The dangers or benefits of Vitamin A and beta-carotene in creams. It's all too ambiguous

[Ericaca65]

I am completely confused. I have read a lot of articles, written by medics, or maybe by pseudo beauticians, or whoever. And, medical doctors often contradict each other, giving their opinion about vitamin A and carotene. Some articles say that the use of beta-carotene prevents sunburn, while other articles say that the opposite is true: it is dangerous to walk in the open sun after taking vitamin A, because of the higher risk of sunburn and a higher photosensitivity of the skin.  For example, Lorial face cream with retinol,

it is said to be a night cream, and you can see that for a reason. And Neutrogena cream, so the description says that when you use it, you should use sunscreen. These are serious cosmetic brands and they know about the dangers. But, a lot of brands put vitamin A in their creams and don't write any warnings. And the reason for my solar keratosis may have been that I uncontrollably and thoughtlessly applied it and did not look at the contents of the cream.  Doesn't anyone else care about that?                                                                                             And how to be now with creams and what to use can not understand.

[tg1973]

Stop reading "articles" and start reading scientific studies.  You need science, not marketing.

[Ericaca65]

 That's the thing, I tried to read only the opinions of doctors and scientists

[WinglessOne]

@Ericaca65  Vitamin A is sensitive to sunlight. So is vitamin C, by the way. Sunlight can cause both of these ingredients to break down. 

Vitamin A doesn’t make your skin more sensitive to sunlight. It doesn’t contain a substance that increases photosensitivity, like citrus oils and juices do (especially lime oil and juice; look up “margarita burn” to see what I mean). It also doesn’t remove dead skin cells from the surface of your face, like alpha hydroxy acids (AHA, which include glycolic acid, lactic acid, mandelic acid, etc.) do. In the US, the FDA wants cosmetic products containing AHA to include a sunburn warning on the packaging because these exfoliating acids definitely increase skin's sun sensitivity. Retinol and other members of the vitamin A family don’t really do that. 

The real reason to use vitamin A at night is the ingredient’s own sun sensitivity. But some vitamin A products are formulated in ways that keep vitamin A stable in sunlight. Also, if you apply a retinol serum or cream in the morning, give it time to settle into your skin, then apply a broad spectrum sunscreen (minimum SPF 30) to all skin exposed to sunlight and give that 10-15 minutes to set up a protective barrier before applying anything (primer, makeup, powder) over it, then the retinol in your serum/cream should be fine. In other words, you can use vitamin A in the daytime if you want, if you also use sunscreen—which you should do daily anyway, all year long—and especially if your vitamin A product is formulated to prevent UV breakdown. 

It’s true that medical doctors aren’t all on the same page about everything. Example: some docs still believe you can’t use retinol and vitamin C together, which has been scientifically proven false. I don’t trust articles from popular magazines when it comes to skincare advice, even if a dermatologist is interviewed for an article. I’d rather ask my personal doctor and/or dermatologist, look up clinical data (if I can access it), and use reliable ingredient databases like INCIdecoder that back their ingredient explanations with scientific study sources. 

[danielledanielle]

@Ericaca65 , just lightly chiming (because my biochemistry is rusty and I'm not a dermatologist) in that Vitamin A and beta carotene are separate molecules, in that retinol is much more readily converted and available to the body vs beta carotene.  You basically need more beta carotene for your body to use it as "vitamin A".

Also to concur what @WinglessOne stated above, you're going to find conflict in studies because research can be conflicting in study design, funding and who is the experimental group.  If I'm looking into a topic, I always look for a meta analysis or a review, if available. 

[Ericaca65]

Specialists write that vitamin A is synthesized from beta-carotene and retinoic acid is synthesized from vitamin A, and as I understand it, all these processes can and do occur in the skin. And it is about retinoic acid that the warnings are written. There is no doubt that with retinol cream is definitely useful and it restrains the aging process. But, that's if you close yourself off from the sun. After all, if retinol was even marginally responsible for micro sunburn and accelerates the onset of cancer, then I would have to think very hard about how to protect myself. They write and say absolutely everything about retinoic acid, that it can lead to burns. But the feeling is that when they write about carotene and retinol, it is as if they do not know or forget that they are the precursors of retinoic acid. And yet I strongly suspect that retinol may have contributed to actinic keratosis, which is a precursor to severe skin cancer.

