Vitamin B12 and Acne

I was hoping this day would never come – the day that I had to admit there might be some potential side effects to vitamin B12 supplements!

I have heard from a few people over the years that they had a reaction to vitamin B12 supplements. In those cases, it was not clear whether it was the actual vitamin B12 or possibly another chemical that was included in the supplement preparation.

But in June of 2010, someone wrote me saying that there had been some discussion on a German Blog that several people started getting “bad” skin after taking b12 supplements. As I am not a reader of German, I noted it but did not research further.

Then, on October 27, someone commented on the Will a Multivitamin Cover B12 Needs? post, saying they had developed acne after supplementing with vitamin B12.

I did some more research and found some cases in the scientific literature in which vitamin B6 and/or vitamin B12 was thought to be the cause of acne and rosacea. I have added the page Side Effects of B12 Supplements to Vitamin B12: Are You Getting It? in order to alert people to this possibility.

It would be good to know what sort of dose could typically cause this problem, how much of a culprit vitamin B12 is compared to vitamin B6, and if all forms of vitamin B12 are implicated. I found very little on it and the most recent report was from 2001, so it is not an area of much study at this point.

Of course, if you suspect high doses of vitamin B12 to be causing a problem for you, opt for smaller doses more often (see Recommendations).

132 Responses to “Vitamin B12 and Acne”

  1. Uber Says:

    I have experienced the same thing. Took 1000 ug vitamin b12 for fatigue. First i got some pimples, but I could manage them with benzoyl peroxide, at some point I got a lot of oily skin. My face was like a cheese pizza, a greasy mess around two hours after washing. Now I have had oily skin for 18 months (without taking b12), and with little improvement (properly because i take vitamin a). I have always had clear skin, even in my teens. I am now 32, and this oily skin is ruining my life. I think my condition is related to b12, so if anyone have solved the problem, please tell me. Sorry for my poor english.

  2. leeann Says:

    Hey Uber I had suffered the same as you as you can see in the above posts and mine did eventually go after about six months it does take a while to leave your system I’m no expert on the matter and I’m sure everyone is different. It is stored in your liver so be patient and believe me I know how hard it is a I lived through it. Best of luck hope it clears soon for you.

  3. Yvonne Says:

    I was never tested for a deficiency and was injected with 8 ml of vit b12 from a nurse at a local beauty salon. I felt fine but on about day five after the b12 shot I got full blown inflamed ance, that would not respond to any treatment. I’m hoping this reaction will go away soon because it’s quite painful and uncomfortable.
    Any ideas on how to rid the body of B12?

  4. Areej Says:

    Hi Yvonne, how long ago did you have the injection? What have you tried already?

  5. Rusty Says:

    I have very severe PA and must give myself injections several times a month. I understand getting the acne and will tolerate them. However my question is: is the expression of this acne a good thing or bad. I understand you need homocysteine but that high levels conversely are bad and can lead to heart and vascular issues. But by having tha acne dies this mean my body is getting rid of the homocysteine in a good way do as to not have future heart issues? Can find no info in this.

  6. Jack Norris RD Says:

    Rusty,

    B12 doesn’t reduce homocysteine by causing it to be released through the skin. Rather, it provides a molecule to turn homocysteine into another molecule that is not harmful.

  7. Dan Says:

    Hello, I’ve always noticed a clear correlation between taking B12 supplements and getting acne. Now there’s research to back it up:

    http://www.sciencedaily.com/releases/2015/06/150624143157.htm

    For those who suffer from this, I recommend trying Methylcobalamin-type, not Cyanocobalamin-type, B12. The Methyl, while not perfect, causes much less severe flare-ups for me.

  8. Jack Norris RD Says:

    Dan,

    It sounds plausible, though I hate to put a lot of trust in a study with a population of only one. Did you try small amounts of B12 such as closer to the RDA?

  9. Valerie Says:

    Hi there!
    It has been three years since I had my outbreak. I am still suffering from the large dark scars that are on my face. Most make-up does not cover it up. I am considering the possibility of trying laser therapy to try to diminish the terrible scarring. Has anyone tried this rout and is willing to share their experience.
    Oh, I thought that I would mention that I had my terrible reaction to the Methylcobalamin-type.

