Anti-Aging Vita Gel (Niacinamide / Tretinoin / Vitamin C / Vitamin E) (30 mL)

Niacinamide

Niacinamide, also called nicotinamide, is a form of vitamin B3, part of the B-complex family. We normally get niacin from foods like animal proteins, beans, green vegetables, peanuts, mushrooms, liver, whole wheat, and unpolished rice. Grains also contain niacin, but most of it is tightly bound to plant proteins, which makes it harder for our body to absorb.

Our main source of dietary niacin often comes from enriched flours and grains, since food fortification programs add it back in. Interestingly, our body can also make niacin from the amino acid tryptophan (found in foods like milk and eggs, which don’t naturally contain niacin but are rich in tryptophan). However, this conversion depends on having enough other nutrients like iron, vitamin B6, and riboflavin. If those are low, the body may not make enough niacin.

When someone doesn’t get enough niacin, it can lead to pellagra, a condition historically seen in people with very poor diets. Today, pellagra is rare in developed countries thanks to food fortification.

The term niacin is often used broadly for both niacin (nicotinic acid) and niacinamide, though the two forms have different uses in medicine. Nicotinic acid is used to lower cholesterol, while niacinamide is not effective for this purpose. Niacinamide is the preferred form in skincare and supplements because it doesn’t cause flushing (a common side effect of nicotinic acid).

Tretinoin

Tretinoin (all-trans-retinoic acid, or ATRA) is a derivative of vitamin A. It belongs to the family of retinoids, which play an important role in regulating how skin cells grow, mature, and renew themselves. Unlike vitamin A itself, tretinoin isn’t converted into rhodopsin (the pigment in the eye needed for night vision).

In dermatology, topical tretinoin is a gold standard treatment for:

Acne (mild to moderate)

Sun-damaged skin (photodamage)

Certain skin disorders related to keratin buildup (e.g., ichthyosis, keratosis follicularis)

Tretinoin works by speeding up skin cell turnover, helping unclog pores, smooth uneven texture, and boost collagen production over time.

Beyond skincare, oral tretinoin is used in medicine to treat acute promyelocytic leukemia (APL), a type of blood cancer. It helps cancer cells mature into normal white blood cells, offering a less toxic treatment option compared to traditional chemotherapy. However, around 25% of patients may experience a serious complication called differentiation syndrome.

Vitamin C

It’s essential for many body functions, including:

Helping the body absorb dietary iron

Producing collagen, which keeps skin, blood vessels, bones, and connective tissues strong

Excellent sources include citrus fruits, berries, tomatoes, potatoes, and leafy greens.

When vitamin C is low, it disrupts collagen production, leading to scurvy — a disease historically seen in sailors without fresh produce. Scurvy symptoms include bleeding gums, skin issues, weakness, and poor wound healing.

In skincare, vitamin C is prized for its ability to stimulate collagen, brighten skin tone, and neutralize free radicals, making it a staple in many anti-aging products.

Vitamin E (Acetate)

Vitamin E is a fat-soluble vitamin found in foods like vegetable oils, wheat germ, nuts, seeds, green vegetables, meat, and fish. It actually refers to a family of 8 compounds (tocopherols and tocotrienols), with alpha-tocopherol being the most biologically active form.

The natural form is d-alpha-tocopherol, while the synthetic version is dl-alpha-tocopherol (often found in supplements as dl-alpha-tocopheryl acetate for stability).

Vitamin E deficiency is rare, but it can occur in people with fat-absorption problems (like cystic fibrosis or chronic bowel diseases). In such cases, supplementation is necessary.

Vitamin E has been studied for many potential benefits, including heart health, cancer prevention, and skin protection. However, large clinical trials have shown mixed or disappointing results:

Cardiovascular disease: Studies like the HOPE and Women’s Health Study found no benefit in preventing heart disease with vitamin E supplements.

Cancer: Some early studies suggested it might reduce prostate cancer risk, but later large trials (like SELECT) showed no protective effect and even hinted at possible risks.

