Vitamin B5 – The Secret to Curing Acne?

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Is Pantothenic Acid a Magic Cure for Acne?

In 2014 a study was published that reported success treating acne using a high dose of pantothenic acid, also known as Vitamin B5.   As you can imagine, as a Naturopathic Doctor specializing in acne I was immediately all over this study.

Could there really be a magic pill for acne?  It seemed too good to be true.  After digging into the study, trying the protocol with my patients and investigating pantothenic acid a bit more I decided to drop pantothenic acid from my acne protocol.  Here’s why.

The Study

One small study is not usually conclusive, and this holds true for the research paper published in 2014 suggesting that pantothenic acid could reduce acne lesions.  More research needs to be done – but it did spark so many questions and interesting insights!

The study was conducted with 40 patients (mostly women) over the course of 12 weeks.  Patients were given 2.2 grams of pantothenic acid daily, and at the end of 12 weeks the number of blemishes on the skin was compared with their baseline (the number of blemishes on their face at the beginning of the study).

The chart of results is shown below:

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The blue bar represents the number of acne lesions at baseline and week 12 in the patients taking a pantothenic acid supplement.  The red bar represents the number of acne lesions at baseline and week 12 in the patients taking a placebo, which means participants THINK they are taking an active medication, but they are not.

As you can see, even though there are some significant results with pantothenic acid, there is also a tremendous result with the placebo – when the study subjects just THINK that they are taking a remedy.  This is called the placebo effect, and it demonstrates that our mind is incredibly powerful – when we think we are taking a remedy we will experience healing.

My question is – even though the study claims that pantothenic acid reduces acne lesions by 67% – how much of that improvement is actually attributed to the placebo effect?

The other interesting thing about the study is that almost all the improvement in acne was seen in non-inflammatory acne, which is blackheads and small whiteheads.  

Acne that was more inflamed, red and cystic did not see the same improvement as milder acne.  This suggests that pantothenic acid is more effective against mild acne.

What is Pantothenic Acid?

Pantothenic acid, also known as vitamin B5, is converted in the body to Coenzyme A (CoA).  The  functions of CoA include converting fats, proteins and carbohydrates into energy, regulating skin function and cortisol production.

These functions are especially important in acne pathogenesis because pantothenic acid can affect fat and oil production in the skin, regulate keratinocyte proliferation, and moderate our stress response – all factors in acne pathogenesis.

For years we thought that pantothenic acid was delivered to our body solely through our diet.  Many food sources contain pantothenic acid, and it is highly bioavailable and absorbable.  It is found in eggs, meat, poultry, lentils, broccoli, cabbage, potatoes, while grains, nuts, and beans – basically most of the foods that are included in a healthy diet! 

Why does pantothenic acid help some mild cases of acne?

If you eat a diet composed mainly of processed foods, you may not get the amount of pantothenic acid required to keep your body healthy.  A daily diet of processed cereals, peanut butter sandwiches, sodas and pizza is void in all nutrients (not just vitamin B5)! 

But it turns out that a pantothenic acid deficiency has less to do with diet, and more to do with the microbiome.

More recent research has revealed that B vitamins are not only acquired through our food but also produced by our microbiome.  In fact, studies are suggesting our most important source of pantothenic acid and other B vitamins is actually from our intestinal microbiome.

This means that if your gut is not healthy and balanced you could be experiencing a deficiency in pantothenic acid, regardless of how much you eat in your diet.  And this is why high-dose supplementation of pantothenic acid is able to positively affect mild acne in some people.  It is thought that a high dose is able to flood the pantothenic acid receptors temporarily to produce CoA in the body.  As discussed before, CoA helps regulate lipid metabolism, keratinocyte turnover and the stress response.

But think about it – in our diet we need approximately 5mg of pantothenic acid per day.  It takes 2.2 grams of synthetic pantothenic acid daily to trigger the response that should be happening naturally in our body.   As a Naturopathic Doctor, I want deeper healing for my patients.

Why do I not recommend high-dose pantothenic acid for acne.

1. As a Naturopathic Doctor I am always investigating the underlying cause of a condition so I can solve the problem for good. Taking high dose pantothenic acid daily does not solve the root issue.  It masks an underlying problem.  Once you stop taking the supplement, the acne will come back.

2. One of the root problems of acne is an imbalanced microbiome. This is what leads to a deficiency of endogenous pantothenic acid in the body, which can negatively affect lipid metabolism and epidermal regulation which can lead to acne.  Instead of targeting the pantothenic acid deficiency by flooding the body’s receptors with synthetic pantothenic acid, my goal is to re-regulate its natural production in the body.

3. When the microbiome is balanced, not only will the body produce adequate amounts of pantothenic acid, but many other imbalances in the body will also improve. Digestion will start to work optimally, inflammation will decline and hormones will start to naturally balance.  Supplemental pantothenic acid will not affect any of the other imbalances caused by an unhealthy microbiome.

4. Supplemental pantothenic acid only affects mild acne, and often my patient population have moderate to severe acne – which means that deeper and more complete healing is required.

5. High dose pantothenic acid works for some people, and not for others. I like to eliminate guesswork as much as possible which is why I choose not to use it in my patient protocols.

The Bottom Line

Supplemental pantothenic acid is a band-aid solution for a much more serious problem – an unbalanced microbiome.  In my practice I choose to solve the underlying issues and get rid of acne for good.

 

References:

https://pubmed.ncbi.nlm.nih.gov/27515213/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065280/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478888/

 

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