  10. Dustin Rhodes Says:

    Valerie,

    I have had some terrible breakouts from b-12 supplementation, too. I know it’s kinda tacky to come to a page (I’ve been following this thread out of interest for years) and recommend a product, but: I have had really great luck using a product from Paula’s Choice. It’s the 25% Vitamin C spot treatment. It’s expensive, but it’s extremely effective (I have not done lasers, as I’ve had such great results with the vitamin C). I don’t know if you are vegan or not, but the product is. There’s also a 15% concentration of vitamin c by the same company that I also use as maintenance, with equally impressive results. I’d recommend pairing one of these products with one that contacts salicylic acid (she has many) for optimal results. In any case, if it doesn’t work there’s a 60 day money back guarantee for everything she sells, so you don’t have to worry about wasting money.

    Dustin

  11. Valerie Says:

    Hi Dustin!
    Thanks a million for your reply! I am willing to try a different product that comes recommend. (esp. seeing that they are currently offering a discount code.) If is very difficult to make a choice among the myriad of products available in the industry in general.
    Is the 15% “maintenance” product you reference the “Resist C15 Super Booster” in the orange “dropper” bottle?
    Thanks again,
    Valerie

  12. Dustin Rhodes Says:

    Valerie, yes. If you can afford it, I’d get both and whichever BHA product is best for your skin type. (I have oily skin, so I use the BHA liquid).

    I forgot to mention this in the first post, but you’ll need to use sunscreen for this to have maximum impact. UVA damage itself prevents skin from healing optimally. But it will be extremely helpful, if not essential, for the recovery of your skin.

    I feel pretty certain if you try the vitamin C’s, the BHA and sunscreen, you will see a very dramatic difference over the next couple of months.

    This is really going to come off as tacky, but I swear I am just trying to be helpful; but if you use me as a refer-a-friend on the Paula’s Choice website, you’ll also be able to get $10 off your order in addition to the sale they are offering (I think they give me a $10 credit, too). If you choose to do that, my e-mail is dustinbuster@gmail.com

    Anyway, I wish you the best of luck. I had a lot of drama with this whole b-12 business — several times — because it took me a long time to figure out the trigger. But in terms of topical products, the ones I have recommended are the only ones which have dramatically changed my skin. I actually do have a couple of scars, but now without any redness — so you’d really have to look closely to see them. For me, that’s good enough. 🙂

    Dustin

  13. Teresia Says:

    So interesting about the hormones. I have had one metylcobalamin injection and got acne. I am Estrogendominant, and have high testosterone (i`m am woman) very low progesteron. I probably have ME and are hypothyroid. I have a feeling the hormones are SO involved in all this. I guess the liver and gut also needs to be adressed. Could it be hard for the liver to process all the toxins? I am contemplating if I shall take the half amount in next injection or skip it and take pills? I shall support my liver anyway with milkthistel.. This is very interesting but very frustrating. I was so looking forward to my injections so I could many have som energy back…and now…well.. I will take it SLOW and hope I do not get worse when I take next dose…I´ll wait a couple of weeks. Tank you all for sharing 🙂

  14. Erin Says:

    This article was just published in Science Translational Medicine, and offers some explanation of how B12 can modify the expression of genes that downregulate certain skin bacteria related to acne. Check it out! http://stm.sciencemag.org/content/7/293/293ra103

    A layperson-friendly explanation of the article can be found here: https://www.sciencenews.org/article/how-vitamin-b12-makes-pimples-pop

  15. Ruby Says:

    Hi Jack,

    This thread is so informative, thanks a lot for creating this awareness about Vit B12. My Dr recently asked me to take 5000 mcg sublingual Vit B12 drops daily. Ever since then my life has been a nightmare. I have itchy painful red papules all over my forehead and jaw along with insomnia.

    Will stop taking it right away & see it it helps.

    Thanks,
    Ruby

  16. Ruby Says:

    Hi Jack,

    This is an update, ok its been 6 days since I stopped my 5000 mcg Vit B12, The acne on my forehead are becoming smaller & subsiding. The chin is taking slightly longer (but they are drying up). All the acne are red & itchy.

    Just wanted your opinion if it is ok to take 20 mg of Vit B6? (My Dr asked me to take 50 mg), or will I break out again?