In skincare, topical vitamin E is often marketed as an antioxidant to reduce photoaging and aid skin healing, but these claims haven’t been strongly proven.

Tretinoin

Tretinoin is a derivative of vitamin A and belongs to the family of compounds called retinoids. Retinoids are powerful messengers in the body, helping regulate how cells grow, mature, and renew themselves. They interact with special receptors in the skin—called retinoic acid receptors (RARs)—which then influence gene activity and protein production.

In skincare, tretinoin works by speeding up skin cell turnover. This helps unclog pores, push out dead cells, and prevent new breakouts from forming. While it doesn’t affect oil production or the acne-causing bacteria directly, its ability to keep pores clear makes it highly effective for acne treatment.

It reduces fine lines, uneven pigmentation, and rough skin texture by preventing the breakdown of collagen (the protein that keeps skin firm). Studies show tretinoin can block up to 80% of the enzymes that break down collagen after sun exposure.

Outside of dermatology, tretinoin has a role in treating acute promyelocytic leukemia (APL), a rare type of blood cancer. In APL, tretinoin helps cancerous cells mature into normal white blood cells, which is why it has become an important therapy in oncology.

Niacinamide

Niacinamide, also called vitamin B3, is a versatile nutrient that plays a major role in how our cells produce energy and repair themselves. The body uses niacinamide to create two coenzymes—NAD and NADP—that are involved in hundreds of reactions that keep cells alive and healthy.

When applied topically in skincare, niacinamide offers a wide range of benefits:

Strengthens the skin barrier, helping it retain moisture.

Improves skin tone, reducing dullness and minimizing dark spots.

Regulates oil production, which can help reduce breakouts.

Unlike another form of vitamin B3, called nicotinic acid (niacin), niacinamide does not cause flushing (the red, warm sensation often associated with niacin supplements).

In medicine, niacin (but not niacinamide) has also been used to improve cholesterol levels, though its cardiovascular benefits have been debated in recent years.

Vitamin C

Since humans cannot produce it naturally, it must come from diet or supplements. Foods like citrus fruits, berries, tomatoes, and leafy greens are excellent sources.

Vitamin C plays several key roles:

Without it, collagen fibers weaken, leading to fragile skin and poor wound healing.

It acts as a powerful antioxidant, neutralizing free radicals that cause oxidative stress and accelerate skin aging.

It boosts iron absorption, supporting healthy blood and energy levels.

In skincare, topical vitamin C is widely used because it helps brighten the complexion, reduce hyperpigmentation, and protect against environmental damage like UV rays and pollution.

A severe deficiency in vitamin C leads to scurvy, a condition once common among sailors, causing bleeding gums, skin problems, and poor healing. While rare today, this highlights just how critical vitamin C is for skin and overall health.

Tretinoin
Tretinoin should not be used in people who are allergic to vitamin A or other retinoids, since cross-reactions can occur, though true allergy is rare. Some brands, like Atralin gel and Altreno lotion, contain fish proteins and may trigger reactions in those with fish allergies. In leukemia treatment, about one-quarter of patients may develop a condition called retinoic acid-APL (RA-APL) syndrome, which can be serious and requires close monitoring. This syndrome sometimes occurs with high white blood cell counts, so doctors may add chemotherapy or steroids if levels rise quickly. For skin use, tretinoin can increase sun sensitivity. Sun protection with sunscreen and protective clothing is advised, and therapy should be delayed until sunburn heals. Those with eczema may experience severe irritation. Except for certain lotions and gels, tretinoin is generally not approved for children under 12. Topical forms are for external use only, should not touch the eyes or mucous membranes, and are flammable.

Niacinamide (Niacin)
Niacin should be avoided in people allergic to niacin or its ingredients. It is not recommended in those with active liver disease, heavy alcohol use, gallbladder problems, or unexplained liver issues, as it may worsen these conditions. High doses may raise liver enzymes, uric acid, and blood sugar levels, so caution is needed in patients with diabetes, gout, or liver risk factors. Niacin can also aggravate stomach ulcers, cause low blood pressure, or interact with heart medicines. Rarely, it can cause muscle damage when combined with statins. Older adults generally tolerate niacin, though sensitivity may vary. In children, high doses are usually avoided unless treating severe cholesterol problems under expert supervision. During pregnancy and breastfeeding, only nutritional amounts are considered safe, not high therapeutic doses.

