Retinyl Palmitate + Sun = Cancer?
What's retinyl palmitate? Is that the same thing as retinol? And what is it used for?
Topical retinoids like retinyl palmitate are used in sunscreens, acne products, cosmetics, anti-aging products, facial creams, and in many other products. They can stimulate the production of new skin cells, fade dark spots, reduce acne, and reduce fine lines.
According to the International Dermal Institute, while retinoids like retinol (pure Vitamin A), Retinyl Palmitate and Retinoic Acid are amongst the most powerful topically applied ingredients to address these skin problems, of all the Retinoids only Retinoic Acid has a direct biological effect on the skin. If Retinoic Acid is the only biologically active form of Retinoid that has a direct effect on the skin, why is it that the cosmetic companies still use Retinol and Retinyl Palmitate to fight aging? Our skin has naturally occurring enzymes that convert Retinol and Retinyl Palmitate into the active form Retinoic Acid. While it may take two and three steps to convert Retinol and Retinyl Palmitate to Retinoic Acid, they can deliver the well-established skin benefits of Retinoic Acid while producing fewer side effects (1).
Is there a link between retinoids and cancer?
For more than a decade, scientists have been investigating retinoids like retinyl palmitate as possible photocarcinogens (meaning that this ingredient could speed up the development of tumors) on sun-exposed skin. A 2012 study by the National Toxicology Program (U.S. Deparment of Health and Human Services) suggests that retinyl palmitate, a form of vitamin A, may speed the development of skin tumors and lesions in the presence of sunlight.(2) While it's true that taking retinoids (vitamin A) by mouth can actually reduce the risk of squamous cell carcinoma in people at high risk for skin cancer (3), this study suggested that it may speed the growth of cancerous tumors when used on skin exposed to sunlight.
According to the Environmental Working Group (EWG), "The strong scientific consensus that has formed around (this) vitamin A study has afforded the FDA an exceptional opportunity to take a bold public health stand on a cosmetic ingredient that has proven harmful in multiple studies. Instead, FDA has decided to await further investigation before making any determination about the safety of retinyl palmitate." (3) EWG's 'Skin Deep Cosmetics Database' gives retinyl palmitate a safety rating of 9 - meaning it is viewed as an ingredient warranting the very most concern (4).
The FDA still hasn’t completed follow-up studies that will allow the agency to take a position on the safety of vitamin A and related chemicals in cosmetics and sunscreens, and most cosmetics companies have not removed these ingredients from sunscreens and other skin and lip products (5).
According to the Skin Cancer Foundation (who refers to EWG as 'a highly funded lobby group'), there is no conclusive research finding that retinyl palmitate in sunscreens is hazardous in any way (6) I would imagine that the Skin Cancer Foundation does not wish to see people stop using sunscreens altogether because of confusing reports about ingredients that may be problematic. The Skin Cancer Foundation asserts, "The claims made by the EWG (which is not a scientific organization) are dangerous because they may dissuade the public from taking proper measures to protect themselves against the world’s most common cancer."
The formal position of the American Association of Dermatology (AAD) is that there is “no evidence that the inclusion of retinyl palmitate in sunscreens can cause cancer in humans.” This is based on three things: the studies were conducted on animals (mice), not humans; mice are “highly susceptible to the effects of UV radiation and can develop skin cancer or other skin abnormalities within weeks of UV exposure, even in the absence of retinyl palmitate”; and, in the studies retinyl palmitate was used on its own, not with other antioxidants. (7)
Bottom Line About Retinoids in Personal Care Products
Retinoids are not just present in sunscreens - they're in makeup and other personal care products, too. There are plenty of effective sunscreens without retinoids in them, and plenty of effective makeup products free of retinoids. Dr. Leslie Baumann (the 'Skin Guru') says that retinoids lose their effectiveness upon sun exposure. So, why are they in sunscreens at all?
It seems further research needs to be done on this issue. If you absolutely don't want to give up using vitamin A products - use them only at night!
I also find it interesting that EWG is dismissed as a 'highly funded lobbying group', when the personal care products and chemical industries have their own large, highly-funded powerful lobbying groups as well that spend hundreds of thousands of dollars persuading the government to protect their interests, not necessarily the consumer's interest. (8,9)
In 1976, the personal care and cosmetics products industry basically created its own industry-funded panel to regulate and test itself (The Cosmetic Ingredient Review, or CIR), and appoints leaders from their own industry to review ingredients used in cosmetics and personal care products for safety. Over the last four decades the CIR has only reviewed approximately 10% of cosmetic ingredients and they have only deemed 12 ingredients as “unsafe” for use in personal care products. Because it’s a voluntary program, companies do not have to actually abstain from using these ingredients. The CIR has found several ingredients to be “safe as used” where there is a strong scientific body of evidence showing harm. Some include:
Topical Retinoids and Pregnancy/Breastfeeding
Dr. Gideon Koren, director of the Motherisk program at Toronto's Hospital for Sick Children, says warning pregnant women against using sunscreen with retinyl palmitate based on the findings of animal studies that use much higher doses than can be absorbed through the skin is unwarranted.