    Ruby

  17. Jack Norris RD Says:

    Ruby,

    I can’t give you advice on how much vitamin B6 you can take as I don’t know much about treatment with vitamin B6 or why your doctor is prescribing it, but here is more information:

    http://www.mayoclinic.org/drugs-supplements/vitamin-b6/dosing/hrb-20058788

    Jack

  18. Ruby Says:

    Hi Jack,

    Thanks for the link. My doctor says I have malabsorption issues along with some inflammation of the gut. So I’m on digestive enzymes with Betaine HCl & B12 & B6. Also I’ve been prescribed peppermint oil and VSL3 probiotic (which is killing me with the bloating) & milk thistle for my liver!!

    SIgh…guys apologies for burdening all of you with my woes!

    Ruby

  19. Anna Says:

    Paul … I don’t know if you’re going to read this. It’s been almost a year since your last post. I actually am going through the exact same thing you went through in terms of acne and breaking out … I am 5 months off b12 and my skin is still reacting. I would really appreciate it if you give me an update on your skin condition.

  20. Nitin Says:

    I’ve recently started taking L-MethylFolate(1.8mg) and B12 MethylCobalamin(1000mcg), in an effort to fix my messed up health. I initially started with a B-complex for a few weeks before, and have then added folate and B12. This had immediately caused acne on the face mostly. So much so that I’ve stopped all medication for a few days now.

    Somehow the B-Vitamins are definitely related to the acne. I think however that the vitamins are simply increasing your body’s self detox capabilities, and all the bad stuff is suddenly coming out at a rate which my body is finding it difficult to eliminate. Hence some elimination through the skin may be occurring. In other words , it may unfortunately be a necessary side effect of the detox.

    My current thinking is to reduce the dosage or use a pulsed dosage (every alternate day supplements). In addition i plan to use Psyllium Husk after meals to increase dietary fiber, which i hope will absorb more of the released toxins, and help reduce the skin acne.

    If someone has tried anything else for the acne that worked, while on Methylation please share. Detox’n’all is fine, but acne really messes up your life. Thanks.

  21. MandyW Says:

    Hi, a few months ago I woke up with bilateral numbness of my limbs and ofc ridiculously tired and pale. After some bloodwork my Md said my hemo was 8 and b12 was bottomed out. Diagnosed with pernicious anemia. Unable to absorb b12 through my stomach I was put on cyanobalmin. 1 a day for a week. 1 a week for a month. Then 1 monthly. By week 3 I was experiencing the worst skin I e ever had in my life. I’ve never really had much of an acne problem even as a teen but this seems untouchable. I’ve yet to find anything that combats it while you are still on the therapy. I’ll have to have the medicine for the rest of my life most likely so any thoughts or suggestions would be appreciated. 🙂

  22. Vicky Says:

    Hi! I’ve been reading all of your responses & experience and have found it very interesting. I was diagnosed with low b12 levels (150) at the end of December 2015 after suffering from increasing muscle pain and ear popping (tinnitus). I was told to take b12 tablets from the health food store for a month and ‘see if anything changes.’ I noticed that I had less headaches and with a magnesium spray, the muscle pain became less noticeable. But I wasn’t sure how I was supposed to feel overall – I wasn’t tired or tingly like the typical description of people with low b12 suffer from.

    So I reported back to my doctor at the end of January and was told I needed injections anyway. I had 3 b12 injections in one week. Within 48 hours of the last injection, my face exploded with awful acne. I should also mention that I have been taking acne medication since May 2015 (and had clear, nice skin). The medication now only temporarily removes the redness.

    Towards the end of February, my skin made some improvement after I stopped the injections and changed my diet (no coffee/dairy, no beef/seafood). Then last weekend, I had an omelette for breakfast, a burger for lunch and then the following day a burger for dinner. The acne is all over my face again! I’m so upset and angry, I’m really really sick of dealing with this now and I keep finding white heads now popping up.

    Now I’m beginning to think that the health food tablets were working fine, that I don’t have PA and that the injections have put my body into overdrive for b12 levels! I don’t know what to do – I hate having to go back to the doctor, and I feel like they wouldn’t do much anyway. I’m going back to being basically a vegetarian and drinking water! I hate this so much, it makes me want to stay home all the time and cry. I thought it would be gone after a month, but it just keeps going. I miss my face (and chest) before this.

