Acne and Vitamin A: Does Vitamin A Help Acne?

Carrots

Vitamin A is crucial for clearing up your skin, but you may need a different kind than you get from carrots.

Are you ever confused by claims like these?

“Vitamin A is a miracle vitamin for your skin!”

“Eating Vitamin A-rich foods is dangerous!”

“Vitamin A cures acne!”

“You should never take vitamin A supplements because they can be toxic!”

“You can get all the vitamin A you need from carrots and other yellow-orange vegetables!”

If you’ve read up on vitamin A, you’re probably aware that it’s both important for health – including skin health – and that it can be dangerous if you get too much of it. This has resulted in many mainstream health experts warning people to avoid all vitamin A supplements, and instead shoot for the USDA’s absurdly low RDA recommended amounts, meeting these daily requirements with fruits and vegetables.

I think this is probably well-meaning, but fundamentally wrong – and your acne may be suffering for it.

First, let’s talk about why vitamin A is so critical for your skin.

How Does Vitamin A Help Acne?

Have you heard of Accutane (isotretinoin, aka 13-cis-retinoic acid)? How about Retin-A (tretinoin, aka all-trans-retinoic acid)? Both of these drugs have a form of vitamin A as the active ingredient. (Not that we recommend them – see below.) Retinoids (forms of retinol, also called preformed vitamin A) combat acne in the following ways. Retinoids:

  • Help prevent dead skin cells from sloughing off and clogging pores
  • Reduce the amount of oil your skin produces, which also reduces pore-clogging
  • Suppress androgen formation (androgens in the skin are a major cause of acne)
  • Protect fats from oxidation (which keeps cell damage and inflammation at bay) [1] [2]

Clearly, vitamin A is a power vitamin for skin! But know this: not all vitamin A is created equal. Some forms of vitamin A are ineffective, so you’ve really got to make sure you’re getting the right kind.

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Retinoids vs. Carotenoids: When Vitamin A Isn’t Vitamin A

There are two main classes of vitamin A – retinoids and carotenoids.

Retinoids – which include retinol and its various metabolites – are the forms of vitamin A that are biologically active in the body. They do vitamin A work. Retinol is found in animal foods, especially liver, but also eggs and dairy products.

Carotenoids are actually yellow-orange pigments, which are found in things like carrots and brightly-colored fall leaves (cool, huh?).  Of the 600 or more carotenoids that have been identified, only a few can be turned into bioavailable vitamin A by the body. The main one is beta-carotene (although alpha-carotene, gamma-carotene, and beta-cryptoxanthin are also forms of provitamin A).[3]  Dietary sources of provitamin A carotenoids include carrots, sweet potatoes, some dark green veggies, and basically any yellow-orange fruit or vegetable.

Now, provitamin A carotenoids like beta-carotene have their own good work they do in the body as antioxidants and other beneficial roles I won’t get into here. But this work is not vitamin A work. In order to do vitamin A work, beta-carotene must be absorbed and converted to retinol in the small intestine.

The problem here is that the body doesn’t absorb and convert carotenes nearly as efficiently as retinol. On average, your body only gets 1/12 (that’s one-twelfth) of the vitamin A activity from carotenes as from the same quantity of retinol!

But don’t think you can address that by diving back into your bag of baby carrots – the more beta-carotene you consume, the less efficiently your body absorbs it![4]  Sad face.

The takeaway here is that it’s great for your health to eat lots of colorful fruits and vegetables, but it is difficult to meet your total vitamin A needs from plant sources alone. That’s why it’s important to include plentiful preformed vitamin A – retinol – in your diet.

Are You Vitamin A Deficient?

