Starting a Prescription Vitamin A
Vitamin A is the most studied ingredient in skin care. The issue is, most over the counter options are not concentrated enough to achieve the results shown in clinical trials. Also, when you buy something off the shelf, it might be several years old and contain preservatives and fragrances that are just unnecessary. Moreover, the active ingredient might be too old or incorrectly stored, in order to work.
Prescription Vitamin A is not for everyone. It is important that you have a consultation with your doctor and also have regular reviews as it may be that your skin’s requirements change and your prescription should be adjusted. There are other great prescription compounds like niacinamide, azelaic acid and astaxanthin which can be used if a specific need arises.
Vitamin A is a family of compounds known as the Retinoids and includes retinol, tretinoin and adapalene as the commonly used forms in Australia. It is widely used in acne management, but also can be used off-label as simply the best anti-ageing weapon second only to sunscreen. When writing you a compounding script, consideration is given to the type of retinoid, it’s concentration, the base in which it is carried and also the packaging must be air resistant to avoid rancidity which is a problem when it comes to storing organic compounds.
Allow me to fuel your visual mind with what the Vitamin A can do for you. It gets into the skin cells and causes them to renew themselves. It finds the pigmented cells and helps them to shed off more rapidly, as well as inhibiting new pigment from forming. By having renewed skin, and by clearing up pigment, you get a fresh looking complexion. I generally notice my patients having a result by 3-6 months.
Now, like anything in life, all this wonder comes with some caution. Retinoids can be irritating so it’s important that you go slowly.
Here are some tips about getting started:
Start with applying every 48 hours. Reactions tends to take two days to appear, so by going slowly you give yourself a chance to back off in the event of a reaction
A reaction looks like – redness, dryness, flakiness or potentially a breakout. It tends to occur around the nose, mouth and chin. For this reason, I advise avoiding applying the product directly around the nose and mouth.
The Sandwich Technique – apply a layer of thin moisturiser or better still, skin oil of your choice, then apply your retinoid. Then, moisturise on top!
The Wear and Wash Technique – a study has shown that wearing the retinoid for 30 minutes then washing it off provides similar benefits to prolonged wear, without the irritation.
Niacinamide use in the morning to counteract side effects of retinoids. This is a wonderful adjunct to retinoid use. Niacinamide is anti-inflammatory and also performs some of the majestic functions of retinoids in a more mild fashion. If you come to a point where you are intolerant of retinoids, then niacinamide is in itself a worthy option too.
Mon-Fri Technique: once you are established on your retinoid, apply it Monday to Friday and then take the weekend off. Let your skin recalibrate. The natural oils and skin lipid barrier is there for a reason and you will do yourself a favour from the perspective of acne, dermatitis and ageing to allow your skin barrier to be unharmed
Ensure your skin is completely dry before applying. Wet skin is more vulnerable to irritation.
First Do No Harm: with any skin care regimen, have a careful look at what products are stripping the skin and AVOID them. The skin is designed to work. It has a microbiome of its own. Current cosmetic science points us towards a more nurturing approach with our skin, so please avoid using your retinoid in conjunction with harsh cleansers or toners. There are some instances such as acne however where the skin is purposely dried out.