Fat-soluble vitamin A
ATC code: A11CA01 (Retinol (vit A))
Brand names
Aquasol A
Retinol is absorbed in the small intestine together with fats and bile acids and stored in hepatic stellate cells as retinyl palmitate. In tissues it is oxidised to retinal and retinoic acid, the active form. Retinoic acid binds nuclear RAR and RXR receptors and regulates transcription of more than 500 genes covering epithelial proliferation and differentiation, spermatogenesis, embryonic development, immune response and phototransduction (via 11-cis-retinal in rhodopsin).
First line
First-line treatment for confirmed vitamin A deficiency. recommends oral 100 000 IU in infants aged 6–11 months and 200 000 IU in children over one year every 4–6 months in regions endemic for hypovitaminosis A, which lowers mortality from measles and diarrhoea. In adults with malabsorption (cystic fibrosis, coeliac disease, biliary obstruction, short bowel syndrome) AEMPS allows maintenance doses under serum retinol and liver function monitoring.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Retinol is a topical retinoid, and retinoids are first-line for acne ( 2024, ). Retinol does help acne but is weaker than the prescription retinoids tretinoin and adapalene, which are preferred for more pronounced acne. Early dryness, peeling, and irritation are expected and manageable, not a reason to stop. Retinol is reasonable for mild acne or when prescription retinoids are not tolerated.
Not recommended
Retinol capsules are sold as a skin rejuvenation or anti-aging tool. Oral retinol does not act on skin: tissue concentrations do not reach a level at which retinoic acid activates the renewal programme. That effect comes only from topical retinoids (tretinoin, retinol in cream form) used for many months. Oral high-dose retinol does not rejuvenate – it causes dry skin and hair loss and accumulates in the liver. If retinol capsules were recommended for rejuvenation, consider seeking a second opinion.
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FDA Category X for doses above 10 000 IU/day. High-dose retinol is teratogenic: causes CNS, craniofacial, thymic and cardiac malformations. AEMPS prohibits doses above 3000 mcg RE/day (10 000 IU) in pregnancy and preconception. With malabsorption and confirmed deficiency, individual doses are set by the clinician under serum retinol monitoring.
Compatible at physiological doses (up to 3000 mcg RE/day). Hale L3 above the dietary reference intake. Retinol accumulates in breast milk. AEMPS advises not to exceed 3000 mcg/day in nursing women to avoid infant accumulation. Doses for confirmed deficiency are set by a clinician.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Retinol is evaluated for the following indications with varying evidence strength: Vitamin A deficiency (evidence tier A), Acne vulgaris (evidence tier B), Anti-aging and longevity (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Retinol (≥ 1 in 100): Dry skin and flaking, Hair loss, Cheilitis and angular fissures, Headache, Nausea. See the Safety section for uncommon and serious reactions.
FDA category X. FDA Category X for doses above 10 000 IU/day. High-dose retinol is teratogenic: causes CNS, craniofacial, thymic and cardiac malformations. AEMPS prohibits doses above 3000 mcg RE/day (10 000 IU) in pregnancy and preconception. With malabsorption and confirmed deficiency, individual doses are set by the clinician under serum retinol monitoring.
Compatible at physiological doses (up to 3000 mcg RE/day). Hale L3 above the dietary reference intake. Retinol accumulates in breast milk. AEMPS advises not to exceed 3000 mcg/day in nursing women to avoid infant accumulation. Doses for confirmed deficiency are set by a clinician.
Retinol is contraindicated in: Hypersensitivity to retinol; Pregnancy and preconception at doses above 3000 mcg RE/day; Hypervitaminosis A; Liver cirrhosis of any cause; Chronic kidney failure. Full list in the Safety section.