It’s not easy to identify a vitamin A deficiency with a blood test unless your levels are really low. That’s because vitamin A is a fat-soluble vitamin that is stored in the liver, and the liver releases it as it’s needed to keep your blood levels relatively constant. However, when these liver stores start running out, blood levels of vitamin A start dropping, and you may develop symptoms.
Early symptoms of vitamin A deficiency include:

  • Night blindness (reduced ability to see in low light)
  • Impaired immunity, susceptibility to infections[5]
  • Rough, dry skin, including hyperkeratosis pilaris (rough bumps on the backs of the arms)[6]

Even if you don’t have these symptoms, you may have too-low vitamin A levels if you have less-than-ideal beta-carotene absorption and don’t regularly eat high-retinol foods like liver. Many factors inhibit the body’s ability to use beta-carotene from food, including:

  • Gut damage (which many acne suffers have!)
  • Strenuous exercise and other stressors
  • Alcohol consumption
  • Zinc deficiency
  • Consumption of polyunsaturated fats (vegetable oils such as canola oil, sunflower oil, safflower oil, corn oil, soybean oil, peanut oil. Olive oil is fine!)
  • Low dietary fat[7]

Furthermore, you may go through vitamin A faster, and therefore need to replenish your supplies more often, if you have inflammation, since the liver releases vitamin A to help deal with inflammatory conditions in the body.[7]  The vast majority of acne sufferers have chronic inflammation – that’s why those zits are swollen, red, and painful!

So in short, our guess is that many people with acne are in the deficient to nearly deficient ranges – and it’s definitely worth boosting that intake!

How Much Vitamin A Do I Need to Get Each Day?

The percent daily value on nutrition labels in the U.S. is based on an intake of 5,000 IU of vitamin A per day.[8]  For optimal acne-busting and overall health, we think you should get about twice this much.

If you are getting at least 4,000 IU of vitamin D3 per day and sufficient vitamin K2, you can very safely consume 10,000 IU of retinol each day.[9]  (Note that if you are not getting sufficient quantities of vitamins D3 and K2 and you consume 10,000 IU of retinol daily, over time, you are putting yourself at risk for vitamin A toxicity!)

Keep in mind as well that vitamin A is a fat-soluble vitamin, so our bodies can store it up for when it’s needed. That means that you can get your vitamin A in spurts – a big dose one day a week in a dinner of liver, for example, can supply you with enough vitamin A to last you until next week!

How Can I Increase My Vitamin A Intake?

So glad you asked. DO NOT, I repeat, DO NOT take retinol as a pill unless this is under the careful direction of your physician. As you may have heard, vitamin A toxicity is a serious matter – basically, once your liver storage capacity is all used up, those storage cells get packed so full that some of them burst and release various vitamin A metabolites into the blood stream, disrupting your body’s oh-so-careful regulation of vitamin A blood levels. The effects of this are numerous, but among the more serious are severe birth defects and miscarriages, liver abnormalities, and bone mineral loss (think osteoporosis). Oh, and even coma and death, if you go really overboard.[9]  Even supplementing with the more innocuous beta-carotene has been linked with increased incidence of cancer in certain populations.[10]

So don’t do that. Instead, get your vitamin A from whole food sources, which contain a natural variety and balance of retinoids or carotenoids and other nutrients. Liver – from beef, lamb, goat, pork, chicken, or fish – is the absolute best source of preformed, highly absorbable vitamin A (animals store vitamin A in their livers, just like we do). Consider eating 1/4 to 1/2 pound of liver once per week (1/4 pound of beef liver contains about 30,000 IU of retinol).[11]

Lamb and goat liver tend to be a little milder than beef liver, in our experience, so they can be a good way to ease into eating liver. When it comes to liver, always go grass-fed! The liver stores toxins and antibiotics that can result from animals raised in feedlots. Also, liver is naturally pretty lean, so eat your liver with some fat to maximize that fat-soluble vitamin absorption.

Pastured eggs and dairy products also contain retinol – though we don’t recommend dairy for other acne-causing reasons, so stick with pastured eggs (about 300 IU per egg).

