Understanding vitamin a

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Understanding vitamin a
South African therapists are respected the world over for their excellent service and solid skills base. However, even the best therapist will lose clients if their product knowledge isn’t up to scratch. With Environ, the most frequently-aired concerns from clients relate to vitamin A. Many do not understand that any reactions they have is temporary or easily addressed. The panel provides some decisive answers on vitamin A reactions.
Question: Why do clients react to vitamin A and what can they expect? Answer: The skin can react to vitamin A, at any time when the dosage is increased or if the dosage is too high. This is called a retinoid reaction. It is an inflammatory skin reaction is caused by certain molecules called cell signals or cytokines. They are literally molecules which act like ‘instruction messages’ to the cells responsible for creating inflammation. These cell signals are released from different types of cells in response to a sudden high dose of topically-applied vitamin A. The reaction looks similar to a skin contact allergy to some irritating chemical. The main difference is that the skin will adapt to the vitamin A in the retinoid reaction and, given time, will recover even if the dose is not altered or stopped. With a true allergy, the skin will worsen if the exposure to the culprit molecules is kept up. In all of these reactions the skin becomes red, itchy, painless, feels thin and frail and may even weep some clear serum. The surface can peel lightly, crack and be very sensitive to light, heat or touch. One can easily treat a retionoid reaction by leaving off the vitamin A for a few days, letting it settle before restarting with alternate day applications once a day. After this slowly increase the application frequency at weekly intervals until one is back to twice a day. During the period of vitamin A abstinence, the client can apply a thin layer of cosmetic-grade petroleum gel or a 1% hydrocortisone cream for a severe irritation. It is seldom necessary to do anything else. Retinoid reactions may occur unexpectedly in seasoned users accustomed to high doses of vitamin A. This happens if the client’s metabolism suddenly changes such as in response to menopause or other sudden endocrine changes.
During winter, metabolism may slow down in certain individuals, decreasing their vitamin A requirements temporarily. A retinoid reaction may then appear at the dose of vitamin A the client has been using comfortably. It happens because the skin metabolises the vitamin A at a slower pace and the ‘heaped up’ vitamin becomes irritant. This is not serious and needs the same treatment as above. Another reason for the reaction is when a client changes to a different and better penetrating formulation, for instance going from the Original Range to the C-Quence range. This is obviously due to the higher penetration of the vitamins. Interestingly though is the observation that when high doses of vitamin A are driven into the skin by means of iontophoresis (low, direct current electricity) and sonophoresis (sound waves) of the DF Machine, the irritant reaction does not occur as easily. This is possibly because more of the vitamins are driven directly into the cells, rather than accumulating in the spaces around the cells as with topical application. True allergy to vitamin A, where the skin will react with inflammation to any dosage and continue to react as long as it is exposed to vitamin A, is possible. Such reactions have been described, but are fortunately very rare. that the vitamin A receptors in the cell nuclei will respond favourably by becoming more active and numerous over time. Starting too quickly with high doses of vitamin A causes an irritant-type skin reaction which is harmless, but uncomfortable and unnecessary. It will leave no damage, but you will need to go off the vitamin A for a few days until the reaction settles down. The products should be returned to the therapist, who should start the client on the suitable start-up dosage found in Debut. The toner and C-Boost should be left until much later. The toner enhances penetration, which will increase the irritation. The C-Boost provides a high penetration of vitamin C, which is great, but only later on when the vitamin A-driven processes in the skin are up and running.

Question: “I have been started on Environ products, but my skin has suddenly gone red, irritated and dry. The therapist promised a wonderful difference, but it’s worse! I am using the Classic Day and Night, C-Boost, Alpha Toner, Cleansing Gel and RAD.” Answer: Your skin is reacting to too much vitamin A introduced too fast. The Environ products have been designed specifically to start with very low amounts of vitamin A and to move you up the vitamin A ladder slowly. This ensures

The environ panel

Question: “I have been using Environ for five years. I decided to switch from the Original Range, where I have been using Ultra Day and Night, C-Boost and Hydrating Oil Capsules, to the C-Quence range. I was given C-Quence 4 as the therapist felt that my skin had already adapted to high doses of vitamin A. Suddenly, on the third day, my neck became red, itchy, swollen and painful like a burn. What have I done wrong? Have I become allergic to the products?” Answer: This is a retinoid reaction that will leave no damage, but the client will need to go off the vitamin A for a few days. Even though the Ultra level of the Original range is about the same as C-Quence 3 in vitamin A content, the C-Quence range is formulated differently and penetrates better. C-Quence 4 is not just one step up from C-Quence 3, but much more intensive. Let the therapist start you on C-Quence 2, which is the safe choice when moving from Ultra in the Original range. You should should also use the C-Quence Crème to complete the complement of anti-oxidants. Remind the therapist to discuss the adequate sun protection when outdoors and to reapply the RAD frequently (every two hours) for the best results. As long as the retinoid reaction is still there, you should cover the area with RAD to protect it against excessive sunlight.

Val Carstens, CEO Dr Des Fernandes, of Environ®. plastic surgeon, chief medical advisor and founder of Environ®.

Dr. Bruce Muir, medical doctor specialising in antiageing.

Dr. Ernst Eiselen, medical doctor and medical advisor to Environ®.

Dr. Geraldine Mitton, medical and wellness director for the Sante Winelands Wellness Centre.

For more information contact 0800 220 402 (South Africa only)

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