Vitamin C
Vitamin C supplements should be avoided in patients with blood conditions like thalassemia, sickle cell disease, or hemochromatosis, since it can worsen iron overload. Excessive intake may increase kidney stone risk and should be used carefully in patients prone to stones. It may also affect blood sugar control in diabetes.

Vitamin E
High doses of vitamin E (above 800–1,000 IU/day) may increase bleeding risk, especially in those taking blood thinners. During pregnancy and breastfeeding, supplementation beyond daily recommended amounts is usually unnecessary unless advised by a doctor. In premature or very-low-birth-weight infants, high vitamin E levels may increase risks of sepsis or intestinal problems, so monitoring is essential. Topical vitamin E is for external use only and should be kept away from eyes and mucous membranes.

Tretinoin
Both oral and topical tretinoin can cause skin reactions, though irritation is more common with topical use. Nearly all patients report redness, peeling, burning, or dryness, and in some cases, the irritation is severe enough to pause treatment or require a mild steroid cream. Around 4% of users stop using it entirely due to side effects. If swelling, blisters, or crusting develop, treatment should be stopped until the skin heals, after which therapy may restart at a lower strength. Skin color changes, either darker or lighter, have been reported in a small number of patients, usually resolving once treatment is discontinued. Tretinoin also increases sensitivity to sunlight, so sunscreen and protective clothing are strongly recommended. Oral tretinoin often causes dry skin and rashes, with other possible effects including itching, hair thinning, swelling, or rare inflammatory conditions like erythema nodosum.

Niacinamide / Niacin
When taken at normal dietary levels, niacin and niacinamide are safe. Problems mainly arise at high doses, especially above 1 gram daily. A well-known side effect of niacin is flushing—warmth, redness, and tingling of the skin, particularly on the face and chest. This may be accompanied by dizziness, headaches, or rapid heartbeat. Flushing is less common with extended-release forms and often improves after a few weeks. High doses can also upset the stomach, causing nausea, diarrhea, or abdominal pain. Some people may develop itching, rash, or, in rare cases, serious allergic reactions. Prolonged use at large doses can harm the liver, leading to jaundice or abnormal blood tests, so regular monitoring is important. Niacin can raise blood sugar, uric acid (triggering gout), and lower phosphorus levels. Very rarely, muscle damage (rhabdomyolysis) may occur, especially when combined with statins.

Vitamin E
High doses of vitamin E supplements can interfere with blood clotting and increase bleeding risk, particularly in premature babies and very low birth weight infants. In these infants, excessive vitamin E has also been linked to serious gut and infection-related complications. Adults taking very large doses over long periods may experience nausea, fatigue, headaches, blurred vision, hormonal changes, or even breast enlargement. Topical vitamin E products can occasionally cause skin irritation or allergic rashes.

Vitamin C
Vitamin C is generally safe, but high doses can sometimes cause issues. It may increase the risk of kidney stones in people prone to them, and some individuals may experience back pain or discomfort. Caution is advised for patients with certain blood disorders or kidney problems.

Tretinoin
Tretinoin carries significant pregnancy risks, especially in oral form. Oral tretinoin has a high chance of causing birth defects if taken during pregnancy, and strict precautions are required. Women must use two reliable forms of birth control during treatment and for one month after stopping therapy, even if they have a history of infertility or menopause (unless they’ve had a hysterectomy). A negative pregnancy test should be confirmed before starting therapy, and monthly testing is recommended during use. Topical tretinoin carries much less risk but should still be used cautiously, avoiding large skin areas or prolonged application.

Oral tretinoin requires stopping breastfeeding. With topical tretinoin, systemic absorption is low, but caution is still advised. Alternatives like azelaic acid, benzoyl peroxide, or topical antibiotics may be safer options.

