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Acne is a multifactorial disease caused by many influences, such as hormonal imbalances, diet, and stress. We also heard that the excess of some vitamins has been linked to acne, but could vitamin deficiency cause acne also?

In this article, I review whether the deficiency of some supplements can cause you breakout, which vitamins you could lack if you experience acne and the ones that could help clear it out. So, let’s dive in.

Does Vitamin Deficiency Acne Exist?

Actually, yes. The deficiency of some vitamins has been linked to acne. Vitamins are essential substances for our survival and are involved in many biochemical reactions.

If you lack any of these, the first noticeable signs of the deficiency usually could be seen on the skin. Because the body is trying to survive and use the small amounts of the minerals and vitamins that it still has for the most critical reactions – cell metabolism, digestion, and heart work.

The skin is not that essential (well, it is crucial – it is the first barrier for the microbes and other outer factors, but not as essential as breathing and blood circulation), so the skin may be “forgotten” by the body. Read below to find out what is vitamin deficiency acne, which vitamins are essential for clearing breakouts, and could the supplementation help you.

What Vitamins Cause Vitamin Deficiency Acne?

The lack of vitamins A, E, D, and the group of B vitamins might make you break out. Vitamins A, E, and D are fat-soluble antioxidants. All the B group vitamins are water-soluble and are involved in thousands of biochemical reactions and cell life (and, of course, our body life).

Vitamin A Deficiency Acne

Vitamin A is essential in the development of the epithelium and healthy keratinization. It lowers keratin production, leading to softer, healthier skin and pores not clogged by the excess keratin.

Low vitamin A is also one of the most important factors in vitamin deficiency acne. When the levels of vitamin A are reduced, the oil glands increase, and the sebum production increases, leading to acne breakouts or worsening of acne.

Retinol (Vitamin A) Benefits, Sources, and Signs of Deficiency, Including Vitamin Deficiency Acne
Retinol (Vitamin A) Benefits, Sources, and Signs of Deficiency, Including Vitamin Deficiency Acne (Shutterstock)

Several studies have found that the levels of vitamin A are lower in persons experiencing acne (1). Furthermore, the levels of this essential antioxidant were even more lacking in severe acne patients compared to those with mild or moderate acne.

That is why all kinds of vitamin A derivates (retinoids) are beneficial in treating acne. Accutane (isotretinoin) or topical tretinoin is also vitamin A derivates prescribed to treat hormonal acne in women and stubborn acne in men.

But if you have mild or moderate acne, you may start by taking vitamin A supplements. Supplements may also be helpful for persons who have resistant and stubborn acne.

Another way to get retinoids is to enrich your diet with vitamin A foods. Some foods containing vitamin A are leafy green vegetables (spinach, broccoli, lettuce, kale) and orange or yellow vegetables (carrots, pumpkin, tomatoes, sweet potatoes, bell peppers, mango). Dairy products and eggs also contain significant amounts of vitamin A.

Vitamin E Deficiency Acne

Vitamin E is thought to contribute to acne indirectly. It is a potent antioxidant and anti-inflammatory, which can reduce inflammation.

Study (1) has shown that the levels of vitamin E are lower in those with acne. It was also thought that smoking reduces vitamin E and may further exacerbate acne.

Several studies (2,3) have shown the benefits of vitamin E on acne, but vitamin E was combined with vitamin A or zinc in these studies. So, it is unclear whether vitamin E alone would significantly reduce acne.

Also, we know that the lack of vitamin E may cause dry skin, which consequently may lead to increased oil secretion to hydrate dry skin.

Vitamin D Deficiency Acne

Vitamin D is a fat-soluble vitamin synthesized in the skin when exposed to sunlight.

It was estimated that people with acne have lower levels of vitamin D. The study also revealed that after two months of supplementation with vitamin D, the number of inflammatory lesions decreased (4, 5).

Another study also found that acne sufferers had lower levels of vitamin D but also increased its levels after isotretinoin treatment (6). They concluded that acne might prevent the synthesis of vitamin D in the skin, or vitamin D may be involved in acne pathways.

However, no significant differences were found between vitamin D levels and the severity of acne (7)

Vitamin D supplements might help to reduce inflammatory lesions and overall inflammation (8).

I would add that vitamin D is also essential for the immune system and skin immunity. If the immunity is weak, inflammation may start.

But there is a question – if it is synthesized in the skin, how can some people lack this essential nutrient? Actually, more than 40% of Americans have insufficiency in this vitamin, especially those with darker skin, because the darker the skin, the less it absorbs vitamin D (9).

Also, not eating well, not having enough time in the sun, and some diseases (celiac disease, Crohn’s disease, kidney diseases) might reduce your vitamin D levels.

B Vitamins Deficiency Acne

The group of B vitamins is essential for skin health. When we are deficient in vitamin B, our skin may become dry, flaky, and sensitive to external factors, such as skin care products or UV rays, lips may turn chapped, and hair and nails tend to be more brittle. The lack of group of B vitamins may also lead to vitamin deficiency acne. Let’s take a closer look at B group vitamins.

