I got a few questions on how to store skincare products when one is living in a hot tropical country with summers of >35°C and when instructions on product labels read “store below 25°C or store sunscreen below 30°C?
This is actually a great question and concern for consumers, I was so impressed at this level of consciousness and curiosity when it comes to skincare and cosmetics.
Since I am not a skincare or cosmetic developer, I am not fully aware of the best answer for this question and so I took the liberty to ask for help from a pharmacist and a post graduate in advanced cosmetology: Catarina Cabeçadas to answer this question. She is also the writer of “The skin balance blog“
As a dermatologist, I’m a firm believer in evidence based medicine. We study dermatological issues and their treatment options throughout our training. We study molecules used in skin or hair care products religiously, reading the research available on them, which active ingredient works, how they work, the dosage, their benefits and side effects and how effective they can be for a particular condition.
Therefore, I personally do not advised nor can I validate the popular culture of “DIY” (do it yourself) or home remedies for skin or hair care.
Yes, dermatologist keep saying that the basics to skin care are ABC (Vitamin A, Vitamin B, Vitamin C), and many of the active ingredients used in skincare are plant derived, this can be confusing to many of us. One can find the “ABC’s” easily in one’s kitchen, pantry, or garden so why shed your money buying expensive products containing the same?
Let me break it down for you in simple terms:
The skin has three layer, the epidermis (uppermost), the dermis (middle) and the subcutaneous tissue (fat and lowermost). the diagram on the right is the epidermis, which is composed of several layers.
The main function of the skin is acting as a barrier, protecting our body from various environmental substances and it does a pretty good job at it too.
This means many of the DIY’s of tomato paste, lemon juice, etc may not even be able to reach the inside of your skin through that “brick wall” to perform the functions you are expecting them to do.
This is why we have well formulated creams, ointments, serums etc because they contain other agents that help deliver the desired active ingredient (be it vitamin A, B or C etc) to cells in the skin.
Secondly, vitamins are present in various forms, for example for vitamin A we have beta carotene, retinol, retinal, and the most active form retinoic acid. Retinoic acid is the one that binds to receptors present in the cells of our skin to bring about beneficial changes such as anti ageing, anti acne etc.
Simply applying a paste of vitamin A rich fruits such as papaya does not achieve the same result, because vitamin A in fruits & vegetables are in the form of beta carotene.
Thirdly, DIY,s could potentially be doing more harm than good. A common example is a condition called “PHYTOPHOTODERMATITIS” where patients develop an irritant dermatitis when the skin is exposed to certain plants/citrus fruits and sunlight.
Patients develop a red rash on areas of exposure, burning sensation and may develop fluid filled lesions as well. The rash would then heal with pigmentation.
Left image is also called “Margarita burn” -phytophotodermatitis due to the limes present in a margarita cocktail followed by sun exposure. Right image– pigmentation left behind when the irritation subsides.
Just because DIY/Home remedies are all natural does not necessarily mean they are completely harmless and safe
Lastly, even though some skin care products use active ingredients such as various forms of vitamin A, B or C, they have been extensively researched in the labs, animal and human studies. Scientists study the active form of these vitamins, the strength at which these ingredients that have been proven to be effective to produce a desired effect (eg: niacinamide- vit B3, strength of at least 4 % works to reduce pigmentation, repair skin barrier, vitamin C of 20% works as an anti-oxidant, anti ageing, salicylic acid of at least 2% helps unclog pores and so on and so forth).
Simply grinding vegetables, or whisking eggs making a paste for your skin, is not going to achieve the same result
How does one know the strength of the vitamin present in that paste?
Yes, Cleopatra may have bathed in milk to maintain a beautiful youthful skin. We now know that milk has lactic acid which helps in exfoliation of the skin, and we have products designed particularly for that now with or without lactic acid, so people wont have to be bathing in milk for a glowing youthful skin.
The only time dermatologist advised on using ingredients available at home is for coconut oil. We advised coconut oil application for patients with conditions causing dryness of their skin, who are not able to afford regular moisturisers.
Consuming fruits and vegetables provides you with more nutrients that can be beneficial for skin & hair rather than external application of various DIY concoctions of eggs/lemons/mango etc
As part of the series for active ingredients for pigmentation and as a continuation to my blog post on “vitamins and skin”, let’s dive in the details of another vitamin, that is – Vitamin A, also known as Retinoid.
Retinoid was a term first used to describe the active form of vitamin A. It comes in two forms: trans retinoic acid (tretinoin) and cis retinoic acid (isotretinoin), depending on the molecule groups orientation. The prefixes “cis” and “trans” are Latin for: “this side of” and “the other side of”.
Today retinoid is used as an umbrella term to encompass all derivatives of viatmin A such as retinoic acid, retinol, retinal esters, retinaldehyde.
