A Treatment Plan for Acne

by Marie Veronique

Acne is usually a result of elevated testosterone levels increasing sebum production. The excess sebum and the bacteria that feed on it, as well as dead skin cells and assorted debris, collect in the pores. The resulting congestion can lead to inflammation, which culminates in a case of acne. Conventional treatments battle breakouts with topical cleansers, exfoliants, antimicrobials, antibiotics and, in serious cases of cystic acne, drugs like Accutane. Now new research suggests that certain vitamins, taken internally as well as applied topically, offer an effective alternative approach to treating acne—without the side effects. This story will explore your options. Let’s start with a close-up on the biggest bully on the block first: Accutane.

Accutane

Accutane is a vitamin A derivative (13-cis-retinoic acid) that is administered orally in pill form, normally for 15-20 weeks. It was originally recommended for people with severe acne that was unresponsive to other treatments, but lately, it’s gained in popularity and is often prescribed for less severe acne. Accutane works by shrinking sebaceous glands, which reduces oil secretion and P. acnes colonization—and thus inflammation. The side effects are numerous and widespread and affect upwards of 80% of patients—most often they’re mild to moderate and reversible, but in some cases, they can be severe or long-term. Clinical research shows extremely high risk for birth defects in pregnant women who use Accutane. In fact, the effects and risks of Accutane on unborn children are so severe that female patients of childbearing age are required to use two forms of birth control while using the medication.

Vitamin B5 and L-carnitine

Vitamin B5 (aka pantethine or pantothenic acid) is as effective as the drug Accutane in treating acne because it also works at the first stage of acne formation. But whereas Accutane shrinks sebaceous glands, vitamin B5 reduces oil production of the sebaceous glands by increasing coenzyme A, which increases the metabolic breakdown of oils—including sebum—by optimizing the normal activity of cell physiology.

The program originally suggested by Dr. Lit-Hung Leung (1997) relied on patients ingesting 5-10 grams of pantothenic acid a day. Dr. Jeffrey Dach suggests a “modified Leung B5 protocol with Pantethine 750 mg with 250 mg of L Carnitine three times a day.”

Vitamin B3

Vitamin B3 (aka niacinamide or nicotinamide) is an anti-inflammatory with “verifiable beneficial effects—[it is used to improve] epidermal barrier function, aging skin, pigmentary disorders and for use on skin prone to acne.” Niacinamide also reduces facial sebum production.

The mighty B alternative 

Vitamin B5 optimizes the breakdown of fats released by the sebaceous gland, thus reducing congestion and heading acne formation off at the pass. Meanwhile vitamin B3 or niacinamide’s many beneficial anti-inflammatory effects maintain skin health. The combination is formidable enough to help with most cases of acne, even severe or of long duration, but it is not an overnight solution. Patience is required.

Treatment: Moderate to severe acne

Take orally:

  • Pantothenic acid 750 mg and 250 mg l-carnitine 3x a day
  • Niacinamide 500 mg 1x a day

Apply topically:

  • Serums containing vitamin B3 and B5 1x a day, at night. (Treatment Serum)
  • Follow with an oil blend composed of antioxidants and omega-3 and omega-6 EFAs morning and night. (Treatment Oil) It may seem counterintuitive to apply oils when the problem is oil over-production, but drying out the skin too much may impede sebum flow to the surface, and that means more rather than less congestion. Topically applied oils penetrate to dissolve congestion matter deep in the follicle where acne problems begin. In addition, skin that is too dry may start a vicious cycle of increased irritation—attracting more bacteria leading to more inflammation. Use oils that keep the skin lubricated and reduce inflammation, i.e., oils high in omega-3s and 6s. Tea tree oil will help keep P. acnes in check. (Treatment Oil)

Treatment: Mild acne

Take orally:

  • Pantothenic acid 750 mg and 250 mg l-carnitine 1x a day
  • Niacinamide 500 mg 1x a day

Apply topically:

Caution

If you are pregnant, planning a pregnancy or nursing do NOT use retinol. It is safe to use either Treatment Serum or Vitamins C+E+Ferulic Serum.

Disclaimer

It is important to remember that when healing the skin, there is never just one thing that will resolve all your issues. Rather there will be a number of factors requiring a variety of responses. For example, Vitamin B5 may help your body regulate sebum overproduction. Fish oil may decrease inflammation and promote proper sebum quality, while Vitamin B3/niacinamide can help with inflammation while supporting capillary health. If you are someone with severe acne caused by excess oil production, we suggest you try the above protocol of Vitamin B5 + L-carnitine, implement the topical products listed above, and follow a clean, low inflammatory diet of whole foods. 
 
However, we have found that most of our acne clients do not suffer from excess oil production, and supplementation will only do so much to improve the acne. 
 
If you are an adult with breakouts (mostly in one area of the face) or inflammatory symptoms such as dermatitis or rosacea, we suggest avoiding the guessing game of which supplement will fix your concerns and instead changing your diet and lifestyle. Make sure you are eating a well balanced, low inflammatory (no dairy, gluten, caffeine, alcohol, soy, processed foods, limited sugars) diet with a lot of variety (lots of different types of green, cooked, veggies each week). Then make sure you are digesting your food well, eliminating regularly with daily bowel movements, and getting plenty of water/staying hydrated. A few months of simply focusing on those areas can do wonders for the skin, especially when coupled with a strong topical plan. 
 
If you really want to incorporate supplements, remember that there is no magic pill. It’s best to get blood work analyzed by a medical professional to determine your priorities. Supplements and herbal remedies should be considered as medicine and taken seriously. Oftentimes taking many at once, without guidance or strategy, can cause more harm than good. 

Have a question or need more information about how this applies to your specific skin concerns? You can email us for personalized advice from our estheticians, or browse our Product Recommendations.