Niacinamide (Niacin)
Niacin is safe in pregnancy when taken at recommended daily allowance (RDA) levels and is classified as category A. However, higher doses used to treat cholesterol problems are categorized as C, meaning risks are possible. Most manufacturers advise avoiding high-dose niacin during pregnancy unless the potential benefits outweigh the risks, since no thorough safety studies have been done.

During breastfeeding, niacin and niacinamide are excreted into breast milk in proportion to maternal intake. At RDA levels, it is considered safe and sometimes necessary if the mother’s diet is lacking. However, lipid-lowering (high-dose) niacin is not recommended because of possible adverse effects in nursing infants.

Vitamin C
Vitamin C is safe in pregnancy at RDA doses and is classified as category A. At higher doses, it is considered category C because risks are unclear, and excessive use has been linked to a rare condition called “conditional scurvy” in newborns. For this reason, supplementation above dietary needs should only be considered when benefits outweigh risks.

Vitamin C passes into breast milk. While no specific harmful effects have been documented, manufacturers advise caution with supplementation during breastfeeding.

Vitamin E
Excess intake during pregnancy may carry risks, and so it should only be used when specifically recommended by a doctor. Vitamin E does pass into breast milk, but within normal dietary amounts, it is considered safe. However, applying topical vitamin E directly to the breasts is discouraged, as it could expose the infant during nursing.

Store this medication in its original container at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

