Reverse and Rewind
03 Jul 2019

As with most things in life, prevention is better than cure. Sun damage is no exception, but what should you do when it’s too late? You will almost certainly be faced with clients who have spent numerous summers happily soaking up the rays with scant regard for UV protection, but what was once a golden tan has now morphed into leathery, pigmented and prematurely aged skin. Reversing the damage can be a challenge, but you have a powerful weapon in your arsenal: Vitamin A.

“I believe that sun damage is a disease that can be treated”, says Environ® founder Dr Des Fernandes. “It’s caused by a deficiency in vitamin A.” Given its extraordinary skin benefits, it’s no surprise that this vital nutrient has powerful, proven anti-ageing properties*. The big skincare companies often use weird and wonderful adjectives when describing their products but the phrase we most often use at the iiaa is that Vitamin A ‘normalises skin.’ Admittedly, this doesn’t sound particularly exciting, but think about what ‘normal’ skin actually is. It’s smooth. It’s even-toned. It’s hydrated and luminous. It shows no sign of premature ageing. Doesn’t sound quite so boring now, does it?

Vitamin A’s normalising abilities are particularly important when it comes to sun damage because there is often a lot to reverse. Clients with this skin concern will often complain of pigmentation marks, excessive wrinkling and a course, thickened skin. These symptoms can manifest themselves decades after UV ray exposure, so even if your clients have shunned the sun and religiously slathered themselves in sunscreen for the past ten years, their skin may tell a different story if they were less careful in their youth.

Thickened skin

Course, leathery skin is the hallmark of sun damage. Think Donatella Versace. Photo damaged skin has a thickened stratum corneum (often referred to as the horny layer) and thinner epidermis, healthy skin has the opposite. When we’re constantly exposed to UV rays the skin tries to protect itself by thickening the horny layer, resulting in a rough texture that absorbs light rather than reflecting it, making it look dull – the polar opposite of a dewy, radiant complexion that so many clients aspire to. If you look at sun damaged skin under a microscope, the cells on the epidermis are loose, there are gaps where the collagen has been broken down, compromising its elasticity and ability to retain moisture.

Healthy skin has a thinner horny layer with ‘compacted’ cells, which means they are tightly packed together. Vitamin A has been shown to play a significant role in influencing the genes that cause epidermal stem cells to grow into fully functioning keratinocytes and mature into healthy layers of the epidermis. It increases the growth of the basal layer which is why the epidermis becomes thicker and therefore more tolerant to damaging environmental effects. It has also been shown to compact the cells on the horny layer, helping to reverse UV damage. 

Collagen breakdown

In addition to thickening the epidermis and thinning an excessively thickened horny layer, Vitamin A also promotes collagen formation by supporting the fibroblast cells which make this essential protein. Our collagen production slows down significantly as we age, so compounding the problem with UV exposure spells disaster – goodbye plump, youthful skin, hello premature sagging and wrinkles. Applying vitamin A topically and taking it orally gives your body the building blocks it needs to make new collagen, resulting in a firmer, younger looking complexion and fewer lines. Vitamin C is also important for collagen formation, so advise clients to add this to their regime, it also has the advantage of lightening and brightening the complexion.

Pigmentation Problems

Solar lentigines, more commonly known as sun spots or liver spots, are another tell tale sign of too much sun and not enough protection. They occur because UV radiation damages the keratinocyte cells. These make up 90% of the epidermis and have several functions during their life cycle, one of which is communicating with melanocytes which are responsible for melanin production. When they are damaged, this communication is disrupted, resulting in either too much melanin being produced (hyperpigmentation) or too little (hypopigmentation). Vitamin A normalises this process by protecting skin from UV damage, repairing the DNA of the keratinocyte which stops it ‘telling’ the melanocyte to make more melanin and reducing the activity of tyrosinase which is ultimately turned into melanin.

Clients may wonder why pigmentation marks can’t be removed with exfoliation. The reasons for this are complex, but in essence melanocytes transfer melanin to the keratinocytes in the lower layers, which then carry it up to the surface of the skin. However, if the melanocyte’s DNA is damaged by UV exposure it will keep ‘giving’ the keratinocytes too much melanin. This cycle will continue until it’s been normalised with vitamin A. 

The vitamin A paradox

“It is a paradox that the most essential vitamin in the skin is damaged by the main feature of the environment that the skin has to encounter (i.e. UV rays)”, says Dr Fernandes. “The photo-decomposition of the retinyl palmitate form of vitamin A is the main cause of photo ageing. This degradation happens day after day, year in, year out. The irony is that vitamin A is required to restore the cellular health of skin”, he explains. “However, the reason it is destroyed is that it absorbs those rays and acts as a very powerful natural sunscreen.” For this reason, high levels of vitamin A in the form of retinyl palmitate, such as those found in Environ®’s AVST 4 or 5, provide an SPF20, although it needs to be reapplied daily in order to make up for the natural degradation by sunlight. 

Start low, and go slow

It’s important to introduce clients slowly to vitamin A in order to avoid a retinoid reaction, hence Environ®’s unique Step Up System. This is particularly true of clients with sun damaged skin - ironically they are the ones in most need of vitamin A, but are the most likely to react to it because the sun has depleted their levels to such an extent that there are very few receptors in their skin. Interestingly, you can apply AVST 4 or 5 to a baby and it’s unlikely to react because their skin is full of vitamin A receptors, but these become damaged on the journey to adulthood thanks to UV exposure.

Inside and out

To maximise the benefits of vitamin A, it’s important to consume it as well as applying it topically. Full fat milk, liver and eggs are all good sources, but intensive farming methods mean that food contains far fewer nutrients than in years gone by. In fact, a staggering 95% of women in the UK don’t get enough vitamin A. "To support vitamin A levels, we recommend that you take vitamin A in supplement form,” says Lorraine Perretta, Head of Nutrition at the iiaa. “It complements topical vitamin A. The skin is a mirror of what’s going on internally, so if the body is making healthy skin on the inside, it’s going to look radiant on the outside.”

Tracy Tamaris, Training Director at the iiaa, agrees. “For maximum results, a holistic approach is needed. If you just apply Vitamin A topically, you’ll get a result. If you just take it orally, you’ll also see improvements, but if you do both you’ll achieve an even better outcome. Then, if you add facials, or products with peptides like our Focus Care™ Radiance+ range, the difference will be much more pronounced. The added advantage of taking vitamin A orally is that it often helps clients tolerate higher levels when it’s applied topically, enabling them to move up the Environ® Step Up System more quickly. Imagine your client wanted to feel more healthy. If they improved their diet that would help, if they then introduced an exercise regime that would be even better and if they then got more sleep and cut down on alcohol their sense of wellbeing would increase dramatically. It’s the same with tackling any skin concern, the more you do, the better the outcome.”

Your not-so-secret weapon

So, if your clients are paying the price for being avid sun worshippers, all is not lost. You can be confident that using vitamin A as the cornerstone of their skincare regime will help to reverse the damage. It won’t happen overnight, and the approach needs to be tailor made to each client, but it’s the most powerful tool you have. “Vitamin A is fundamentally the most important molecule in addressing sun damage and anti-ageing”, says Dr Fernandes. “There is simply nothing else like it.”

UK National Diet and Nutrition Survey 2003 & American Journal of Clinical Nutrition 2007;85:860-8. Ni, Z et al Phytotherapy Research 2002.
Skin integrity was assessed using a measurement of TEWL (Trans Epidermal Water Loss). When this is a problem, skin loses water and can appear dull and dehydrated.