And finally, you can top it all off with a diet rich in varied yellow-orange (and some dark green) fruits and vegetables for some less-absorbable but still very healthy carotenoids. Sweet potato, pumpkin and winter squashes, carrots and cantaloupe are great choices, as are dark greens like kale, collards, and spinach. These plant sources have about 1,500 – 3,000 IU of provitamin A per half cup (cooked) serving.[12]

If you’re not hot on eating liver (though it’s really yummy fried up with bacon, garlic, onions, and greens!), an alternative source of retinol is fermented cod liver oil (FCLO) (which you can read more about here). We recommend the Green Pastures FCLO / butter oil blend, as the butter oil is a primo source of vitamin K2. One-half teaspoon a day of Green Pastures FCLO gives you about 4,600 IU of retinol, or half of your daily vitamin A needs, in a very natural form.[13]  If you are consuming no other animal products, you might take up to a full teaspoon each day.

Also, you don’t need to worry about whether eating your fruits and veggies will put you over the 10,000 IU mark. Carotenoids do not contribute at all toward vitamin A toxicity, so eat those carrots and sweet potatoes to your heart’s content. The worst thing that can happen if you get too much beta-carotene from food is that your skin might turn orange! (Totally reversible, don’t worry.)[13]

As I mentioned previously, make sure you’re also getting plenty of D3 and K2. You can get your D from daily sun exposure or supplementation (we recommend 5,000 IU per day – read our post on vitamin D for more info). K2 is found in fermented foods and in the butter oil fraction of Green Pastures FCLO / butter oil blend. Supplementation in pill form is also an option.

A Word on Isotretinoin, Tretinoin, and Other Synthetic Vitamin A-Based Acne Treatments

I mentioned these vitamin A-based acne treatments earlier in this post, but before I sign off I want to emphasize that these treatments are in no way “natural” or “healthy.” In food, vitamin A shows up in hundreds of different forms and along with gazillions of other molecules that affect their absorption and metabolism in ways we can’t even begin to understand. Isotretinoin (Accutane and other brands) contains a very large dose of one particular form of vitamin A that naturally occurs in the body only in very small quantities. Some of the effects of isotretinoin are consistent with vitamin A toxicity (e.g. severe birth defects, possible bone mineral loss with prolonged use), and some suggest vitamin A deficiency, as the isotretinoin may block the more appropriate vitamin A metabolites in the eyes, brain, and nerves.[14]

Prolific health blogger and holistic health practitioner Chris Kresser asserts that it is definitely possible to get the acne-defeating benefits of retinoids by eating foods naturally high in them – and with none of the terrible side-effects![15]

Key Takeaways

Okay, that was a lot of information! I hope knowing the “whole story” will help you feel confident in your food and supplement choices when it comes to meeting your vitamin A needs – for your skin, and for your overall health, too! To summarize the main points:

  • Vitamin A has a number vital acne-fighting functions.
  • Aim to get 10,000 IU of vitamin A, mostly in the form of retinol, each day. Get this by eating 1/4-1/2 pound of liver weekly, or by taking 1/2 teaspoon of fermented cod liver oil (blended with butter oil for K2) per day. Also eat plenty of pastured eggs, yellow-orange fruits and vegetables, and dark leafy greens.
  • Make sure you balance your vitamin A intake with at least 4,000 IU of vitamin D3 each day, either from sun or supplements, plus sources of vitamin K2 (fermented foods).
  • Check any multivitamin supplements you may be taking. If they contain vitamin A (as retinol, beta-carotene, or something else), discontinue them.
  • While having robust vitamin A levels is important if you’re trying to cure acne, it is only one piece of the overall acne-and-health puzzle! Check out our book to learn how to heal your acne with an all-natural diet and lifestyle.
Sources (click to expand)

