B12 and Acne

Acne Caused by B12 Supplementation

An increasing amount of new data links vitamin B12 supplementation to the development of acne in some individuals.

In 2015, Kang and colleagues from UCLA showed that vitamin B12 supplementation repressed the expression of vitamin B12 biosynthesis genes in bacteria known as Propionibacterium acnes and altered the transcriptome of the skin microbiota. One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation. The authors showed that vitamin B12 supplementation in P. acnes cultures promoted the production of chemicals known as “porphyrins”, which have been shown previously to induce inflammation in acne.

New data suggests a potential association between vitamin B12 and acne in some users

In 2018, Veraldi and colleagues described five cases of acneiform eruption caused by vitamin B12 in 5 females aged 37, 32, 62, 29, and 21 years, respectively. The eruption consisted of papules and pustules on the face and appeared from 1 week to 5 months after the beginning of the therapy with oral vitamin B12 or intramuscular therapy. In three of the five patients, similar lesions were also present on the neck, shoulders, chest, and upper portion of the back. Notably, comedones and cysts were absent. In two patients, serum vitamin B12 levels were very high. Biopsy of the acne lesion was performed in one patient and showed an eosinophilic folliculitis. Complete remission occurred in all patients 3-6 weeks after vitamin B12 was stopped.

Vitamin B12 induced acne was also reported in a 2018 study by Martínez de Espronceda Ezquerro et al.

Summary

These findings are interesting and I certainly wonder if there are many patients with acne type lesions from B12 supplementation that are missed. In the hair clinic, we see countless numbers of patients with extremely high B12 levels. One wonders if any of these patients are experiencing acne type lesions from their excessive B12 supplementation.

Reference

Iñigo Martínez de Espronceda Ezquerro et al. Vitamin B12-induced acne. Med Clin (Barc) 2018; Aug 10;151(3):e15.

Kang et al. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis. Sci Transl Med. 2015 Jun 24;7(293):293ra103.

Veraldi et al. Acneiform eruptions caused by vitamin B12: A report of five cases and review of the literature.  J Cosmet Dermatol 2018 Feb;17(1):112-115. doi: 10.1111/jocd.12360.Epub 2017 Jun 8.