Vitamin B1 (Thiamine) Deficiency Acne

As the name prompts, vitamin B1 was the first-ever discovered vitamin B. It is an essential vitamin for the nervous system, used to treat neuritis and relieve stress. As we already know, that stress may cause you to break out, and reducing stress may help heal your acne lesions.

In addition, vitamin B1 boosts the immune system, so the skin’s immunity may also become more robust. It also helps with wound healing (10).

If you lack vitamin B1, you may experience acne. You may lack vitamin B1 if you consume too much coffee or tea, as they reduce the absorption of this essential vitamin.

Vitamin B2 (Riboflavin) Deficiency Acne

Vitamin B2 improves the absorption of zinc and iron (11). As we know, zinc is an indirect anti-androgen, lowering the levels of androgens and contributing to acne healing. So, if you lack vitamin B2, you might also lack zinc.

Also, the deficiency of vitamin B2 is the MAIN vitamin deficiency that may increase skin oiliness!!! The lacking of riboflavin was also associated with seborrheic dermatitis and exacerbation of rosacea (12).

Vitamin B3 (Niacin/Niacinamide) Deficiency Acne

Vitamin B3 has several forms:

  • Niacin (or nicotinic acid) is involved in steroid hormone production, lowers bad cholesterol, and improves circulation.
  • Niacinamide (or nicotinamide) can be made in the body from niacin. You may find niacinamide in various cosmetic products, including anti-acne routines.
  • Other derivatives (e.g., inositol hexanicotinate).

Niacinamide increases the differentiation and maturation of the keratinocytes, the cells covering the skin’s surface. Some skin diseases may occur if their differentiation is prolonged, and skin pores may become clogged, leading to acne.

Niacinamide Benefits for the Skin, Including Vitamin Deficiency Acne
Niacinamide Benefits for the Skin, Including Vitamin Deficiency Acne (Shutterstock)

Niacinamide strengthens the skin’s immunity and improves the skin’s barrier function. So, if you lack niacinamide or niacin, weaker immunity and improper skin surface barrier may cause inflammation in the skin, and pimples may emerge.

Niacinamide reduces the water loss from the skin, leaving the skin hydrated, smooth, and without excessive oil production (if the skin is dry or dehydrated, oil glands may increase the sebum production to keep the skin hydrated) (13).

Note! Niacin supplements may cause skin flushing (redness) and bruising (when taken along with blood thinners (medications that prevent blood clotting). In this case, niacinamide will have fewer side effects.

Vitamin B4 (Adenine) Deficiency Acne

Adenine is not a real vitamin. However, it plays a crucial role in cell energy processes, genetic information (a component of the DNA and RNA), boosting immunity, and maintaining healthy sugar levels.

It can also help with stress. Stress is a known acne trigger, causing the stress- hormone cortisol to rise and cause acne.

Vitamin B5 (Pantothenic Acid) Deficiency Acne

Pantothenic acid plays a significant role in the synthesis of coenzyme A (CoA) (14). CoA increases the fatty acids’ breakdown, including the sebum oils (15). So, pantothenic acid and CoA can prevent oil excess, clogged pores, and pimples.

Additionally, CoA, made from pantothenic acid, is also used in the synthesis of cortisol, a stress hormone (16). We need cortisol to respond to stress (not only emotional but also physical stress, illness, and trauma).

But if we experience prolonged stress and have too high cortisol levels, we might run out of the pantothenic acid in our body and need to supplement it. This is why pantothenic acid is called an anti-stress vitamin.

Moreover, a double-blinded 12-week study showed that pantothenic acid reduced the number of total acne blemishes and inflammatory acne lesions. Pantothenic acid was safe and well tolerated (17).

If you lack vitamin B5, you may experience acne. Good thing, pantothenic acid, as its name describes, is found almost everywhere!

Also, panthenol is a derivate from pantothenic acid. It is a stable form of vitamin B5 and is used in various cosmetic products. It is a powerful moisturizing, soothing, and anti-inflammatory ingredient.

Vitamin B6 (Pyridoxine) Deficiency Acne

Vitamin B6 is a known hormone regulator. It plays a significant role in the estrogen and progesterone balance and the regulation of steroid hormone receptors. If you lack vitamin B6, you may experience hormonal acne.

Pyridoxine can aid you in reducing stress and stress-induced acne because it is involved in the synthesis of the happy hormone serotonin and some neurotransmitters that regulate depression and mental state (18).

It was also estimated that vitamin B6 could decrease weight, fat mass, and cholesterol and fight insulin resistance, which is associated with acne (19). In other words, if you lack vitamin B6, it will be easier to gain weight and maybe develop insulin resistance later in life (if you are not experiencing insulin resistance now).

