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Skin Health vs Beauty

The Role of Vitamin A (Retinoids) and Vitamin B3 in non-malignant skin cancers

During the last 25 years I have been working in skincare and plastic surgery in the harsh climate of the Arizona desert, USA. I have witnessed firsthand many people suffering from the results of long-term sun exposure, environmental damage and chronic skin conditions such as premature aging, actinic keratosis (which can lead to some forms of skin cancers), hyperpigmentation, wrinkles and in the worst-case scenario malignant and non-malignant skin cancers.
In the years of treating our patients we have seen the benefits of not only aesthetic improvement but also the reversal of skin damage through the use of advanced chemical peels, lasers, photo light and advanced medical skincare products.

It was very important to customize a treatment plan for our patients as not one person is born with the same skin! What works for one person may not work for someone else.

Aesthetic benefit and history of Vitamin A

Vitamin A was originally developed by Dr. Albert Kligman and approved by the FDA in 1971.  It was developed for acne patients but in the years following, Retin-A proved (American Academy of Dermatology) to also improve skin and wrinkles. In a 1987 letter from The Harvard Medical School Health it stated that “persuasive clinic data indicate that (Retin-A) actually does improve the quality of the skin and reduce the appearance of wrinkles. At that time the cream was repackaged under the name Renova.

While aging leaves skin weaker, the major cause of wrinkles, spots, and sagging is the sun. This condition is caused by a process called photoaging, exposures to UV (Ultraviolet) and IR (InfraRed).

While everyone ages, an emphasis is put on looking young for the longest time possible. Plastic surgery, injectables (fillers and Botox), and overpriced creams are all options for slowing the signs of aging, but a simpler solution is the use of Retin-A. Even though Retin-A was discovered almost 50 years ago, it is still a relevant treatment for wrinkles.

The original formula and perhaps purest form of Retin-A is prescribed through a physician.  However, it is nearly impossible (even if it is allowed for home use by a physician) to use it without significant side effects of peeling. Redness and at times “raw” not easy to manage skin; simply not possible we found our practice to use, unless it was mixed with steroid creams, which defeats the purpose of achieving skin health (steroid creams thin the skin and also are damaging to the body).

Multiple manufacturers have since developed different formulas for the market, most however, ineffective. Many factors dictate the safety and efficacy of the product.  Not only is penetration (does it enter the epidermis, or lower layer, the dermis, and the skin cells to be targeted) of importance, but what other ingredients are entering the skin and bloodstream. Are these safe, or ultimately negatively effecting the hormonal balance and other health issues in the body?

In my years of researching products while I was working in a plastic surgery clinic, I have found very safe, effective products that will achieve results and show little to no discomfort while using these products with effective ingredients that target and improve skin cells, some restoring the DNA through use of epigenetics.

Nonprescription Retinol, as a stabilised molecule is now considered the ideal form of delivering topical Vitamin A with maximum stability and effectiveness and minimal irritation.

In summary, when it comes to treating the skin, topical Retinol is preferred over oral vitamin A supplements.

What are the different types of Retinoids?

  • Retinyl Palmitate
  • Retinaldehyde (Retinal)
  • Retinoic Acid
  • Hydroxypinacolone Retinoate (HPR)

The overview below shows the main benefits and drawbacks of these 5 Retinoids.

Medical benefits of Vitamin A (Retinoids) and B3 (Niacinamide)

In recent scientific studies, (November 2019, e.g., NIH, United States Library of Medicine) the use of Vitamin A and Vitamin B3 show a medical benefit of decreasing the risk of skin cancer.

While the main reason many choose to use Retin-A purely for cosmetic reasons, many other benefits result from using this cream, such as the reversal of skin damage.

Vitamin A has been shown in multiple research studies to reduce to reduce the risk of skin cancers. This study by the NCBI (ncbi.nlm.nih.gov/pubmed/31365038) suggests that increased intake of dietary vitamin A is associated with a decreased risk of incident SCC (Squamous Cell Carcinoma).

Vitamin B3 (nicotinamide, niacinamide) plays a significant role in supporting energy-dependent cellular processes, including DNA repair. (University of Alberta 2017, Vitamin B Derivative (Nicotinamide)Appears to Reduce Skin Cancer Risk.) **

Topical Vitamin B3 is truly the multitasking skin vitamin. It is used to treat acne, inflammation, fine lines, dehydration and flaking skin, pigmentation and even skin immunity. Niacinamide is able to work on so many levels when used topically and everyone will benefit from this skin vitamin. My favorite is the Vitamin B Serum from Synergie Skin.

Current studies from The National Institute of Health (Australia)* suggests that B3 works more effectively on the skin when used topically rather than orally, particularly for treating acne, redness and dehydration. Furthermore, because B3 is a water soluble vitamin, it is not stored in the body so what is not used by the body is rapidly excreted.

Skin cancer statistics world-wide

There are two main types of skin cancer: melanoma and non-melanoma. The most common non-melanoma tumors are basal cell carcinoma and squamous cell carcinoma.

Non-melanoma skin cancer (NMSC) is the most common cancer worldwide. Australia has the highest incidence of skin cancer in the world, exceeding 2000 per 100 000 person-years and it is increasing [1]. In the USA, more than 3 million individuals are diagnosed with NMSC each year [2,3]. In the UK, during 2014–2016, about 147 000 new NMSC cases were diagnosed every year, more than 400 every day [4]. Data show that between 1976 and 1984, the overall incidence of basal cell carcinoma (BCC) increased by 145% and of cutaneous squamous cell carcinoma (SCC) by 263%.
It may be surprising to find out which countries have the highest number of skin cancer cases.

Statistics below show the top 5 countries with the highest amount of skin cancer rates, per WCRF (World Cancer Research Fund). These statistics might be surprising considering that some of these countries are not countries with much sun. It underscores that skin protection is needed even on cloudy or complete overcast days. The best prevention of UV damage is limiting the exposure to the harsh environment.

It is imperative to use a good sun protection, which should be used daily regardless whether it is a sunny day or not.

1 Australia
2 New Zealand
3 Norway
4 Denmark
5 Netherlands
14 UK
17 USA

In summary, protection from our harsh environment, partially due to depletion of the earth’s ozone layer, is ciritical. In addition safe, and effective skin care products and according to scientifically well researched data the use of topical vitamins for the skin.  In a later blog we will address the importance of using the right sun protection and the difference in UV and IR protection.

Preventive strategies play an important role in their increased frequency of developing both premalignant and malignant skin lesions. Sun protection and regular skin cancer screening are critical. In addition, chemoprophylaxis (use of medication to treat already existing skin cancers) with retinoids (Vitamin A), nicotinamide (Vitamin B3) can significantly reduce the development of new skin cancers. (excerpt from Clinical Oncology Online)***

Sources: Terri Vinson, Synergie Skin, NCBI, University of Alberta (Pubmed/28888216), Clinical Oncology Online (article S0936-6555(19)30341-3