A reader has asked my opinion about the use of retinol, which is Vitamin A, in skin creams, and whether it might cause cancer.


The use of retinol in skin creams has been around for quite a long time- at least 25 years. The prescription forms of it usually contain an analogue of Vitamin A, such as Retin-A, and the over the counter forms contain regular Vitamin A, retinol.


Whether it's the natural Vitamin A or an analogue, the benefit from using it comes from its mildly irritating effect, which causes the outer skin cells to shed. A comparison has been made to an onion. If you peel the outer, dry, crusty layers of an onion, you get to a layer that is smooth and soft and moist. And it certainly looks much younger.


As to whether the use of retinol might cause or increase the risk of skin cancer, it is, after all, an irritant, and chronic irritation is a factor in many cancers. Moreover, it increases sun sensitivity, and the sun is obviously a factor in skin cancer. That's the reason why the use of sunscreen is recommended to all those using Vitamin A creams.


But, you should also know that some dermatologists prescribe Retin-A as an ancillary treatment for some kinds of skin cancer. The same is true for pre-cancers such as actinic keratosis.  And I mean they have the patient apply the Retin-A directly on the affected skin.


I feel that as long as the individual pays attention to the signs of excess irritation (such as redness, excessive shedding, peeling) and backs off when necessary, and so long as sunscreen is applied daily, that there should be no cause for concern. I think it's safe, and used properly and cautiously, it may actually reduce the risk of skin cancer.


However, I would not use a sunscreen that contained retinol. We're talking apples and oranges here. An anti-aging skin cream with retinol or one of its derivatives is one thing. A sunscreen is something else. They're two separate products, or at least they should be.  


Again, used properly, I feel that retinol creams are safe, and I have no compunction to discourage their use.