesis of androgens. This produces desirable effects on the skin including reducing the size and secretion of the sebaceous gland and the reducing bacterial population on the skin and in the pores.

Vitamin A can also reduce inflammatory response to acne damage on the skin. It achieves this by inhibiting the proinflammatory effects of immune cells. By this mechanism, vitamin A can help prevent and reduce inflammatory acne lesions.

Vitamin A is also an antioxidant. As an antioxidant, it removes harmful free radicals and other toxins on the skin.

In this way, it protects the integrity of the outer layer of the skin and so prevents colonization by acne-causing bacteria or inflammatory response by the immune cells that are released when the skin is breached and injured.

Taking Vitamin A for Acne

Both oral and topical preparations of vitamin A and its analogs are available for acne treatment.

While vitamin A analogs like the retinoids (for example, isotretinoin) are commonly prescribed and appear to work faster, they do have some serious side effects. Accutane, for example, should not be used by pregnant women and can only be taken under medical supervision.

Topical vitamin A acne medications are also not the best way to use vitamin A in acne treatment. Topical preparations of the vitamin only depend on the exfoliating effects of vitamin A.

Since exfoliation is only one of the many benefits of vitamin A supplementation for acne sufferers, topical preparations do not provide the best possible therapeutic benefits.

In addition, these topical vitamin A preparations can cause skin irritation and leave red scars on the skin.

Oral vitamin A dosage forms are the best use of the vitamin in treating acne. Since no one vitamin can “cure” acne, the best way to take vitamin A for acne is to have it included with other supplements that are effective in acne treatment.

Actimine is one such acne supplement that includes vitamin A and other vitamins and minerals proven to be effective in acne treatment. This acne supplement even contains zinc which is known to increase the anti-acne benefits of vitamin A and vice versa.

A study published in Acta Dermato-Venereologica in 1978 by French researchers described the additional benefits of combining oral vitamin A with zinc.

The study results showed that taking zinc along with oral vitamin A caused significant increase in the serum levels of retinol-binding proteins (RBPs; they are responsible for the transport and distribution of bioactive vitamin A to organs such as the skin) in acne patients after 4 weeks.

This effect was not observed in study participants who took only zinc or only oral vitamin A.