Vitamin A and its derivative
The order of activity of a topical retinoid
The order of activity of a topical retinoid is as follows:
In others words retinoic acid is highly effective while retinol esters are least reactive. The irritant potential however is reverse, retinol esters causes the minimum irritation while retinoic acid causes maximum irritation.
How Vitamin A works on the skin?
Vitamin A derivative found in our skin are retinol and retinyl esters. These are then converted to retinoic acid, the biologically active form, by certain enzymes. Retinoic acid binds to receptors present inside the nucleus (center) of our skin cells to mediate various biological effects.
It regulates the cell turnover: As the cells in our skin divide and move from the basal layer to the uppermost layer as dead cells (the stratum corneum) and are shed off, there are various changes that can take place, such as changes in the shape and composition of the cells. This entire process is call “keratinisation” or in simple words “cell turn over” which takes approximately 28-30 days. Retinoids help regulates and makes sure this process is occurring normally. This is particularly useful for acne, where the follicular keratinisation (the cell lining inside of a hair follicle) is abnormal. Check out my previous blog post on to see how acne develops: “How to deal with truncal acne?”.
It also affects the growth and differentiation of cells: it increases the activity of cells responsible for production of collagen, and causes an increase in the thickness of the epidermis.
Retinoids also increase production of extracellular matrix and prevent its degradation by UV rays. Extracellular matrix are carbohydrate molecules present in the dermis which act as a cushion in which blood vessels, collagen and elastin are embedded and is responsible for the suppleness of our skin.
Anti-inflammatory: Thus helps prevent the development of inflammatory (red, painful) acne.
Reduction in pigmentation: Retinoid inhibits tyrosinase – an enzyme required for melanin production (pigment responsible for our skin colour) and due to the increase cell turnover it reduces the transfer of melanin to the keratinocytes.
The expected results with retnoid
The overall clinical effects of topical retinoid are:
It prevents formation of comedones (white heads, black heads), reduces the number of breakouts. Retinoids are the topical medication for choice for non inflammatory comedonal acne.
Helps reduce fine lines, and can reverse changes seen with chronic unprotected sun exposure (photoaging).
Retinoids can help improve the appearance of pores, and provides a smooth texture with a youthful appearance to the skin.
Retinoid in the form of retinoic acid (tretinoin) is used in combination with hydroquinone (depigmenting agent) and mild steroid called “triple combination” to decrease pigmentation and evens out skin tone. This combination has been the standard first line treatment by dermatologists for pigmentary disorders such as melasma, post inflammatory pigmentation (dark spots following conditions such as acne, or various forms of dermatitis). Another combination using 10% retinol + 7% lactic acid has shown to be equally effective to reduce pigmentation.
Therefore, retinoids in various forms are used for the management of acne and as an anti ageing ingredient.
Commercially available retinoids
1. Retinoic acid
The biologically active retinoid, retinoic acid is available as tretinion. It comes in three strengths : 0.025%, 0.05% and 0.1% formulated in a cream base. There is also a microsphere gel base in the strength 0.04% and 0.1%.
Adapalene is a synthetic retinoid similar to all trans retinoic acid tretinoin. It is available as a 0.1% gel, cream or solution and as a 0.3% gel for the treatment of acne. Adapalene (Differein) can be bought at the pharmacy without a prescription. It is now available as a combination with benzoyl peroxide (Deriva BPO gel, Epiduo gel) or with clindamycin (ClearApgel, Deriva CMS gel) as well.
Retinaldehyde is the immediate precursor of the active form of Vitamin A-retinoic acid. Retinaldehyde in 0.05% and 0.1% concentration used twice daily for 12 weeks have been shown to be effective in treating photodamaged skin (rough, dry skin with fine or coarse wrinkling) and pigmentation. After application, retinaldehyde needs to be converted in the skin to retinoic acid by certain enzymes. This prevents the over saturation of our skin with retinoic acid and thus is better tolerated with fewer side effects. However the expected results can be slower than with retinoic acid.
Many over the counter anti ageing, and pigmentation cream contain various concetration of retinols (0.3%, 0.5%, 0.1%) as the active ingredient. As you can see from the above image on vitamin A & its derivative, retinol needs to be converted to retinaldehyde which is in turn converted to retinoic acid. Retinol is 20 times less potent than retinoic acid (tretinoin) but the bears the advantage of less side effects. But retinol is highly unstable and gets degraded easily to inactive forms therefore the choice of the vehicle is of utmost importance for this ingredient. This neutrogena does not mention the concentration of retinol but from what I found online, its probably a lower concentration of 0.025%, which is great if you’re just starting with a retiniod.