[danielledanielle]

Yes, retinal, retinol, retinoic acid and beta carotene can all be used as "vitamin A".   But, vitamins in general can have multiple forms, polymers that can either be used easily or require so many steps for conversion.  That's why you'll be unlikely to see a warning for beta carotene.  Retinol on the other hand is easier to use.

Vitamin A has a function in cell turnover.  It's too simplistic to say it causes photosensitivity because it takes both the exposure to light and depletion of natural protective factors.  You could have photosensitivity from just a deficiency in niacin, for example, but that would also incur a deficiency in antioxidants as niacin is bountiful on a variety of foods.

  IMO, again not a dermatologist, but I tried to view the need for sunscreen with vitamin A as a functional issue vs it makes you photosensitive on its own.  So, because most people are vitamin D deficient, the ozone layer is depleted (which is a part of getting less uvb) and I want to encourage healthy cell turnover in my already cancer prone epithelial cells (skin), I'm going to have an adequate diet so supplementation for vitamin A isn't necessary and I'm getting different forms in controlled sources, try to sleep to encourage healthy cell cycles and wear clothing to block UVB.

Overall @Ericaca65 ,@ I'm sorry you have to go on a quest to discover what will prevent cancer, but still feel healthy, but I find this is a common caveat.  Research follows dollars, and while done things that have strong evidence can be easily solved, there's still so much to be discovered.  If you haven't already, definitely find a GP and dermatologist that can adequately address your concerns.

[Ericaca65]

Many people, including me, after 50 years of age, faced with actinic keratosis or skin cancer, coming to a GP (especially) or dermatologist suddenly see and hear that most doctors are unable to find and answer half of the questions, whether because of illiteracy or reluctance. It is very difficult to find a competent doctor. You write very well and very correctly. But believe me, neither a balanced high-vitamin diet or even sun block will save you from the hellish sun on the beach in South America, southern Spain or Italy, if you are a blonde or a redhead, And if you add any substances or products that increase skin sensitivity, the sun will burn you to the bone.  Only after the age of 50 or 60 do we start to wonder what we did wrong when we were younger. Wearing normal clothes doesn't always save you from skin cancer. My uncle's wife has two basal cell tumours on her back. And she's never had a tan, can't stand the sun or the heat. She's also a natural blonde, by the way.

[danielledanielle]

@Ericaca65, very kind of you to say, super late response here, but a high balance vitamin diet is oversimplification, and it's more about balanced foods (which in themselves have variety of nutrients usually working in tandem) with a consistency in intake.  And that's just one line of prevention.  If I eat vegetables everyday and and wear long sleeves, it would reduce my risk, but does not eliminate it in totality.  Much like a risk ratio doesn't always equate in disease, either.

I do find seeking a well-matched practitioner a challenge, but I don't always feel it is a lack of competence.  Since I am in America, I feel like it's an effect of training.   Currently, it is a field that's reactive (instead of pro-active to a problem) and with the U.S. being so litigious: I pose no one wants to give a definitive answer based of research, because science in its self is constantly evolving, which is what science does.  Also, there's so many medical conditions, it is unlikely you'd be able to have a definitive answer to each case, but you have tot be able to assign a care plan or a diagnosis, so you will likely get a range of different responses because everyone sees different cases during their training.

You also have to take into account that there are a variety of carcinogens present, so yes, while you may have done something in your youth, it is possible you were exposed to other carcinogens (take something as omnipresent plastic) and its interaction with sun + vitamin A.  Pollution.  Over processed founds.  Increased sedentary time.  I could go on.  Cancer is usually found in cells with high turnover (skin being large also makes it a good target), so again, it's things in tandem at play, versus a single characteristic.

