Vitamin A and D ointment is a thick, petroleum-based skin protectant used mainly for diaper rash, minor cuts and scrapes, chapped or cracked skin, and small burns. Its official labeling lists those uses explicitly, and the product has been a medicine-cabinet staple for decades, particularly in newborn care.
What Is Actually in the Tube
Despite the name suggesting something vitamin-rich, the heavy lifting in most A and D ointment formulas comes from petrolatum (petroleum jelly) and lanolin. Those two ingredients form a greasy, water-resistant barrier on the skin’s surface that locks in moisture and shields damaged or irritated areas from friction and wetness. The vitamin A component is typically retinyl palmitate, a fat-soluble form of vitamin A that the skin can convert to active retinoids. The vitamin D component is cholecalciferol (vitamin D₃) in very small concentrations. The vitamins are present at levels far lower than what you would find in a prescription retinoid cream or a therapeutic vitamin D preparation, so it is best to think of them as supporting players rather than the main act. The ointment base itself does much of the protective work.
A study comparing petrolatum’s effect on skin barrier function found that it reduced transepidermal water loss while also improving hydration and reducing redness.1PubMed Central. Effects of Extra Virgin Olive Oil and Petrolatum on Skin Barrier Function and Microtopography That occlusive barrier is the core reason the ointment helps with so many minor skin complaints. It physically prevents moisture from escaping and keeps irritants from reaching raw or fragile skin.
The Labeled Uses
The FDA-listed indications for over-the-counter vitamin A and D ointment are straightforward: treating and preventing diaper rash, temporarily protecting minor cuts, scrapes, and burns, and relieving chapped, chafed, or cracked skin and lips.2DailyMed. VITAMIN A AND D ointment – petrolatum, lanolin ointment The labeling also specifies that it helps seal out wetness in the diaper area, which is why you will see it recommended for newborns and infants constantly.
In practice, people use it for a wider range of purposes than the label strictly covers. Tattoo artists sometimes suggest it during the healing phase to keep fresh ink moist. Breastfeeding mothers apply it to cracked nipples. Some people dab it on razor burn or windburned cheeks. These are all variations on the same principle: the ointment creates a protective film over irritated skin, reduces moisture loss, and lets the skin underneath heal in a relatively undisturbed environment.
Diaper Rash and What the Evidence Actually Shows
Diaper rash is the single most recognized use for A and D ointment, and it is the first indication listed on most product labels. The logic is sound. Diaper rash happens when moisture, friction, and irritants from urine and stool break down the skin’s outer barrier. An occlusive ointment physically blocks those irritants from reaching the skin while retaining the skin’s natural moisture.
However, the evidence for vitamin A specifically making a difference in diaper rash outcomes is surprisingly thin. A Cochrane systematic review examining topical vitamin A and its derivatives for the treatment and prevention of diaper dermatitis found no significant difference between groups in severity or duration of the rash in the single included study of 114 newborns.3Cochrane Database of Systematic Reviews. Topical vitamin A and derivatives for the treatment and prevention of napkin dermatitis in infants An earlier study comparing A and D ointment plus hygiene measures against hygiene measures alone reached a similar conclusion: both groups cleared up at roughly the same rate.4TheScholarsRepository@LLU. A Study Comparing the Effectiveness of Two Methods of Treating Ammoniacal Diaper Rash
That does not mean A and D ointment is useless for diaper rash. It means the barrier effect of the petrolatum and lanolin base is likely doing most of the heavy lifting, and the vitamins themselves may not be contributing much beyond what a plain petroleum jelly would do. For mild diaper rash, the ointment works because it is an effective occlusive. For more stubborn rashes, particularly those caused by yeast, you probably need an antifungal cream rather than a thicker layer of ointment.
How the Vitamin Components Work on Skin
Even though the vitamin concentrations in over-the-counter A and D ointment are modest, both nutrients play genuine roles in skin biology, and understanding those roles helps explain why the ointment was formulated this way in the first place.
