Vitamin B for Acne

Vitamin supplements are just as important in acne treatment as regular acne medications.

They can provide the nutritional support essential to skin health, prevent nutritional deficiencies that can result in acne-like skin conditions and even serve as a first-line therapeutic option in acne prevention and treatment.

The most important vitamins used to treat acne are vitamins A and E and some of the members of the B vitamins.

Vitamin B complex comprises a wide variety of essential compounds. They are all water-soluble, safe and well-tolerated. They are used for treating acne primarily because these vitamins are responsible for most enzymatic activities and food metabolism in the body.

However, not all B vitamins are beneficial to acne treatment. Some do not have enough scientific evidence to back their use in acne treatment and some may even cause acne breakouts.

Discussed below are the four B vitamins that are most relevant to acne development and treatment.

Vitamin B5 and Acne

Vitamin B5 or pantothenic acid is the most important and most effective B vitamin for treating acne. It is an essential nutrient in humans because it is involved in the metabolism of fats, proteins and carbohydrate.

Pantothenic acid is also required for the optimal functioning of Coenzyme A, a molecule needed for energy production in the body.

D-pantothenic acid is the active form of this vitamin. It is supplied as pantothenol and calcium pantothenate in supplements. These forms of the vitamin are more stable in formulations but they are broken down to release free pantothenic acid before the vitamin is absorbed into the body.

Pantothenic acid is found in almost all foods but particularly in meat, eggs, avocado, whole grains, cereals, legumes and yogurt. The recommended daily intake for adults is 5 – 7 mg/day.

Vitamin B5 deficiency is very rare because it is easily obtained from foods. However, where it occurs, it causes a number of symptoms one of which is the appearance of acne-like lesions on the skin. To treat this deficiency, vitamin B5 supplements are recommended.

The efficacy of vitamin B5 in acne treatment was first discovered and described in 1995. The accidental discovery showed that high doses of pantothenic acid can reduce sebum production and improve acne symptoms.

Since vitamin B5 is a water-soluble vitamin, it can be safely taken in the high doses needed for treating acne.

There are 2 major ways by which pantothenic acid can relieve acne symptoms and prevent the breakout of new acne lesions.

Furthermore, vitamin B5 reduces the production of male sex hormones such as testosterone and dihydrotestosterone. These androgens are responsible for acne breakouts especially in adolescents.

When they are increasingly produced, they cause the hormonal imbalance that increases sebum production, promotes bacterial colonization of the skin, causes skin inflammation and leads to the appearance of acne.

Therefore, pantothenic acid supplementation prevents the development of acne by so many means that the sum of its effect is a dramatic and quick improvement in acne symptoms.

Because the large doses of vitamin B5 (about 10 g/day) required to treat acne may cause gastrointestinal side effects, it is better to use a lower dose of the vitamin (about 2 g/day in divided doses) along with a booster such as L-carnitine (about 1g/day in divided doses) to reduce these side effects while getting comparable therapeutic benefits.

Alternatively, the dose of vitamin B5 needed can be split between oral and topical dosage forms of the vitamin.

Vitamin B6 and Acne

Vitamin B6 is also called pyridoxine. The active form of this water-soluble vitamin is pyridoxal phosphate.

It is involved in the metabolism of amino acids and fats, in the productions of neurotransmitters, heme and histamine, in the conversion of glycogen to glucose, and in gene expression.

The recommended daily intake of vitamin B6 is 1 – 2 mg for adults. Dietary sources of this vitamin include meat, vegetables, nuts, and whole grains.

Deficiency & Toxicity

When Vitamin B6 deficiency do occur it is usually caused by malabsorption of the vitamin due to diet, drugs and diseases.

The symptoms of vitamin B6 deficiency are either neurological or dermatological.

Neurological symptoms include mental confusion and lethargy. The dermatological symptoms of vitamin B6 deficiency present as acne-like seborrhea, dermatitis and skin ulceration.

Vitamin B6 toxicity is possible and it results after prolong and regular ingestion of 200 mg/day of the vitamin. The major outcome of this toxicity is nerve damage and it can be addressed by stopping the vitamin regimen.

Vitamin B6 is useful for treating acne. Its efficacy is backed by studies which showed that taking 50 – 250mg/day of the vitamin can reduce sebum production and improve acne symptoms of most of the patients receiving it.

Pyridoxine works for acne because it can regulate hormones and prostaglandins.

Hormonal imbalance is one of the major causes of acne. Specifically, the increased production of male sex hormones such as testosterone and dihydrotestosterone leads to the enlargement of the sebaceous glands and the increased production of sebum.