"Scaring pregnant women is a national sport both here and in the United States,"
"You need to poison yourself with vitamin A almost," Koren said, adding the "misinformation" scares women against using sunscreen and increases their risk of melanoma.(10) Dr. Koren published a study in Lancet that showed babies born to mothers taking a topical cousin of vitamin A, isotretinoin, found in an acne medication, were 'fine'.
However, the March of Dimes, a nonprofit organization that works to improve the health of mothers and babies by preventing birth defects, premature birth and infant mortality says
'We don’t know if topical retinoids are safe during pregnancy. But small amounts may be absorbed by the skin, so it’s best to avoid them. We’re not sure if using topical retinoids while breastfeeding is safe for your baby. It’s best not to breastfeed while using these medicines. (11)
According to the March of Dimes, taking ORAL isotretinoin during pregnancy increases the risk of:
Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
Premature birth. This is birth that happens too early, before 37 weeks of pregnancy.
Your baby having birth defects. Birth defects are health conditions that are present at birth that change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works.
Your baby having intellectual and developmental disabilities later in life. These are problems with how the brain works that can cause a person to have trouble or delays in physical development, learning, communicating, taking care of himself or getting along with others.
Birth defects that can be caused by isotretinoin include:
-Congenital heart defects. These are heart conditions that can affect the heart’s shape or how it works, or both.
-Cleft palate and other birth defects of the face. Cleft palate is when a baby’s palate (roof of the mouth) doesn’t form completely and has an opening in it.
Ear problems. Some babies also are born with small ears or are born missing ears. Some babies have hearing loss.
Eye problems. Some babies have microphthalmia, a condition that happens when one or both eyeballs are very small. It may lead to vision loss. Some babies are born missing eyes.
Hydrocephalus. This is fluid buildup in the brain. Extra fluid can cause the head to swell and put too much pressure on the brain. Hydrocephalus can cause intellectual disabilities. In some cases, a surgeon needs to drain the extra fluid from a baby’s brain.
Microcephaly. Babies born with microcephaly have a smaller-than-normal head because the brain doesn’t develop properly or has stopped growing. Babies with microcephaly may have intellectual and developmental disabilities, hyperactivity (trouble sitting still or paying attention), short height, seizures and problems with coordination and balance.
Small or missing thymus gland. This gland is in the upper chest. It makes white blood cells to protect the body from infection.
Because isotretinoin can be so harmful to a developing baby, both women and men must register with the iPLEDGE program before they can take it. iPLEDGE is sponsored by the company that makes isotretinoin. iPLEDGE is approved by the Food and Drug Administration (also called FDA), the government agency that checks the safety of medicine and food in this country.
Both men and women who take isotretinoin must agree to follow strict iPLEDGE rules to help prevent pregnant women and women who may become pregnant from having contact with isotretinoin. Only doctors and pharmacists who are registered in the program may prescribe and give isotretinoin to patients.
Again, as I mentioned before, there are PLENTY of very effective topical products on the market that do not contain retinoids. No one is advising pregnant women, breastfeeding women, or anyone for that matter, not to use sunscreen (or cosmetics or other personal care products). Suggesting that consumers should read labels and understand what's in the product they're using is NOT a scare tactic.
1) International Dermal Institute, 'A New Generation of Retinoids' https://www.dermalinstitute.com/us/news/tag/retinyl-palmitate/
2) National Toxicology Program, ' Abstract for TR-568 - Retinoic Acid and Retinyl Palmitate' https://ntp.niehs.nih.gov/results/pubs/longterm/reports/longterm/tr500580/listedreports/tr568/index.html
3) T.E. Moon et al., Effect of Retinol in Preventing Squamous Cell Skin Cancer in Moderate-Risk Subjects: A Randomized, Double-Blind, Controlled Trial. Southwest Skin Cancer Prevention Study Group. Cancer Epidemiology Biomarkers & Prevention, 1997, 6:949.
4) EWG Skin Deep Database, 'Retinyl Palmitate (Vitamin A Palmitate) https://www.ewg.org/skindeep/ingredient/705545/RETINYL_PALMITATE_(VITAMIN_A_PALMITATE)/#.WarNnl68bIV
5) EWG, 'What Scientists Say About Vitamin A in Sunscreen' http://www.ewg.org/research/what-scientists-say-about-vitamin-sunscreen#.Waq_wl68bIU
7) Truth in Aging. 'Vitamin A: Is it Safe?" http://www.sunscreensafety.info/retinyl-palmitate/
9) Center for Responsive Politics, Chemical Industry https://www.opensecrets.org/lobby/issuesum.php?id=CHM
11) March of Dimes, 'Isotretinoin and Other Retionoids During Pregnancy' http://www.marchofdimes.org/pregnancy/isotretinoin-and-other-retinoids-during-pregnancy.aspx