Do face creams, anti-aging serums, and acne gel treatments containing vitamin A or retinol reduce bone density or increase the risk of fractures?

Answer:

Vitamin A derivatives, or retinoids, such as retinol, retinyl-palmitate, retinyl-acetate and retinaldehyde are common ingredients in anti-aging creams and serums that promise to improve skin tone and dimmish fine lines and wrinkles. These derivatives are also found in over-the-counter acne treatments such as Differin gel (which contains adapalene, a synthetic form of retinyl-palmitate). There is evidence that topical retinoids have antibacterial, anti-inflammatory and antioxidant effects, and may also promote the synthesis, and slow the breakdown of collagen — all of which may improve the appearance of the skin.

Although there have been concerns that high oral doses of retinol may reduce bone mineral density and increase the risk of fractures, not all studies have found an increased risk, and there does not appear to be increased risk associated with topical retinoid products.

However, topical retinoids can cause other side effects, such as redness, scaling, dryness, and stinging/burning, and there are ways to minimize these occurrences. There have also been reports linking topical retinoid use and birth defects.

More details are in the Topical creams, gels, and serums section of our Vitamin A Supplements Review.