And finally, one old study even found that taking vitamin B6 in doses of 50 to 250 mg daily significantly reduced sebum production and cleared acne (20). Just do not overdose because you may get an adverse reaction – worsening of acne.

Vitamin B7 (Biotin) Deficiency Acne

Biotin, also called vitamin B7 or vitamin H, is necessary for healthy hair, skin, and nails. Good thing that biotin deficiency is rare. But in some cases, we may develop biotin deficiency:

  • Increased demand for vitamins: fast growing in infancy or teenage years, pregnancy, and breastfeeding.
  • Prolonged alcoholism.
  • Genetic disorder called biotinidase deficiency.
  • Biotin competes with vitamin B5, the pantothenic acid, and sometimes may be lacking (if B5 is winning or you overdose vitamin B5).

The symptoms of biotin deficiency include a red rash around the eyes, nose, and mouth, skin infections, brittle nails, and loss of hair. But there is no scientific evidence that biotin deficiency could cause acne.

Vitamin B8 (Inositol) Deficiency Acne

To be honest, inositol is not a vitamin at all. It is only referred to as vitamin B8 and is found in cell membranes. But inositol is very important in acne pathways.

Scientists found inositol helpful for women with PCOS (Polycystic ovary syndrome). Women with PCOS experience hyperandrogenism (increased levels of androgens, which lead to acne and hirsutism – facial hair), insulin resistance, high cholesterol, triglyceride levels, and, usually, infertility.

Inositol is involved in hormonal balance regulation and reduces androgen levels. Also, it increases the sensitivity of insulin, and this way lowers blood sugar, bad cholesterol, and triglyceride levels. Inositol may improve ovarian function and the menstrual cycle (21). In conclusion, hormonal balance – decreased androgens and up-regulated insulin – leads to improved PCOS and cleared acne.

PCOS Symptoms, Including Acne
PCOS Symptoms, Including Acne (Shutterstock)

Inositol affects our mood and has an impact on preventing depression, as it is involved in the actions of dopamine and the “happy” hormone serotonin.  It was estimated that people experiencing depression and other mental disorders have lower levels of inositol (22, 23). Stressed and depressed persons may develop stress acne (Oh, yes, so many reasons to develop stress-induced acne!).

Inositol works best when combined with folic acid.

Vitamin B9 (Folic Acid) Deficiency Acne

Folic acid is also known as vitamin B9 or vitamin M and vitamin B11 – another form of vitamin B9.  It is usually prescribed as a prenatal vitamin to prevent birth defects. Folic acid is necessary for metabolism and hormone balance.

As I wrote above, folic acid works well when taken together with inositol for PCOS (or even alone) (24). Folate reduces blood sugar and cholesterol and improves overall metabolism and health in women with PCOS (25). Upregulated metabolism and balanced hormones may help to clear acne.

It was also estimated that patients undergoing isotretinoin (Accutane) treatment had significantly lower levels of folic acid (26). While this deficiency does not cause acne, supplementation with folic acid is advised for those on Accutane.

But the scientific research is conflicting on whether folic acid deficiency or excess may cause acne. Further studies are needed.

Vitamin B12 (Cobalamin) Deficiency and Acne

Vitamin B12 is super essential for new cells as it is involved in DNA synthesis.

Vitamin B12 is derived from cyanocobalamin or methylcobalamin.  Methylcobalamin is a natural form of vitamin B12, found in nature (only in animal sources) and supplements, while cyanocobalamin is a synthetic form found only in supplements. Both forms work similarly.

As our bodies do not produce this vitamin, we need to get it with our diet. You may run low on vitamin B12 if you eat too little animal source products (meat, milk, eggs) or are a vegan.

As with the folic acid, it was estimated that people undergoing isotretinoin (Accutane) treatment were low on blood vitamin B12 (26). I recommend taking vitamin B12 along with isotretinoin treatment to prevent homocysteine.

Homocysteine is significantly higher in acne patients and requires vitamin B12 and folic acid to metabolize in the liver (27). Lower levels of vitamin B12 and folic acid may lead to higher homocysteine levels and more severe acne.

Vitamin Deficiency Acne Takeaway

Now you know that the lack of some vitamins may cause you vitamin deficiency acne!

The most involved in acne vitamins (if you lack them) are vitamins A, E, D, and B group.

Vitamin A is essential in the maturation of the epithelium and healthy upper layer of the skin. It lowers keratin production, so pores do not get clogged. No wonder the most important medical remedies are made from retinoids (vitamin A), such as tretinoin ointment and isotretinoin pills.

The B group vitamins cover thousands of chemical reactions and are very important for our skin. The two vitamins that stand out from the group are inositol and folic acid, which can help with PCOS and reduce acne.

Also, people on isotretinoin might lack folic acid and vitamin B12, which subsequently may lead to acne again.

Vitamin B2 helps to absorb zinc, which acts as an androgen. If you lack vitamin B2, you might lack zinc too.

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