Retinyl palmitate, the vitamin A form in the ointment, is involved in the normal turnover of skin cells. The layered structure of the outer skin depends on retinoid-influenced cell division and differentiation, and retinoids also affect wound healing and immune defense in the skin.5PubMed. Physiological role of retinyl palmitate in the skin Lab studies have shown that retinyl palmitate can increase the rate at which skin cells migrate across a wound, which is one of the early steps in repairing damage.6PubMed Central. Efficacy and mechanism of retinyl palmitate against UVB-induced skin photoaging Whether the concentration in a drugstore ointment is high enough to produce a clinically meaningful version of that effect is an open question. The studies showing clear benefits from topical vitamin A typically use higher concentrations than what you find in a standard A and D product.
Vitamin D₃ plays a role in skin barrier integrity and antimicrobial defense. Research has found that vitamin D helps regulate cathelicidin, an antimicrobial peptide the skin produces to fight off bacteria.7PubMed Central. The vitamin D pathway: a new target for control of the skin’s immune response? In one experiment, topical calcitriol (the active form of vitamin D) improved the skin’s permeability barrier and boosted antimicrobial peptide production, even restoring barriers that had been damaged by corticosteroid use.8British Journal of Dermatology. Topical calcitriol restores the impairment of epidermal permeability and antimicrobial barriers induced by corticosteroids Again, the doses and forms used in those studies differ substantially from what is in an over-the-counter ointment, so the direct applicability is limited. But the rationale for including both vitamins is grounded in real biology, even if the product itself is more barrier cream than therapeutic vitamin delivery system.
Minor Wounds, Burns, and Cracked Skin
For small cuts, scrapes, and superficial burns, A and D ointment works much the way any occlusive wound dressing does. Keeping a wound moist rather than letting it dry out and scab over has been standard wound-care advice for years. A layer of ointment prevents the wound from drying, reduces pain from air exposure, and creates a physical barrier against bacteria in the environment.
The ointment is not antiseptic. It does not kill bacteria the way antibiotic ointments do. For clean, minor wounds in healthy people, that usually does not matter. Research on whether antibiotic ointment is actually superior to plain petroleum-based ointment for uncomplicated minor wounds has been mixed, and many dermatologists now suggest plain petrolatum for simple cuts to avoid the risk of developing a contact allergy to antibiotics like neomycin or bacitracin.
For cracked, chapped, or windburned skin, the ointment’s thickness is the advantage. Thinner lotions evaporate quickly or get rubbed off, but a waxy ointment stays in place for hours, which is particularly useful on lips, knuckles, and heels. The lanolin component also has some emollient properties of its own, though it comes with a caveat discussed below.
The Lanolin Problem
Lanolin, the waxy substance derived from sheep’s wool, is a standard ingredient in many A and D ointment formulations. It helps the product spread and gives it additional moisturizing properties. On healthy, intact skin, lanolin lubricates well and supports the skin’s lipid barrier. But lanolin is also a well-documented contact allergen, and the risk of a reaction goes up when the skin is already damaged or inflamed.9PubMed Central. Hypersensitivity to Lanolin: An Old-New Problem
This creates an unfortunate catch-22: the situations where you most want to use the ointment, such as raw diaper rash, cracked nipples, or eczema flares, are exactly the situations where lanolin sensitivity is most likely to develop. If you notice that a patch of irritated skin gets worse rather than better after applying A and D ointment, or if you develop new redness and itching around the application site, lanolin sensitivity is a real possibility. Switching to a lanolin-free petrolatum product and seeing whether things improve is a reasonable first step. People who know they are sensitive to wool should be especially cautious.
What A and D Ointment Is Not Good For
The ointment’s popularity leads people to reach for it in situations where it is not the best choice, and in a few cases where it could make things worse.
- Deep or infected wounds: A and D ointment has no antibiotic or antiseptic properties. A wound that is red, swollen, warm, oozing pus, or showing signs of spreading infection needs medical attention, not a thicker layer of ointment.
- Fungal rashes: Many persistent diaper rashes are caused by Candida yeast. Occlusive ointments can actually create a warmer, moister environment that yeast thrives in. If a diaper rash has lasted more than a few days and has satellite spots or a bright red border, an antifungal cream is a better option.