[Ericaca65]

 I agree, we all live surrounded by many carcinogens, and the number is not getting less.  I wanted to say that some of the most important and persistent carcinogens hang over our heads. And while we are young we don't think about anything, what we eat, what we put on our face. I can remember, for example, my friend. She's been drinking orange and carrot juice all her life, just like me.  She is brunette and doesn't have the actinic keratosis that I had, but she had 2 basal cell tumors.  She suffered fewer and less frequent sunburns than I did, but it was regular. She has a son who once had to take a course of antibiotics. So he got a sunburn from being out in the yard and in the open sun for just ten minutes. She asked the doctor what the consequences would be and what to expect. So he said it was important how the burns were caused. But if it was caused by eating a drug or a product that increases light sensitivity, then the burns are deeper and more dangerous. The burns are almost guaranteed to cause precancer or skin cancer in 20 years. Young people don't want to limit themselves to anything, I was like that myself. I've been using retinol cream on my face for over a decade. I had actinic keratoses mostly on my face. I don't think it's a coincidence.

[Ericaca65]

Yes, you're right, vitamins A and C are easily destroyed by ultraviolet light. But as far as increasing the photosensitivity of the skin after vitamin A penetration is concerned, this is an open question. The thing is that the opinions of doctors and various specialists are divided. Some write that vitamin A protects, while others say that it increases photosensitivity of the skin after consumption, which in the future greatly accelerates the appearance of actinic keratosis and skin cancer. Vitamin A is a retinoid, and in medical and scientific literature it is written that retinoids, when taken and come into contact with the skin, can cause sunburn.  I asked my doctor a question: "Retinoids cause sunburn?", he said yes. I asked about vitamin A, and then he said, "I should clarify. Yeah, about lime, it's written everywhere that it's not safe. Maybe vitamin A is noticeably less likely to cause skin burns, but that's not reassuring, because there is a cumulative effect.  I have the challenge of finding a safe cream, without potentially dangerous additives that do not react with ultraviolet light in the skin. The return of actinic keratosis I just can't stand it.

[WinglessOne]

@Ericaca65  Quick BIC tip: remember to @ the person you reply to so they'll get a notification. Otherwise they might never see their reply. 

Eh, more like retinoids are vitamin A if we wanna get technical about it. 🙂 If your doctor's advised you to avoid retinoids and vitamin A altogether, then you should follow your doctor's advice unless you feel you need a second opinion from another doctor. 

My dermatologist is among the doctors who believe, based on clinical data, that topically-applied retinoids don't actually cause photosensitivity. Retinoids boost the skin cell growth (division) cycle, resulting in new skin at a faster rate. But this doesn't mean dead skin cells on the skin surface are suddenly removed as part of that process. That's why some of us who use retinoids (in my case, retinaldehyde) also use a chemical exfoliant—AHA, BHA, or PHA: to remove those dead skin cells and reveal the new skin. 

When I first started using retinoids (back then, it was retinol), I asked both my derm and my primary care doctor lots of vitamin A questions. This was after I'd already studied up on vitamin A; I wanted my docs' expertise to either confirm or disprove my understanding, plus I was interested to hear where they both landed on a few topics. They both said vitamin A was safe for me to use, especially since I was already a sunscreen user. I assume you also use sunscreen as well as limit your sun exposure, if you've had actinic keratosis before. 

If you feel safer avoiding retinoids, then definitely do that. Especially if your doctor thinks you should. Actinic keratosis is very serious, so I completely understand your concern. This doesn't mean everyone must avoid retinoids. Vitamin A hasn't been proven unsafe except in the case of pregnancy. The FDA still considers retinoids to be safe. In the end, do what's best for you. 

[Ericaca65]

The problem is that I have type 1 skin, I am blonde. Before the disease, I used creams with added vitamin A for at least 10 years. At 52 years of age . There is no doubt that vitamin A is very useful, but there are nuances and sunlight is one of them. As for retinoids. In the instructions for retinoids, which are used to treat psoriasis and acne, they're supposed to increase photosensitivity. Also, the instructions for Regencorr, which I used to treat actinic keratoses, say that they should not use retinoids. That's when I started to think about what I was eating and what I was putting on my face. I've read scientific articles and made the conclusion that vitamin A definitely makes my skin more photosensitive, but compared to citrus or anti-fungal products, vitamin A is said to be less sensitive and less risky than citrus or anti-fungal products, for example. But, apparently for us blondes, this is enough to have and aggravate problems with the sun. Blondes, please tell us how you are doing with retinol in the cream and other additives in the composition and your reaction to the sun?