Excess sebum on the skin is directly responsible for the clogging of skin pores and the appearance of acne-causing bacteria.

Vitamin B6 supplementation can turn down sebum production by regulating the syntheses of male sex hormones.

Furthermore, vitamin B6 also regulates prostaglandins which are involved in inflammatory reactions. Therefore, the vitamin can help relieve and prevent inflammatory acne lesions.

In spite of the benefits of vitamin B6 in acne treatment, it can also cause acne. Some users, especially those who take large doses of the vitamin, report acne breakouts soon afterward.

The exact mechanism by which vitamin B6 causes acne is still unknown but it is possible that megadoses of the vitamin can tip the downregulation of hormones and prostaglandins the other way so that more androgens and inflammatory immune cells are released.

Vitamin B7 and Acne

Vitamin B7 is also called biotin, vitamin H or Coenzyme R. It is needed for fat metabolism and the conversion of glycogen to glucose.

Additional biological roles of vitamin B7 include its importance in the production of isoleucine and valine, its contribution to blood sugar control and its function in cellular growth.

It is actually found in variable amounts in almost all foods. Therefore, there are no strict required daily intake values for the vitamins. Experts, however, advise 12 – 15 micrograms/day for adults.

Vitamin B7 deficiency is rare except in the elderly, athletes, burn patients and those who underwent partial gastrectomy. 

A deficiency can also be created in pregnant or lactating women because biotin metabolism is increased during gestation and breastfeeding.

Biotin supplements are usually prescribed for diabetics to lower blood sugar level and also to treat seborrheic dermatitis in infants. Besides these medical uses, its other uses are to strengthen hair and nails.

Biotin competes with vitamin B5 for absorption. Oral broad-spectrum antibiotics also reduce its absorption in the gut. Isotretinoin, an acne medication known as Accutane, inhibits the enzyme responsible for activating and replenishing vitamin B7 in the body.

There is very little evidence that biotin improves acne symptoms except in people who have vitamin B7 deficiency. In fact, there are more evidences that high doses of the vitamin may cause or worsen acne.

High doses of biotin may trigger acne breakouts by suppressing the absorption of vitamin B5.

Vitamin B5 is a known anti-acne vitamin. When biotin causes the levels of vitamin B5 to fall, it could cause vitamin B5 deficiency and acne is a symptom of this deficiency.

Therefore, if biotin must be included in acne treatment, it should only be taken in low doses with an upper limit of 100 micrograms/day.

It should be included in the multivitamin treatment of acne so as to prevent a deficiency in the vitamin especially when vitamin B5 is also included.

Vitamin B12 and Acne

Vitamin B12 or Cobalamin is also essential for fat metabolism. It is required in energy production, DNA synthesis and in the nervous system.

Both plant and animal sources of vitamin B12 rely on bacteria to produce the vitamin.

The form of vitamin B12 synthesized by bacteria is hydroxocobalamin. This molecule picks up cyanide during commercial production to become cyanocobalamin which is the most common form of the vitamin sold.

However, the cyanocobalamin is converted back to hydroxocobalamin in the liver. Further conversion to the bioactive forms of vitamin B12, methylcobalamin and adenosylcobalamin, also occurs in the liver. This is why the richest dietary sources of vitamin B12 are animal livers.

Cobalamin can also be obtained from eggs, milk and dairy products, fish, mollusks and fortified foods.

2 – 3 grams/day of Cobalamin is required to prevent vitamin B12 deficiency. The symptoms of this deficiency involve neurological damage.

In acne treatment, vitamin B12 offers no specific benefits besides improving overall health including skin health. Because of the extensive role of the vitamin in the body, it is possible that it can contribute to the hormonal balance which may help improve acne symptoms.

In an effort to improve the results of vitamin B12 in acne, some people increase the dose of the Cobalamin supplement they take.

Unfortunately, high doses of vitamin B12 may cause or worsen acne. This effect is more apparent when high doses of vitamins B12 and B6 are combined.

From reports, more acne cases were recorded for the hydroxocobalamin form of the vitamin than cyanocobalamin.

No one knows exactly why high doses of vitamin B12 trigger acne.

However, some experts believe megadoses of vitamin B12 might push some biochemical reaction into high gear so that they cause hormonal imbalance and inflammatory responses which is reflected as acne-like lesions on the skin.

Some other experts think the increased excretion of the vitamin via the skin may irritate the sebaceous follicles and trigger acne reactions. Others argue that contaminants in hydroxocobalamin injections, such as iodine and sorbitol, are responsible for the acne outbreaks.