Side effects of topical retinoids and how to combat it
Over saturation of our skin with retinoic acid can irritate our skin. Therefore the side effects are mostly seen with topical retinoic acid such as tretinoin. For this reason and because retinoic acid has biological effect when applied on the skin, it is considered a drug and requires a doctor’s prescription. Such regulations are not followed in India, and one can buy almost anything over the counter here, but I strongly discourage using retinoic acid as part of your skin care regimen without a prior dermatological evaluation or without supervision from your prescribing doctor.
During the first few weeks of topical application of a retinoid, redness, flaking of the skin, acne flare, photosensitivity are expected. This can be minimised by starting with the lowest concentration of retinoid, or by limiting the amount and the frequency of application.
It is advised to start with either twice in a week application, or alternate days application once at night for the entire face and never in the morning. The frequency and strength can be increase according to our skin’s tolerance to the product. Moisturisers and sunscreens are a must while using a retinoid.
Retinaldehyde and retinols have fewer chances of causing this irritation and are the best bet if one wants to start using a retinoid in their skin care and for someone with sensitive skin.
Retinoic acid such as tretinoin being more irritant should be avoided for someone with dry, sensitive skin or someone with skin conditions such as Rosacea.
Retinoids should not be used during pregnancy.
Interested in a vegan option?
Retinol, retinaldeyde and retinoic acid are animal derived forms of vitamin A while beta carotene is derived from plant and fruits. Beta carotene can be converted to retinal esters and retinaldehyde in our body which are then converted to the active form retinoic acid.
However a carrot can only provide a maximum of 6 mg of beta carotene. So if you want to duplicate the results of this study, you’ll need at least 6 large carrots a day.
Since long term study on the effect of vitamin A supplementation on our body as a whole has not been carried out, the potentials dangers that may result from toxicity of vitamin A has not been ruled out yet. Till we know more about the the benefits and risks of oral intake of vitamin A (beta carotene supplements), its best to avoid oral supplementation and stick to what we know, which is topical sunscreens and topical retinoids to fight signs of ageing and pigmentation.
It is important to note that, scientific research on the role of an active ingredient for pigmentation or ageing are performed over weeks with a minimum of 12 weeks before any conclusion can be drawn from the studies.
Therefore, always use a product for at least 12 weeks before you decide to conclude that the product is not working and move on to the next best thing.
As the hunt for white skin continues especially in a country like India, where “pale, fair skin equates to beauty and better social status”, did you ever wonder what exactly does “fair and lovely” or “ponds white beauty” actually contain?
These fairness products contain a water soluble vitamin B3 called ”Niacinamide”. Like all vitamins, Vitamin B3 is required in small quantities for our body’s normal physiological process. Vitamin B3 is of two forms: nicotinic acid (used for lowering blood cholesterol) and niacinamide (biological form in skin care products).
This vitamin was first isolated by an Austrian chemist from nicotine following a complex process of oxidation with nitric acid. When this vitamin was fortified with flour (similar to fortification of salt with iodine- called iodised salt) in the US, they ran an ad saying “TOBACCO IN YOUR BREAD”. This was a misconception. We cannot get nicotine from consuming vitamin B3 rich food nor does tobacco contains vitamin.
I’ve mentioned in my previous blog post “The juicy story of vitamin C”, that the only indication for oral vitamin supplementation is for conditions or situations that causes a deficiency of the respective vitamin. We’ve learnt that vitamin C deficiency causes scurvy, deficiency of vitamin B3 causes a condition call “Pellagra” which is a multi system disease, and med students remember the symptoms of this disease as 4 D’s -diarrhoea, dermatitis, dementia and death. Since its deficiency causes dermatitis (inflammation of the skin), it means vitamin B3 plays an important role in our skin. Vitamin B3 is derived from food items such as salmon,tuna,pork,liver,chicken,whole wheat and peanuts. Pellagra was seen to be endemic in areas where the stable food is corn (maize), as viatmin B3 in corn is found in a bound form which is not available for absorption therefore these individuals were deficient in this vitamin. Individuals whose stable diet was rice (wheat contains niacinamide) were protected from this disease.Thus Vitamin B3 is also call Vitamin PP or PP factor which means Pellagra preventing factor.
Multiple well controlled studies of the benefits of niacinamide in treating acne are available . The percentage of niacinamide used in these studies are 2-4%. It has been shown to reduce the number of acne and also has a role in reducing sebum (oil) production. However, combination treatment is more efficacious for the treatment of acne.
Niacinamide prevents the transfer of melanosomes (cellular structures containing the pigment melanin-responsible for our ski colour) from the melanocytes to the neighbouring keratinicytes. For this action, niacinamide is required at a higher concentration. A study comparing the effect of 4% hydroquinone (skin bleaching agent) to 4% niacinamide shows that hydroquinone is superior to niacinamide as a skin lightening ingredient. Niacinamide also takes a longer time (3-4 weeks later than hydroquinone) in reduction of skin pigmentation. Creams such as “fair and lovely”, “ponds white beauty” and more use niacinamide in their products as a skin whitening agent.