1. Niaspan (niacin extended-release) tablet package insert. North Chicago, IL: Abbott Laboratories; 2015 Apr.
2. HPS2-THRIVE Collaborative Group. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med 2014;371:203-12.
3. Taylor AJ, Villines TC, Stanck EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 2009. Epub ahead of print, doi:10.1056/NEJMoa907569.
4. Lee JMS, Robson MD, Yu LM, et al. Effects of high-dose modified-release nicotinic acid on atherosclerosis and vascular function: A randomized, placebo-controlled, magnetic resonance imaging study. J Am Coll Cardiol 2009;54:1787—94.
5. McKenney JM, et al. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7.
6. Vesanoid (tretinoin) capsules package insert. Nutley, NJ: Roche Laboratories Inc.; 2004 Oct.
7. Abdullah M, Jamil RT, Attia FN. Vitamin C (Ascorbic Acid) [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available on the World Wide Web at https://www.ncbi.nlm.nih.gov/books/NBK499877/– LinkOpens in New Tab
8. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes – Panel on Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids and the Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine (IOM). Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. 2000.The National Academy of Sciences Press, Washington DC.
9. Stampfer MJ, Hennekens CH, Manson JE, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993;328:1444-9.
10. Rimm EB, Stampfer MJ, Ascherio A, et al. Vitamin E consumption and the risk of coronary disease in men. N Engl J Med 1993;328:1450-6.
11. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996;347:781-6.
12. Hodis HN, Mack WJ, LaBree L, et al. Serial coronary angiographic evidence that antioxidant vitamin intake reduces progression of coronary artery atherosclerosis. JAMA 1995;273:1849-54.
13. Rapola JM, Virtamo J, Haukka JK, et al. Effect of vitamin E and beta carotene on the incidence of angina pectoris. JAMA 1996;275:693-8.
14. Yusuf S, Dagenais G, Pogue J, et al. The Heart Outcomes Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 2000;342:154-160.
15. Lee MI, Cook NR, Gaziano JM, et al. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women’s Health Study: A randomized controlled trial. JAMA 2005; 294:56-65.
16. Mosca L, Women’s LJ, Benjamin EJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 2004;109:672-93.
17. Hercberg S, Galan P, Preziosi P, et al. The SU.VI.MAX Study: a randomized, placebo controlled trial of the health effects of antioxidant vitamins and minerals. JAMA 2004;164:2335-42.
18. Lonn E, Bosch J, Yusuf S, et al. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47.
19. Virtamo J, Pietinen P, Huttunen JK, et al. Incidence of cancer and mortality following alpha-tocopherol and beta-carotene supplementation: a postintervention follow-up. JAMA 2003;290:476-85.
20. Chan JM, Stampfer MJ, Ma J, et al. Supplemental vitamin E intake and prostate cancer risk in a large cohort of men in the United States. Cancer Epidemiol Biomarkers Prev 1999;8:893-9.
21. Heinomen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998;18:440-6.
22. National Cancer Institute news release. October 27, 2008. Review of prostate cancer prevention study shows no benefit for use of selenium and vitamin E supplements. Accessed November 17, 2008. Available on the World Wide Web at www.cancer.gov/newscenter/pressreleases/SELECTresults2008.
23. Fisher GJ, Wang Z, Datta SC, et al. Pathophysiology of premature skin aging induced by ultraviolet light. N Engl J Med 1997;337:1419-28.
24. Grignani F, Fagioli M, Alcalay M, et al. Acute promyelocytic leukemia: from genetics to treatment. Blood 1994;83:10-25.
25. Altreno (tretinoin lotion) package insert; Bridgewater, NJ: Valeant Pharmaceuticals North America LLC; 2018 Aug.
26. Moore DE. Drug-induced cutaneous photosensitivity: incidence, mechanism, prevention and management. Drug Saf 2002;25:345-72.
27. Colletti RB, Neufeld EJ, Roff NK, et al. Niacin treatment of hypercholesterolemia in children. Pediatrics 1993;92:78-82.
28. Expert Panel: National Cholesterol Education Program. Report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992;89(suppl 2):525-84.
29. Niacinamide. In: Drugs in Pregnancy and Lactation. A Reference Guide to Fetal and Neonatal Risk. Briggs GG, Freeman RK, Yaffe SJ, (eds.) 7th ed., Philadelphia PA: Lippincott Williams and Wilkins; 2005:1140-1
30. Health Care Financing Administration. Interpretive Guidelines for Long-term Care Facilities. Title 42 CFR 483.25(l) F329: Unnecessary Drugs. Revised 2015.
31. Booth SL, Golly I, Sacheck JM, et al. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr 2004;80:143-148.
32. Freedman JE, Keaney JF. Vitamin E inhibition of platelet aggregation is independent of antioxidant activity. J Nutr 2001;131:374S-377S.
33. Lawrence RA. Chapter 9: Diet and dietary supplements for the mother and infant. In: Breastfeeding- A Guide for the Medical Profession. 5th ed. St. Louis MO: Mosby, Inc.; 1999.
34. Brion LP, Bell EF, Raghuveer TS. Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2003;(4).
35. Brion LP, Bell EF, Raghuveer TS, et al. What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants? J Perinatol 2004;24:205-207
36. Tretinoin capsules package insert. Sellersville, PA: Teva Pharmaceuticals; 2009 Jun.
37. Retin-A Micro (tretinoin gel) package insert. Quebec, Canada: Valeant Pharmaceuticals North America, LLC; 2017 Oct.
38. Ascorbic acid use during pregnancy. Drugs.com. (n.d.). Retrieved June 29, 2022, from https://www.drugs.com/pregnancy/ascorbic-acid.html– LinkOpens in New Tab
39. Tretinoin capsules package insert. Chestnut Ridge, NY: Par Pharmaceutical; 2017 Jan
40. Renova 0.02% (tretinoin cream) package insert; Bridgewater, NJ: Valeant Pharmaceuticals North America LLC; 2013 Jun.
41. Niacor (Niacin tablets) package insert. Minneapolis, MN: Upsher-Smith Laboratories, Inc.; 2000 Feb.
42. Zenk KE, Sills JH, Koeppel RM. Neonatal medications and nutrition. A comprehensive guide. 3rd ed. Santa Rosa: NICU Ink Book Publishers; 2003.
43. Vitamin C side effects: Common, severe, long term. Drugs.com. (n.d.). Retrieved June 29, 2022, from https://www.drugs.com/sfx/vitamin-c-side-effects.html