The relationship between vitamin B12 and acne is multifaceted and not fully understood. Evidence suggests both deficiency and excess of B12 may play roles in acne pathogenesis, albeit through different mechanisms.
Some studies found lower serum B12 levels in acne patients compared to healthy controls. This suggests a potential link between B12 deficiency and acne, though the mechanism remains unclear [1,2].
Conversely, multiple case reports and studies describe acneiform eruptions following B12 supplementation, particularly with high-dose intramuscular injections [3,4,5].
Insights into potential molecular mechanisms have been provided by recent research. It was found that B12 supplementation altered the transcriptome of skin microbiota, particularly Propionibacterium acnes (now Cutibacterium acnes). This led to increased production of inflammatory porphyrins, potentially explaining the link between B12 and acne [5].
Not all individuals develop acne with B12 supplementation, suggesting other factors (genetic, environmental, or microbial) may influence susceptibility.
Various forms (cyanocobalamin, hydroxocobalamin) and routes (oral, intramuscular) of B12 supplementation have been associated with acne development. High-dose intramuscular injections seem particularly likely to trigger acneiform eruptions in susceptible individuals [3,4,5].
Some studies found no significant difference in serum B12 levels between acne patients and controls, highlighting the complexity of the relationship [6].
Another study found that serum homocysteine levels were higher in acne patients than controls, suggesting that deficiency of B12, folate, B6 might play a role [7]. (edited)