  23. Areej Says:

    Vicky thank you for sharing your story. It sounds like you’re doing all the right things and previous posts are full of suggestions as well. I know from personal experience how much acne can affect your confidence and mood but I’m also certain the worse you feel about it, the more stress you cause, the worse it will likely get. Just remember that it will disappear, try and feel calm and patient, and know that you are much more than the appearance of your skin.

  24. Russell Dubbels Says:

    Vicky,
    You do not have acne. What you do have are eruptions of toxins being expressed (leaving your body through your pores). These toxins are primarily homocysteine, a chemical needed by your body but, which in excessive amounts are bad and are also involved with heart health issues.

    I’m a novice trying to explain this because I’m not a doctor and I’m not a brainy biochemist when it comes to organic chemistry or trying to understand the complex chemical actions and conversions going on in our bodies.

    The production is involved in the conversion over the B12 we inject for B12 deficiency or in more extreme cases like mine pernicious anemia. B12 when ingested, whether naturally with protein and then separated with intrinsic factor, or on our case by injection, must be converted through a series of organic chemical injections in our body. This conversion creates homocysteine. Because we inject, we are putting a large amount of B12 into our body and this conversion process is huge when compared to natural conversion (like highs and lows in someone taking opioid but no high). This huge conversion produces high amounts of homocysteine which your body needs to convert to methionine (I think I got this right like I said I’m not a biochemist). Since it can’t convert efficiently, the excess homocysteine is expressed through our skin since, like I said, high amounts of it are poisons to our body. Since we have large amounts of sweat pore cells in our heads and upper body we get pimple like lesions. They’re is no pustule in the pimple because the pore isn’t really plugged with dirt or oils.

    I have done a lot of research trying to understand the B12 conversion process. It is interesting but very complex. B12 isn’t really burned up in your body but it’s conversion facilitates a lot of other processes including replication of DNA, health of myelin sheath on your nerves (peripheral neuropathy and subacute degeneration of the spinal cord, my big issue), red blood cells formation and size (why we get fatigued because the ill formed and sized red cells don’t pack oxygen efficiently), and several other functions.

    I hope this helps you understand. The only way to get rid of these skin eruptions that I know of would be to give yourself very minute injections every day to simulatensure how your body absorbs B12 but this might even be too big and all at once as compared to how you eat protein during the day.

    There are some good you tube videos on the conversion of B12 by a doctor from India (he teaches at some university here in the states I think). Also one of the PA B12 Facebook groups have a series of download files explaining this and other issues. Pat Kornic is the head admin to join the group if you aren’t already a member.

    Good luck. We suffer from this. Unfortunately, the medical profession treats this like from the dark ages.

  25. Jack Norris RD Says:

    Russell,

    > These toxins are primarily homocysteine, a chemical needed by your body but,

    For a variety of reasons, this doesn’t seem plausible to me. Has anyone found large amount of homocysteine in these pimples?

  26. Vicky Says:

    Thanks guys.

    What I’ve found is very bizarre – my skin calmed down soon after I wrote this, and I had about 2 weeks of respite from the acne. My forehead became clear, and cheeks weren’t as bumpy.

    Then yesterday (19/3) again, the acne has started to return. I haven’t had any b12 supplements and I’ve cut down on meat, no seafood and no red meat.

    I’m beginning to wonder if my body is getting rid of the excess b12 through cycles? (bad acne, then clears up, then begins to reappear but less severe)

    I don’t understand it. I feel like I’m trying to fight something but I don’t really know how. Has anyone experienced this?

  27. Laure Says:

    I had sudden and bad acne after increasing my B12, I was taking a solgar cyano supplement everyday or every 2 days whenever the dosage was fine for a week (I don’t recall the exact dosage it was from solgar and it was cyano so anything from 100 mcg to 500 mcg), suspecting a problem (there was a clear link) I spaced out the intake, but it calmed down with me stopping B12 for a while (skin did went back to normal) and then switching to another form (methyl in spray form). I actually quite often “overdose” on the methyl, but never experienced the same bad effect. I am therefore wondering if the type of B12 (cyano) is not the culprit. However I now still sometimes take cyano (but no big amounts) and my skin is ok.
    Heard about excess and coagulation problems (high platelets), could there be a link (in people taking lots of B12).