It is important to note that, the a certain percentage of niacinamide is required for the “whitening” effect. Most companies fail to mention the percentage of concentration of niacinamide in their products. Also as these are cosmetics, the companies manufacturing them do not need to prove the efficacy of the product (which means they do not have to prove the product does what it claims).
It has been shown in laboratory studies that niacinamide can increase production of collagen (structural framework of our skin). This together with its photo-protective action (protection from damages induced by UV rays), can slow down the process of photoageing. With ageing and chronic unprotected sun exposure, a process call glycation of proteins occurs in the skin, which causes the production of stiff and rigid collagen and elastin. This is reflected in the skin as a change in the natural complexion and loss of elasticity of the skin. The skin appears yellow and less supple. Niacinamide has been shown to prevent this process from occurring thereby slowing the process of ageing.
This is by far the most useful property of niacinamide. It increases the production of proteins, fatty acids in the skin which is responsible for providing a natural moisturising effect as well as restore the damages skin barrier. Therefore its moisturising and anti inflammatory effect is particularly useful for patients with atopic eczema, rosacea, dry skin.
When to incorporate niacinamide to your skin care?
Niacinamide is the perfect skin care ingredient for dry, dehydrated skin, or for patients with eczemas, or highly sensitive skin not tolerating other ingredients.
As for acne, niacinamide alone may not be very ideal. This in combination with other active ingredients such as benzoyl peroxide, adapalene will prove to be more beneficial.
As a skin lightening, niacinamide can potentiate the effects of other active components that also work to reduce skin pigmentation. Topical application of a combination of niacinamide with N-acetylglucosamine (NAG) has been shown be to significantly effective in reducing pigmentation. However niacinamide monotherapy for this indication is unlikely to be effective.
As an anti ageing ingredient, niacinamide (4-5%) have also been shown in clinical studies to reduce the appearance of fine lines, sunspots, red blotchiness and sallowness (yellowish discolouration) of the skin. As niacinamide does not irritate the skin, it is suitable for vulnerable areas such as peri-orbital region (around the eyes) where other active agents such as retinoid may prove to be to harsh.
Cosmetic companies opt for niacinamide as the active agent for their “skin lightening” products as niacinamide unlike other vitamins like Vitamin C, is easier to formulate. It is a stable compound, not pH dependent, penetrates the layers of the skin easily and rarely causes any side effects.
Products that actually mention the % of niacinamide
LRP a reputed skin care line made in France have multiple products containing niacinamide. They use a combination of 4% niacinamide along with glycerine, ceramides (fatty acid present in skin for moistursing and barrier effect).
The ordinary 10% niacinamide + 1% zinc serum. Zinc and niacinamide works together to reduce sebum (oil) production and reduces inflammation which is responsible for the development of red acne bumps- papules, pustules in acne patients.
Skin ceuticals founded in 1994 by dermatologist and scientist Dr Sheldon Pinnel in U.S.A. Ever since the company has been producing high end evidenced based skin care products. Their metacell renewal B3 serum conatains 5% niacinamide + tripeptides +15% pure glycerine tackles early signs of ageing, dry skin and discoloration.
Common products that contain niacinamide but fail to mention the concentration.
Fair and lovely is the number 1 fairness cream in the world. Sold under Uniliver, a company that first used niacinamide as a skin lightening agent in creams in 1971. The brand launched in India in 1975 and ever since has grown to a net worth of $200 million dollars. The brand is known for its controversial advertisement strategies, portraying darker skin individuals struggling in society until fair and lovely rescues them with a “whiter” skin tone. Like I mentioned earlier, being a cosmetic brand, the company does not need to prove the efficacy of the product. The instant gratification with this cream is due to the presence of titanium dioxide (a physical sunscreen) which gives a whitish coat on application to the skin. As to weather this cream really does what it claims, my research on this is based solely on user’s review and failed to find a definite YES or NO to this question.
Another common fairness cream available in India. Also contains niacinamide without a mention of the percentage it contains.
Is niacinamide a magic ingredient for skin lightening?
Niacinamide can reduce pigmentation and even out skin tone. It is not as effective as hydroquinone ( holy grail ingredient for skin ligthtening), but since its has various other benefits to the skin, is relatively free of side effects and is well tolerated , niacinamide is a great ingredient if formulated at the correct concentration and in a correct vehicle.
If the aim is to reduce pigmentation and achieve a more even skin tone gradually, niacinamide plus a sunscreen along with ingredients such as glycolic acid, or retinioids can act as a “magic” ingredient that potentiate the effect of the other active components and also minimise the side effects of using glycolic acid & retinoids.
If you’re expecting blemish free and whiter skin overnight with just niacinamide as an active ingredient, that I can assure will not be a magical experience.