Vitamin D and A ointment is a topical preparation combining two fat-soluble vitamins commonly used in the UK for dry, cracked, or irritated skin and nappy rash. These barrier emollients support skin repair through vitamin A's role in epithelial regeneration and vitamin D's contribution to skin barrier function. Many UK products are classified as cosmetics or medical devices rather than licensed medicines, so always check for a Product Licence (PL) number. This article covers safe application, potential side effects, and important contraindications, particularly for pregnant women and those with chronic wounds requiring professional assessment.

What Is Vitamin D and A Ointment Used For?

Vitamin D and A ointment is a topical preparation combining two fat-soluble vitamins that may support skin health. These products are typically used as barrier emollients for minor, superficial skin irritation and to support the repair of damaged skin. Vitamin A (retinol) may support epithelial cell regeneration, whilst vitamin D has potential roles in skin barrier function.

In the UK, these preparations are commonly used for dry or cracked skin, minor skin irritation, and nappy rash. It's important to note that many vitamin D and A ointments available in the UK are classified as cosmetics or medical devices rather than licensed medicines. Always check for a Product Licence (PL) number and follow the specific product information leaflet.

Some products combine vitamins A and D with additional ingredients such as zinc oxide or cod liver oil to enhance protective properties. The ointment base provides an occlusive barrier that helps maintain moisture, which may create a better environment for skin healing.

Important considerations:

• These ointments are not recommended for pressure ulcers (which require assessment by a healthcare professional)

• Do not apply to fresh burns (follow NHS first aid: cool the burn under cold running water for 20 minutes, then seek appropriate medical care)

• These products are not substitutes for appropriate wound care or treatment of underlying conditions

• This article does not refer to prescription vitamin D analogues (like calcipotriol for psoriasis) or prescription retinoids (like tretinoin for acne)

Patients with chronic wounds, infected lesions, diabetic foot ulcers, or significant skin damage should seek medical assessment rather than relying on topical vitamin preparations. If a skin condition does not improve within 7 days, consult a healthcare professional.

How to Apply Vitamin D and A Ointment Safely

Proper application technique is essential to maximise the benefits of vitamin D and A ointment whilst minimising the risk of adverse effects or contamination. Before applying the ointment, thoroughly wash and dry your hands to reduce the risk of introducing bacteria to the treatment area. The affected skin should be gently cleansed with lukewarm water and patted dry with a clean towel.

Apply a thin, even layer of the ointment directly to the affected area. Avoid applying excessive amounts, as this does not enhance efficacy and may increase the risk of skin maceration or irritation. These products are generally intended for intact but irritated skin—always check the specific product information leaflet for guidance.

Key application points include:

• Apply as directed in the product information leaflet or by your healthcare professional

• Avoid contact with eyes, mucous membranes, and open wounds unless specifically advised by a healthcare professional

• Do not apply to deep, moderate-severe, chemical or electrical burns

• Do not apply to infected wounds (increasing pain, redness, swelling, pus, or warmth)

• Cover with an appropriate dressing if recommended

• Replace the cap immediately after use to prevent contamination

For patients with diabetes, peripheral vascular disease, or compromised immune systems, even minor skin damage should be assessed by a healthcare professional before self-treating. Never share ointment tubes between individuals, as this poses a cross-contamination risk. If you are using other topical preparations on the same area, allow the previous product to be absorbed before applying the next one. Store the ointment according to the manufacturer's instructions and check the expiry date before each use.

Seek urgent medical attention for burns that are larger than the size of the patient's hand, affect the face/hands/genitals, are deep or blistered, or are chemical/electrical in nature.

Potential Side Effects and Skin Reactions

Vitamin D and A ointments are generally well-tolerated when used appropriately, but like all medicinal products, they can cause adverse effects in some individuals. The most commonly reported reactions are localised skin irritation, redness, itching, or a burning sensation at the application site. These effects are typically mild and transient, often resolving as the skin adapts to treatment or when application frequency is reduced.

Some patients may develop contact dermatitis, either as an irritant reaction to the ointment base or as an allergic response to one of the active ingredients or excipients. Signs of allergic contact dermatitis include persistent redness, swelling, vesicle formation, or worsening itching that develops after several applications. If you suspect an allergic reaction, discontinue use immediately and consult your GP or pharmacist.

Products containing retinol (vitamin A) may increase skin sensitivity to sunlight, so consider sun protection for treated areas if exposed. Prolonged or excessive use of vitamin A-containing preparations may occasionally lead to skin peeling, increased sensitivity, or paradoxical dryness. Vitamin D toxicity from topical application is extremely uncommon, as systemic absorption through intact skin is minimal.

When to seek medical attention:

• Signs of infection develop (increased pain, purulent discharge, fever, spreading redness)

• The condition fails to show improvement within 7 days

• Severe skin reactions occur (extensive blistering, severe swelling, systemic symptoms)

• You experience unexpected symptoms after application

• Accidental ingestion occurs (contact 111 or your GP)

• Accidental eye exposure (rinse thoroughly with water; seek care if irritation persists)

Patients should report any suspected side effects to the MHRA Yellow Card Scheme via yellowcard.mhra.gov.uk, the Yellow Card app, or through the NHS App. This reporting helps the MHRA monitor the safety of healthcare products in the UK.

Who Should Avoid Vitamin D and A Ointment?

Whilst vitamin D and A ointments are suitable for many patients, certain individuals should exercise caution or avoid these preparations altogether. Pregnant women or those trying to conceive should avoid vitamin A (retinol)-containing topical products, in line with MHRA and NHS guidance. Although systemic absorption from topical application is generally low, vitamin A derivatives can be teratogenic, and a precautionary approach is recommended.

Patients with known hypersensitivity or allergy to vitamin A, vitamin D, or any excipients in the formulation should not use these ointments. Those with a history of contact dermatitis to similar products should perform a patch test or seek medical advice before widespread application. Individuals with severe renal impairment or hypercalcaemia should discuss vitamin D-containing preparations with their doctor, though topical absorption is typically insufficient to cause systemic effects.

Specific contraindications and cautions include:

• Deep, infected, or necrotic wounds requiring specialist wound care

• Application to mucous membranes or near the eyes

• Concurrent use of other topical retinoids without medical supervision

• Patients with rare disorders of vitamin metabolism

• People with diabetes, peripheral vascular disease, or immunosuppression should seek assessment for any foot or leg wounds

• Extensive application in neonates or premature infants is not recommended

Breastfeeding mothers should avoid applying the ointment to the breast or nipple area, or ensure thorough removal before nursing to prevent accidental ingestion by the infant. Patients taking systemic retinoids (such as isotretinoin or acitretin) should inform their healthcare provider, as cumulative vitamin A exposure requires monitoring. Those with chronic skin conditions such as eczema or psoriasis should seek dermatological advice before use.

This article does not cover prescription vitamin D analogues for conditions like psoriasis, which should only be used as prescribed. If you have any underlying health conditions, are taking multiple medications, or are uncertain about the suitability of vitamin D and A ointment for your situation, consult your GP or pharmacist before commencing treatment.

Frequently Asked Questions