  28. Allie Says:

    My 17 year old daughter was given 3x B12 shots following a borderline reading from blood tests. I asked the nurse about the link between B12 shots and acne prior to the shots being given and was told she had never heard of that as a side effect. I reluctantly agreed and now 6 months after the last injection my daughters once beautiful skin is covered with acne and the dermatologist wants to start isotretinoin treatment. I am opposed to this but she is very distressed with her appearance and scarring is a major concern. Anyone experienced anything similar?

  29. Vicky Says:

    Hey Allie,

    Yeah of course, I also had the same amount of B12 given after a borderline reading and suffered through months of aggressive acne that was totally relentless. Nothing worked, not ‘waiting it out’ or becoming vegan, it was awful and at the very least traumatic. I stayed out of work for a week, caked on the make up…horrendous. I finally went to the dermatologist in May 2016, and after being given a round of antibiotics and rubbing on EpiDuo every night on my face for 2 months, my skin is back to normal. The EpiDuo is very strong and made my skin dry and peely, but it helped get rid of the scarring by shedding off the pigmented, scarred skin. It was so horrible, and the nurse where I went also ‘never heard of it.’ When I showed the doctor what the injections that she prescribed had done, she said it was an ‘allergic reaction’ and to wait it out for 4 weeks. I felt like I was given nothing but crap information from all of the so-called trusted sources. Never again, is all I have to say about b12 injections.

  30. Allie Says:

    Thanks Vicky for sharing your similar experience. The anti-biotics my daughter is on are having no affect at all on the acne and I have tried every topical treatment available with little or no positive affect. Very reluctant to start the isotretinoin as the side effects are reported to be quite dramatic, even though the so called health professionals are telling me it’s fine. I agree with you about ‘never again’ for b12 shots but will look for natural ways to maintain her levels. What is the Epiduo cream comprised of? Is it available over the counter?
    Many thanks,
    Allie

  31. Anna Says:

    Hey Allie

    [I appreciate all the time Anna took to help you out, Allie, so I’m putting this comment through, but please talk to your physician before taking any of Anna’s suggestions. I can’t be responsible for anything you (or anyone else) decides to do based on what you read on this page. – Jack Norris, RD]

    I am really sorry about your daughter’s skin condition as I have gone through almost the same experience after getting 5 shots of b12 and about 10 (1000-mcg) pills of b12 supplements. When my situation was at its peak I read this article and was assured that b12 was the culprit. I even wrote earlier to someone who commented here to know how long does it take for my skin to get back to normal – which is actually all that matters to those plagued by this condition. I got no answer back then. This is why I am writing this comment which is based on my personal experience with b12 acne. I just want to ease your daughter’s mind and yours and to give you a heads up of what to expect for the next 10 to 12 months as she is unlikely to get better before then (of course each body is different and it also depends on the dose – I had 5 shots and supplements while she had only 3 shots so that’s a fortunate thing in her case).

    The only thing that does actually help in this condition is to be patient; there will be times when her body might give her skin a break only to shock her with more and more breakouts later on (though I hope she doesn’t go through that – but she needs to be emotionally prepared). Picture it like this; she was sentenced to almost a year of acne and she has no other choice but to serve. Acceptance is the key, because if she resists the idea she will get stressed and stress along with acne is like adding insult to injury.

    Once the psychological and time factors are understood by a patient who is plagued by such a condition, the rest that they could do is as follows;

    1- Topical antiseptic sprays (Hexomedine) and soothing creams that contain antibiotics (Fucidin) are the only medication your daughter really needs. I am not a supporter of Accutane or any oral or injection treatment as you could never tell how each body responds to their side effects (if history is any indication the problem in the first place was caused by the side effects of a previous treatment that irritated your daughter’s liver – B12 shots) thus, you could never tell what body organ isotretinoin could irritate this time. So, my advice is to keep her body healthy and to fight acne through natural stuff.

    2- Make sure she follows a healthy diet and don’t worry about b12 levels as she could have her intake of b12 from natural food.

    3- Avoid shampoos or soap that contains synthetic vitamin b12 or Keratin.

    4- Drink a lot of water.

