Dr. Des Fernandez on Vitamin A, Skin, and Longevity

When we recorded our recent Skin Talks episode with Dr. Des Fernandez, we expected a conversation about Vitamin A. What we didn’t expect was how much it would reframe our thinking about skin health, prevention, and longevity.

Dr. Fernandez is not new to this conversation. He is a plastic and reconstructive surgeon and the founder of Environ Skincare, and he has spent decades studying how skin changes over time. His work with Vitamin A did not begin as a cosmetic pursuit. It began with a question medicine still struggles to answer: why are we better at treating disease than preventing it?

That question became personal early in his career when he treated a young patient with melanoma. Despite repeated surgeries, the patient eventually passed away. In the aftermath, Dr. Fernandez searched the medical literature for any evidence of prevention. He found a 1959 paper that cited the use of Vitamin A to treat early skin cancers. That moment changed the direction of his work.

As he explained, Vitamin A is not a “trend” ingredient. It is a biological requirement. Humans cannot produce it. We rely on diet to obtain it, and every cell in the body depends on it to grow, divide, and mature. From the moment a single fertilized cell begins to divide, Vitamin A guides that process. It helps cells determine what they are meant to become and how they are meant to function.

This matters for skin longevity because aging is not just about time passing. It is about cells gradually losing their ability to function normally. Skin that turns over more slowly, repairs less efficiently, and becomes chronically inflamed is aging at a biological level.

One of the most misunderstood aspects of Vitamin A is how it is stored and functions in the body. Dr. Fernandez explained that most Vitamin A in our tissues is stored as retinyl esters. Only a very small percentage exists as retinol, retinaldehyde, or retinoic acid. These active forms are powerful but can be inherently irritating if used incorrectly.

This is why he strongly pushed back against the idea that higher percentages automatically mean better results. Two products can claim the same retinol percentage yet behave very differently on the skin. Potency depends on how much active Vitamin A is delivered, how stable it is, how it is protected from light and oxygen, and how the skin is prepared to receive it. This is why marketing language often oversimplifies a biologically complex topic.

Another critical point he made is that skin is uniquely vulnerable to Vitamin A deficiency. Unlike other organs, skin is exposed to ultraviolet light daily. Vitamin A is highly sensitive to UV radiation and is easily destroyed by both UVA and UVB exposure. Even brief daily exposure can gradually deplete Vitamin A levels in the skin faster than diet alone can replace them. This depletion is cumulative. It is not the dramatic sunburns that do the most damage, but the small, repeated losses over the years. Dr. Fernandez compared it to throwing away small amounts of money every day. You barely notice at first, but over decades the cost becomes significant.

This is where topical Vitamin A plays a role in longevity skin care. Not as an aggressive corrective tool, but as a way to maintain normal cellular function in an environment that constantly depletes it.

He also explained why so many people struggle with retinoids. Sun damage reduces the number of Vitamin A receptors in the skin. When receptors are low, applying potent forms too quickly can cause irritation, peeling, and barrier disruption. His solution was not avoidance but patience. Start low. Go slow. Allow the skin to rebuild receptors over time. Longevity, by definition, is not rushed.

One of the most powerful moments in the conversation came when Dr. Fernandez spoke about age. He shared that Vitamin A can produce positive changes in skin even in people well into their eighties and nineties. It is never too late to support healthier skin. That said, starting earlier preserves more structure, resilience, and function over time.

The takeaway from this conversation was clear. Healthy skin is not skin that never changes. It is skin that remains resilient, functional, and capable of repair. Vitamin A is not a miracle. It is a foundational nutrient that helps skin behave more like itself for longer.

This is why the conversation about skin longevity needs to move beyond trends, fear, and quick fixes. Longevity is built on consistency, education, and respect for biology. That is the conversation we wanted to have with Dr. Des Fernandez, and we think it will matter even more in the years ahead.

Until next time,

Beate