Are Environ's vitamin A formulations safe to use during pregnancy?

As experts in professional skincare, Environ is frequently asked about the safety of applying skincare products containing vitamin A during pregnancy. It seems that many expecting mothers are advised to avoid using vitamin A based products, especially in the first trimester of pregnancy, to reduce the risk of harm to the foetus.

Based on scientific facts, it is extremely unlikely that topical cosmetic vitamin A skincare products could pose a health risk or a risk to pregnancy because the active molecules are not absorbed into the bloodstream. This is not the same as taking vitamin A orally where absorption into the bloodstream is part of the natural biological process.

How does vitamin A work in the skin?
Here are the facts.

1. Once the cosmetic vitamin A skincare product is applied to the skin and absorbed, it is trapped in the skin. Humans do not have the enzyme systems to transfer vitamin A from the skin into the bloodstream.
2. We should always remember that one of the most important functions of the skin is to protect the body against harmful external influences and therefore, like so many other chemicals, only a small percentage of vitamin A active molecules are actually absorbed in the skin. According to COLIPA (The European Cosmetic and Perfumery Association), less than 6% of skincare products are able to penetrate the skin’s natural protective barriers.
3. The most common cosmetic formulations with vitamin A contain retinyl palmitate, retinyl acetate, retinyl propionate or retinol. (Retinoic acid is only permitted in medical formulations and is not used by Environ). If any of these cosmetic forms of vitamin A is applied to the skin, some of it will get into the interstitial fluid around cells and will be absorbed into the cell itself as retinyl palmitate. This is the natural storage form of vitamin A inside the skin, and where it remains until further metabolised in the skin when required.
4. During December 2021, the Scientific Committee on Consumer Safety Commission in the EU concluded that vitamin A in cosmetics, at the specified regulated concentrations is safe. It is important to be mindful rather of vitamin A contributions from other sources such as food, food supplements, medicines etc.
5. Environ's essential skincare ranges containing vitamin A are deemed safe to use during both pregnancy and lactation. However, during pregnancy, the skin’s response to cosmetics may change due to the hormonal changes taking place in the body. It is recommended that you use lower levels of vitamin A or discontinuing the use of vitamin A if the skin is too sensitive, especially during the first trimester. If you have paused your daily vitamin A moisturiser during pregnancy or for a period of time, it is recommended that you re-introduce vitamin A at a low concentration and step up gradually under the guidance of your Skincare Professional.

Dr. Des Fernandes (Environ Founder and Scientific Director) explains vitamin A and the placental membrane.

“Retinyl palmitate (natural storage form of vitamin A found in the skin) cannot cross the placental membrane, whereas all-trans-retinoic acid and its isomer cis-retinoic acid, as well as retinol can cross the placental barrier. This is how the foetus is naturally supplied with vitamin A which is essential for the normal development of the foetus. This is a naturally occurring process and further illustrating the safety of topical cosmetic forms of vitamin A (Retinyl Palmitate) in pregnancy. We know vitamin A is responsible for normal cellular and DNA activity. So, this seems an excellent case for showing that women need vitamin A supplementation in pregnancy. (In Japan they assessed vitamin A in the diets of healthy pregnant women and found that the vitamin A levels were on about 86% of the normal daily requirement)

We do not need to be concerned about cosmetic skincare applications of vitamin A (containing retinyl palmitate and retinyl acetate etc.) during pregnancy. I also believe we do not have to worry about products containing retinol because the total amount of vitamin A that gets down into the skin is only a tiny fraction of what is applied. That dose is generally insignificant when compared to the total daily oral consumption of vitamin A.

For interest, these foods contain vitamin A (i.u = international vitamin A unit of measurement):

Slice of liver:	+- 20,000 to 50,000 i.u.
An egg:	+- 260 i.u.
A slice of lean meat:	+- 8 i.u.
A slice of fatty meat:	+- 20 i.u.
An éclair:	+- 1550 i.u.
Canned apricots:	+- 2900 i.u. (as beta-carotene)

Where concerns arise around vitamin A causing foetal abnormalities, it is specifically about the oral cis-retinoic acid (for which a medical prescription is required), in which case doses of up to 300,000 i.u. of vitamin A are prescribed.

When looking at cosmetics only; if you apply a gram of a vitamin A cream containing 5000 i.u. per gram then you will apply 5000 i.u., and a maximum of 300 i.u. will reach the keratinocyte layer over about 260 square centimetres. This is about 0.13 i.u to a maximum of 1.3 i.u. per square centimetre. Remember this vitamin A is trapped in the skin.

Even if you use a cosmetic product with 10,000 i.u. per gram the levels of vitamin A are minimal. If all the applied vitamin A were absorbed, the dose is still small compared to the recommended daily dietary allowance and even this differs around the world.

In the 1980’s researchers examined 100 pregnant women who took varying amounts of vitamin A orally. The amount ranged from 4000 i.u. per day to 100,000 i.u. per day. Evidence showed that whilst the number of foetal abnormalities were no different to the normal parameters (ranging from the simplest to the most complex), what was evident, was that no abnormalities were found in women taking 100,000 i.u. daily. Neither in women taking 40,000+ i.u daily. Foetal abnormalities were only shown in those of sample taking less than 10,000 i.u. daily."

Environ will always recommend consulting your Medical Professional as well as your Skincare Professional for guidance on a safe and effective Environ skincare routine.

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References:

Mastroiacovo, P., et al., High vitamin A intake in early pregnancy and major malformations: a multicenter prospective controlled study. Teratology, 1999. 59(1): p. 7-11.

Nohynek GJ, Meuling WJ, Vaes WH, Lawrence RS, Shapiro S, Schulte S, et al. Repeated topical treatment, in contrast to single oral doses, with Vitamin A-containing preparations does not affect plasma concentrations of retinol, retinyl esters or retinoic acids in female subjects of child-bearing age. Toxicol Lett. 2006;163(1):65-76.

Wiegand, U.W., S. Hartmann, and H. Hummler, Safety of vitamin A: recent results. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 1998. 68(6): p. 411-6.

Bendich, A. and L. Langseth, Safety of vitamin A. Am J Clin Nutr, 1989. 49(2): p. 358-71.