Healthy and Herbal
Menu
RemediesIngredientsDIYSafetyLearnHow we rate evidence
Independent·Non-commercial·No products soldEducational only — not medical advice
Tocopherols (fat-soluble vitamin)

Vitamin E

Vitamin E has one good trial for a specific liver condition, non-alcoholic steatohepatitis (NASH), where 800 IU a day improved liver histology in adults without diabetes. For the reasons most people buy it, the evidence points the wrong way: large trials found no protection against heart disease or cancer, and the biggest, SELECT, found more prostate cancer with 400 IU a day. Topical vitamin E oil has no good evidence for scars, dry skin or hair, and in one trial a third of people developed contact dermatitis.

Updated
30 September 2026
Vitamin E softgel capsules with almonds and sunflower seeds
At a glance
Last reviewed 30 September 2026
Evidence
Moderate
Best for
Fatty liver disease (NASH)
Typical form & use
Oral capsule, 800 IU/day (NASH trial)
Onset
4+ weeks
Safety
High doses raise bleeding and prostate cancer risk. 2 known interactions, most serious with blood thinners.
Check with your medications →

What it's used for

Evidence is rated per use. The same ingredient can be strong for one thing and traditional for another.

UseEvidenceWhat the research shows
Fatty liver disease (NASH), oralModerateIn the PIVENS trial, 247 adults with NASH and no diabetes took vitamin E 800 IU daily, pioglitazone or placebo for 96 weeks. Liver histology improved in 43% on vitamin E versus 19% on placebo (P=0.001), with lower liver enzymes and less steatosis and inflammation, but no improvement in fibrosis. This is one well-run trial, so we rate it moderate. It tested adults without diabetes and is a treatment for a doctor to supervise, not a self-treatment for a fatty liver found on a scan.5
Scars, topicalLimitedA systematic review found six prospective studies: three reported better scar appearance (one in children as monotherapy, two combining vitamin E with other treatments) and three found no improvement with vitamin E alone. It concluded the evidence does not justify widespread use. In a double-blind trial of 15 surgical wounds, vitamin E ointment did not improve scars, 90% did no better or worse, and 33% developed contact dermatitis. Trials tested ointments applied for weeks, not straight oil.8,9
Hair loss, oral tocotrienolsLimitedThis is the tocotrienol form of vitamin E, not the vitamin E oil sold for hair. In one small trial, 21 volunteers with hair loss took 100 mg of mixed tocotrienols daily and 17 took placebo; hair count rose 34.5% at 8 months against 0.1% fall on placebo, but hair weight did not change. It is a single small study and we found no replication.10
Preventing heart disease and cancer, oralTraditionalRated at the bottom of the scale because large trials found no benefit. HOPE-TOO (400 IU natural vitamin E, median 7 years) found no reduction in cancer or major cardiovascular events and more heart failure (RR 1.13). The Women's Health Study (600 IU every other day, 10 years, 39,876 women) found no reduction in major cardiovascular events or cancer, and no effect on total mortality. A meta-analysis of nine trials found vitamin E cut ischaemic stroke by 10% but raised haemorrhagic stroke by 22%.2,3,4
Prostate cancer risk (harm signal)TraditionalNot a use, a warning. In SELECT, 35,533 men took 400 IU a day of synthetic vitamin E, selenium, both or placebo. With longer follow-up, 620 men on vitamin E developed prostate cancer against 529 on placebo (HR 1.17, 99% CI 1.004 to 1.36), about 1.6 extra cases per 1,000 person-years.1
Dry skin, face and hair, topical oilTraditionalWidely used and widely sold, but we found no controlled trial we could open showing benefit for dry skin, facial skin or hair when vitamin E oil is applied. Skin allergy is the documented risk (see scars). This rating reflects popular use, not evidence.9

How much

Ranges below are what studies used and what supplements commonly contain. They are not a recommendation for you. Start at the low end.

Studied for NASH
800 IU daily5,6
Used for 96 weeks in the PIVENS trial. EFSA equates 800 IU to 540 mg, which is above the general upper limit, so this dose belongs under medical supervision.
Studied for prevention
400 IU daily or 600 IU alternate days1,2,3
HOPE-TOO used 400 IU natural vitamin E, SELECT 400 IU synthetic (all-rac), and the Women's Health Study 600 IU of natural vitamin E on alternate days. None showed benefit; SELECT showed harm.
Upper limit (EFSA)
300 mg/day for adults6
Set on blood clotting and bleeding risk, from all sources including food. It does not apply to people on anticoagulant or antiplatelet drugs, people on secondary prevention for cardiovascular disease, or people with vitamin K malabsorption.
Upper limit (US IOM)
1,000 mg/day for adults6
The older US Institute of Medicine value, cited in the EFSA opinion, based on rat data. The US NIH fact sheet was not readable for this entry, so we cite EFSA's account of it.
Timing · No source we read gave timing advice. In the NASH trial vitamin E was taken daily for 96 weeks.With food? · Vitamin E is fat-soluble. None of the sources we read gave food guidance, so follow the product label.How long to trial · Only the NASH trial gives a sense of how long: histology was judged at 96 weeks, so this is not something to trial for a few weeks. For topical use, the scar trials applied ointment for 4 weeks or longer.

