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Antioxidants, Anti-aging and Skin Rejuvenation
More on VITAMIN A - Part 4
By Peter T. Pacik, M.D., F.A.C.S.

As discussed in our last email topical Vitamin A can be a powerful addition to any Skincare regimen, but the need to add a Vitamin A product can vary between individuals. A number of patients have found that they were able to discontinue the use of topical Vitamin A as they graduated to increased strength glycolics. Others resumed the use of topical Vitamin A because they felt it produced enhanced results.

In cases where people use both a Vitamin A product and a glycolic product, it is recommended that they be used on an alternating nightly basis following the use of a glycolic facial cleanser. When using a Vitamin A product, it is important to note that there is increased exfoliation (and drying) and sun sensitivity. Therefore, the use of a moisturizer (Kinerase or Replenishing Hydrating Cream) and a sunscreen (SPF 15, SPF 30) are a must after your morning cleansing and application of your glycolic lotion or cream. The safety of Vitamin A products has not been established for pregnancy or nursing; therefore, should be avoided at these times.

In 1913, US biochemist Elmer McCollum discovered and named Vitamin A and in 1931 German chemist Paul Karrer determined the structure of Vitamin A (Retinol) and successfully synthesized the compound that soon became commercially available. Karrer later received the Nobel Prize for his work on Retinol. A recent study sheds additional light on the efficacy of Vitamin A, and specifically research on Retinyl Palmitate. Vitamin A is essential not only for normal skin development, but also for the growth and maintenance of bones, glands, teeth, nails and hair. Vitamin A (Retinol and beta-carotene) is found in green leafy vegetables such as spinach. The highest concentrations are in beef and veal liver, carrots, and sweet potatoes. Concentrations meeting daily requirements are found in watercress, cabbage, squash and melon. Lesser amounts are in pumpkin, mangoes, tomatoes, broccoli, apricots, papayas, tangerines and asparagus. As the body ages, the rate of metabolism slows down causing cell renewal to slow down, and a subsequent thinning of the skin. The thinner skin becomes wrinkled and there is a loss of elasticity. Increased water loss (Trans Epidermal water loss) leads to dry, cracked skin. Cracking of the skin interferes with the normal protective barrier of the skin making the skin more vulnerable to the penetration of environmental toxins and foreign materials.

As discussed in the last e-mail, topical Vitamin A enhances collagen synthesis and results in increased skin thickness. Retinyl Palmitate (a more stable ester derivative of Vitamin A) has been shown to penetrate into the deeper skin structures (dermis). The vehicle base that enhances penetration of Retinyl Palmitate is Squalane, a naturally occurring lipid (fat) found in human sebum (natural oils on the skin). Squalane is the vehicle used in Nutri-A Daily Repair Cream; and in addition to the benefits of Vitamin A, Nutri-A helps replace the natural fats lost during the aging process. The particle size is quite small (nanosome) in this product allowing better penetration into the target tissues. Retinyl palmitate showed similar increase in dermal collagen content in the 0.1% to 5% range, and improved elasticity with higher doses. A minimum of 2 weeks of daily application is necessary to show improved elasticity. The longer the treatment, the more clinical benefit achieved.

On a personal note, I have been using the MD Forte Skin Rejuvenation Eye Cream with Retinol for about 2 years, and I love it! My lower lids have continued to improve, and I wake up in the morning with smooth skin instead of the triple bags I used to look at in the mirror while shaving!

Lastly, we want to acknowledge the email that was received from Kris B. who inquired about vitamin supplements used in conjunction with topicals to obtain maximum skin results. The average person's diet fails to meet Recommended Daily Allowance levels; therefore, vitamin supplements are recommended for daily use. It has been suggested that the daily allowances for optimal health are often ten or more times higher than the RDA levels. Additional information can be read in the following books: The Optimum Nutrition Bible, by Patrick Holford, The Crossing Press, Freedom, California 1999. Enter the Zone, by Barry Sears Ph.D,, Regan Books, 1995.

For more information, please visit our Web site skincare-md.com and our plastic surgery website plasticsurgerypa.com. All of our previous educational e-mails , as well as The MD Forte 4-Step Daily Regimen, Obagi Nu-Derm System Daily Regimen, and Obagi-C Rx Recommended Daily System Application are found on our website www.skincare-md.com. If you have any additional questions or would like to speak to or would like to speak to Lisa Roberge, our esthetician, please feel free to call us during office hours Monday thru Thursday 9-4, Friday 9-3 EST at 1-800-640-0290 or (603) 669-0290. If there are any topics that you would like covered in these educational e-mails, suggestions or concerns you may have, please let us know. We encourage you to share your experiences both positive and negative with us. Your comments are important to us.

Peter T. Pacik, M.D., FACS
Medical Director

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