- Atopic dermatitis as a standalone treatment: While people sometimes use it as an everyday moisturizer for eczema-prone skin, the product was flagged in dermatology literature as not an appropriate emollient for atopic dermatitis specifically. The lanolin content and the ointment’s formulation may not suit the needs of chronically inflamed atopic skin, and purpose-designed emollients or prescription barriers tend to perform better for that condition.
- Sunburn prevention or sun protection: Despite the presence of vitamin A, the ointment has no SPF rating and provides no protection against ultraviolet radiation. Applying it before sun exposure will not prevent sunburn.
For any of these situations, a pharmacist or dermatologist can point you toward a product that matches the problem more precisely.
Skin Aging and Collagen
One use that goes well beyond the product label involves aging skin. The connection between vitamin A and skin aging is well established in dermatology, even though it is mostly studied with prescription-strength retinoids rather than over-the-counter ointments. In a study of people over 80 years old, topical application of 1% vitamin A for just seven days increased fibroblast growth and collagen synthesis while reducing the enzymes that break down collagen.10PubMed. Vitamin A antagonizes decreased cell growth and elevated collagen-degrading matrix metalloproteinases and stimulates collagen accumulation in naturally aged human skin The researchers found that naturally aged skin and sun-damaged skin share key features, including reduced collagen production and elevated levels of collagen-degrading enzymes, and that topical vitamin A can partially counteract both.
Should you smear A and D ointment on your face as an anti-aging treatment? Probably not. The concentration of retinyl palmitate in the ointment is much lower than the 1% vitamin A used in that study, and the greasy petrolatum base is not formulated for facial skin. If you are interested in the anti-aging benefits of topical retinoids, dedicated retinol serums and prescription tretinoin deliver the active ingredient at effective concentrations in cosmetically elegant vehicles. The A and D ointment study is more interesting for what it tells us about how vitamin A works on skin than for what it says about the ointment itself.
Use During Pregnancy and in Newborns
Because A and D ointment is so closely associated with baby care, the question of safety during pregnancy and in newborns comes up often. Systemic vitamin A at high doses is a known teratogen, meaning it can cause birth defects. This is the reason pregnant women are cautioned against oral retinoid medications and very high-dose vitamin A supplements. Researchers have documented the teratogenic potential of various vitamin A derivatives and synthetic retinoids, including case reports of systemic effects from topically applied drugs.11PubMed. The potential for teratogenicity of vitamin A and its congeners
The practical risk from A and D ointment applied to small areas of skin is extremely low. The retinyl palmitate in the product is present in tiny amounts compared to prescription retinoids like tretinoin or isotretinoin, and systemic absorption through intact skin is minimal. That said, slathering the ointment over very large areas of broken skin for extended periods is different from dabbing it on a cracked lip or a small patch of diaper rash. Pregnant women with concerns should check with their doctor, but for the typical uses and quantities involved, the ointment is generally considered safe. For newborns, the product is widely used in hospital nurseries as a barrier cream, and no significant safety concerns have emerged from decades of that practice.
A Very Old Remedy in a Modern Tube
The pairing of vitamins A and D for skin complaints has roots that go back far longer than the branded products on pharmacy shelves. Cod liver oil, which is naturally rich in both vitamins, was used medicinally for skin conditions for centuries. The use of fish liver oils for chronic skin eruptions was noted as far back as ancient Greek and Roman medicine, both as a topical application and taken internally.12JAMA Network (American Journal of Diseases of Children). THE HISTORY OF COD LIVER OIL AS A REMEDY Early A and D ointments were essentially cod liver oil in a petrolatum base, and the formulation has not changed dramatically since. The fishy smell that some users notice in certain brands is a direct legacy of that origin.
The longevity of the product says something about its utility, even if the clinical evidence for the vitamin components themselves is modest. A cheap, shelf-stable, non-prescription ointment that reliably protects irritated skin and keeps small wounds moist fills a real niche. It is not a sophisticated treatment, and it does not need to be. For the situations where you are reaching for it, such as a newborn’s irritated bottom, a scraped knee, or dry winter hands, the combination of a strong occlusive base with trace vitamins that support skin health has been good enough for generations. The research has caught up to explain why it works, and the answer is mostly that the grease does the job while the vitamins contribute a modest biological assist.