How people take it

Capsule, natural (RRR-alpha-tocopherol)400–800 IU in the trialsThe form used in HOPE-TOO and the Women's Health Study. PIVENS reported its dose in IU.
Capsule, synthetic (all-rac-alpha-tocopheryl acetate)400 IU in SELECTThe form in SELECT. EFSA notes that 400 IU of this equals about 364 mg of free alpha-tocopherol.
Tocotrienol capsule100 mg mixed tocotrienols dailyThe form used in the hair trial. A different part of the vitamin E family from most vitamin E products.
Vitamin E oil or ointment (topical)No established doseScar trials used vitamin E in an ointment base twice daily. No trial tested pure oil on face or hair that we could open. Patch test on a small area first.

Safety

Who should avoid
  • Anticoagulants or antiplatelets (warfarin, aspirin) — ask your doctor first
  • Before surgery — high doses may raise bleeding risk; tell your surgeon
  • Men with or at risk of prostate cancer — SELECT found more cases with vitamin E
  • Heart failure or vascular disease — HOPE-TOO found more heart failure
  • Vitamin K malabsorption — EFSA's upper limit does not apply; ask first
  • Past haemorrhagic stroke — meta-analysis found more of this type with vitamin E
  • Skin oil on broken skin or scars — contact dermatitis reported in trials
Known interactions
CautionBlood thinners — High-dose vitamin E (300 mg a day or more) may alter the effect of warfarin and aspirin, and EFSA says its upper limit does not apply to people on anticoagulant or antiplatelet drugs.
CautionAspirin & NSAID painkillers — A review of vitamin E and drug interactions flags aspirin at high supplement doses, and EFSA excludes people on antiplatelet drugs such as aspirin from its upper limit.

Questions people ask

Is vitamin E oil good for skin, face or hair?

We found no controlled trial we could open that shows it helps dry skin, facial skin or hair. It is a common cause of contact dermatitis in scar trials, so patch test first. Products sold as vitamin E oil are cosmetic; the evidence we found does not show a benefit.

Does vitamin E help scars?

Probably not by itself. A systematic review found three of six studies showed no improvement with vitamin E alone, and one double-blind trial found no benefit and contact dermatitis in a third of participants. Ask your surgeon before putting it on a healing wound.

What are the side effects of vitamin E?

The main risk with high-dose supplements is impaired blood clotting and bleeding, which is why EFSA set its upper limit at 300 mg a day. Large trials also found more prostate cancer (SELECT), more heart failure (HOPE-TOO) and more haemorrhagic stroke (meta-analysis). Applied to skin, contact dermatitis is the documented problem.

Should I take vitamin E to prevent heart disease or cancer?

The large trials say no: they found no protection, and some found harm. Vitamin E from food is a different question that these supplement trials do not answer.

How do I use vitamin E oil safely?

There is no proven regimen. If you use it, test a small area of skin first, keep it off broken or freshly stitched skin unless your surgeon agrees, and stop if a rash or itching develops.

Sources

  1. Randomised controlled trial Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011.
  2. Randomised controlled trial 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.
  3. Randomised controlled trial Lee IM, 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.
  4. Systematic review Schürks M, Glynn RJ, Rist PM, Tzourio C, Kurth T. Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials. BMJ. 2010.
  5. Randomised controlled trial Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010.
  6. Regulator opinion EFSA NDA Panel. Scientific opinion on the tolerable upper intake level for vitamin E. EFSA Journal. 2024.
  7. Review Podszun M, Frank J. Vitamin E-drug interactions: molecular basis and clinical relevance. Nutr Res Rev. 2014.
  8. Systematic review Tanaydin V, Conings J, Malyar M, van der Hulst R, van der Lei B. The role of topical vitamin E in scar management: a systematic review. Aesthet Surg J. 2016.
  9. Randomised controlled trial Baumann LS, Spencer J. The effects of topical vitamin E on the cosmetic appearance of scars. Dermatol Surg. 1999.
  10. Randomised controlled trial Beoy LA, Woei WJ, Hay YK. Effects of tocotrienol supplementation on hair growth in human volunteers. Trop Life Sci Res. 2010.

Reader notes

Experiences and questions from readers, read by an editor before they appear. They are personal accounts, not evidence, and are not medical advice.

Used it? Share how it went, or ask a question.

Share what you made, tried or noticed, or ask a question. Please don't give other people medical advice, post doses for someone else, or include links or brand names. Your name is shown with your comment; your email (optional) never is. See our privacy policy.

Last reviewed 30 September 2026 · Next review March 2027 · How we rate evidence