  1. Ross, A. C. (2006). Vitamin A and Carotenoids. In M. E. Shils, M. Shike, A. C. Ross, B. Caballero, & R. Cousins (Eds.), Modern Nutrition in Health and Disease (10th ed., pp. 351–375). Philadelphia: Lippincott Williams & Wilkins. ^
  2. Jaminet, P., & Jaminet, S.-C. (2012). Vitamins A, D, and K2. In Perfect Health Diet (pp. 265–280). New York: Scribner. ^
  3. Chapman, M. S. (2012). Vitamin A: history, current uses, and controversies. Seminars in Cutaneous Medicine and Surgery, 31(1), 11–6. ^
  4. Ross, A. C. (2006). Vitamin A and Carotenoids. In M. E. Shils, M. Shike, A. C. Ross, B. Caballero, & R. Cousins (Eds.), Modern Nutrition in Health and Disease (10th ed., pp. 351–375). Philadelphia: Lippincott Williams & Wilkins. ^
  5. Chapman, M. S. (2012). Vitamin A: history, current uses, and controversies. Seminars in Cutaneous Medicine and Surgery, 31(1), 11–6. ^
  6. Kresser, C. (n.d.). Nutrition for Skin Health. ^
  7. Fallon, S., & Enig, M. G. (2002). Vitamin A Saga | Weston A Price. Wise Traditions in Food, Farming, and the Healing Arts. Retrieved May 22, 2014, from http://www.westonaprice.org/health-topics/abcs-of-nutrition/vitamin-a-saga/ ^
  8. National Institutes of Health. (n.d.). Daily Value. Dietary Supplement Label Database (DSLD). Retrieved May 22, 2014, from http://www.dsld.nlm.nih.gov/dsld/dailyvalue.jsp ^
  9. Jaminet, P., & Jaminet, S.-C. (2012). Vitamins A, D, and K2. In Perfect Health Diet (pp. 265–280). New York: Scribner. ^
  10. Druesne-Pecollo, N., Latino-Martel, P., Norat, T., Barrandon, E., Bertrais, S., Galan, P., & Hercberg, S. (2010). Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials. International Journal of Cancer. Journal International Du Cancer, 127(1), 172–84. doi:10.1002/ijc.25008 ^
  11. National Institutes of Health. (2013). Vitamin A. Office of Dietary Supplements. Retrieved May 21, 2014, from http://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/#h4 ^
  12. Higdon, J. (2007). Vitamin A. Linus Pauling Institute at Oregon State University. Retrieved May 22, 2014, from http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/ ^
  13. Fallon, S., & Enig, M. G. (2009). Cod Liver Oil Basics and Recommendations | Weston A Price. Wise Traditions in Food, Farming, and the Healing Arts. Retrieved May 22, 2014, from http://www.westonaprice.org/health-topics/cod-liver-oil-basics-and-recommendations/#clarify ^
  14. Logan, A. C., & Treloar, V. (2007). The Clear Skin Diet (pp. 14–16). Naperville, IL: Cumberland House. ^
  15. Kresser, C. (n.d.). Nutrition for Skin Health. ^

{ 98 Comments }

    • Devin Mooers says

      I’m still not entirely clear on this. Most supplements contain retinyl palmitate, which I believe is the form the liver stores vitamin A in, but not sure. Retinoic acid is the active form of vitamin A, AFAIK. I still don’t know whether retinyl palmitate from supplements is safe for long-term consumption. If you turn up any research on that, please let me know. If I could recommend that to people, it would help many folks boost their A intake if they can’t get a source of grass-fed liver or liver capsules. But eating 4-8oz of liver per week is a great way to get vitamin A and tons of other great nutrients!

    • Devin Mooers says

      Hey Nyi! Zincovit looks like a pretty good multi, though without knowing the individual forms of each vitamin/mineral, it’s hard to say how good it really is. For Cotrim, we really don’t recommend taking antibiotics long-term. SO many people who come to CSF, buy our book, and try our program have long-standing gut problems and other systemic problems from taking antibiotics. Consult your doctor on this, of course. Our book has a big section on why we don’t recommend treatments like antibiotics for acne, since they don’t do anything about the root causes of acne. I hope this helps!

Like what you read? Have something to share? Leave a comment below! Your ideas are much appreciated, though we can't answer every individual question. :)

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