    5- Another thing that did really help in my case surprisingly was popping whiteheads; (Let’s hope she doesn’t), but if your daughter goes through the phase of whiteheads, popping isn’t always a bad thing if done correctly – though there will always be casualties.

    Speaking of whiteheads phase I will record the phases that my skin went through so that your daughter might make an analogy as well as know what she could expect had her body responded the same way to b12 side effects:

    Phase 1: greasy skin and aggressive lesions (month 1-2)

    Phase 2: patches of continuously formed whiteheads and random pustules (month 3-4-5-6)

    Phase 3: decrease in the number of newly formed whiteheads especially if old ones are removed as well as occasional acne breakouts that heighten around menstruation and ovulation (month 7-8-9)

    Phase 4: pimples get smaller in shape and there is a gradual decrease in the number of pimples until the skin starts to regain its previous glowing and natural tone (month 10-11-12)

    P.S. In addition to facial acne I also had upper body acne especially on my back which was even more aggressive than the facial one.

    Also, I suggest she take photos of her face regularly and to keep them in a personal file as this helps her tolerate setbacks and celebrate improvements. This helps her keep track of how the treatment is going as well (it gives the illusion that she has control over the situation – emotionally it helps as acne could be very depressing). Plus, no matter how much she goes on and on about her acne try to be as considerate as possible. Let her vent out her feelings as she must be feeling terribly vulnerable.

    As for picking; if she suffers from whiteheads (I hope not) and she takes care of those whiteheads before they become fully-fledged pimples she wins. However, let me be clear about this; each (whitehead picking wave) is likely to give her one or two big pimples that take no less than a month to fully heal – (since the whiteheads are so close to each other and she might miss one or two that could get inflamed after the attack) but the upside is that she gets rid of so many whiteheads per attack. The best advice really for picking is to clean the area with water and soap and to wear doctor gloves while picking and to try her best to get all the sebum out of the whitehead. If you or she does not feel good about this whole picking thing, forget it and let her skin take care of it on its own.

    Finally, as for the scarring, it depends on the area and type of skin your daughter has; if she is lucky she will be left with no scarring or acne marks whatsoever even if she picks them. However, if she is not lucky, even if she does not touch her skin she will get scars.

    Disclaimer: I repeat this is all from my personal experience and the amount of reading I did while going through that condition. I am not well-versed in medicine or dermatology and I don’t claim to be 100 percent right about what I said here. I am merely sympathetic and trying to help.

    I hope your daughter makes the quickest full recovery as I could feel exactly what she must be going through right now.

    Be safe.

    Anna

  32. Allie Says:

    Dear Anna, thank you so much for your comprehensive recount of your own experience with b12 and the phases that you observed before recovery. I have carefully read it and shared it with my daughter. It is heartening to read that there may be some light at the end of the tunnel and we are prepared to be patient rather than starting an aggressive form of treatment. I acknowledge the comments about everyone may respond differently and the recovery rate can also vary, but your information has provided us with a good idea of what we can expect. I estimate we are probably in about month 5-6 so will see what the next few months may bring. Much appreciated for the time you have spent sharing your experience it helps to know others have had a good outcome. Warmest regards, Allie

  33. MatevĹľ Jeran Says:

    Some new studies on that topic are out there now:
    https://www.ncbi.nlm.nih.gov/pubmed/?term=b12+acne

    “One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation.”

    Kang, D., Shi, B., Erfe, M.C., Craft, N. & Li, H. 2015. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis. Science Translational Medicine, 7(293): 293ra103-293ra103.
    http://stm.sciencemag.org/content/7/293/293ra103.short

    Review:

    Brescoll, J. & Daveluy, S. 2015. A Review of Vitamin B12 in Dermatology. American Journal of Clinical Dermatology, 16(1): 27–33.
    http://link.springer.com/article/10.1007%2Fs40257-014-0107-3

  34. Essere Says:

    Seems like the Vaccine issue with all the man made toxic molecules added to it.

    Sadly many MSDS B12 injection papers found online do not list all the ingredients found in these injections however they do indicate that someone should wash their hands if they come into contact with it because it contains a skin irritant.. yet it is fine injecting it? The irony.

    My suggestion would be to drink water to hydrate and therefore flush out whatever other ingredient is in these injections that has become trapped between the cells and is causing inflammation.

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