Multi-Vitamins

Once Daily Multivitamin

Multi-vitamins are nutritional supplements that combine many vitamins, minerals and other nutrients into a single formulation. Regular intake of a balanced multi-vitamin at the recommended dosage is an excellent way to maintain healthy levels of essential nutrients in your body. Multi-vitamins are rarely used as a direct treatment for acne, but they are often incorporated into comprehensive acne treatment plans as part of the dietary regimen.

Organic Multi-Vitamin Supplement Label
Organic Multi-Vitamin Supplement Label

There is no robust evidence that taking Multi-vitamins is an effective treatment for any disease, at least in otherwise healthy people. However, deficiences in essential Vitamins and Minerals can cause a wide range of health problems, suppress the immune system and trigger acne symptoms. For example, B Vitamin (B2, B5 and B6) deficiencies can cause skin problems and acne-like symptoms. Deficiencies in Vitamins A and D, as well as important minerals like Zinc, may also trigger acne symptoms.

Overall, taking a once-daily, balanced multi-vitamin is unlikely to significantly reduce the frequency or severity of acne symptoms in most people. That’s because most people who eat a reasonably well-balanced diet do not have acute Vitamin or Mineral deficiencies. But regular use of multi-vitamins at recommended dosages is generally safe and is an excellent way to ensure your body has all the nutrients that it needs.

Multi-Vitamin Images

References

Multivitamins @ Wikipedia

Fish Oil

Fish Oil and Acne

Fish Oil refers to the naturally occurring oils in the flesh of fish. Fish Oil is extracted from many types of fish and is among the most popular nutritional supplements on the market. Fish Oil is purported to have many health benefits, such as decreasing inflammation and improving skin tone. Fish Oil supplements are commonly included in holistic Naturopathic acne treatment plans.

Fresh Caught Sardines
Fresh Caught Sardines

There have been several research studies to investigate whether Fish Oil supplements can help improve acne symptoms. Many of these studies found that regular consumption of Fish Oil led to reduction in the severity and frequency of acne outbreaks. However, these effects tend to be fairly small and Fish Oil is not expected to dramatically improve acne symptoms for most individuals. Fish Oil supplements do not appear to have a significant risk of side effects when consumed at recommended levels and they can be combined with most other acne treatments.

Fish Oil contains significant concentrations of Omega-3 fatty acids, such as EicosaPentaenoic Acid (EPA) and DocosaHexaenoic Acid (DHA). These fatty acids have been reported to provide multiple health benefits and they may be responsible for anti-inflammatory properties of Fish Oil. Fish Oil is approved by the FDA to help lower levels of blood triglycerides (fats). The powerful anti-acne drug Isotretinoin (Accutane) can cause unsafe increases in blood triglycerides in some individuals. There has been at least one research study which found that Fish Oil supplementation can help limit Isotretinoin-caused increases in blood triglyceride levels. Because of this, some dermatologists prescribe Fish Oil supplements to patients who are undergoing oral Isotretinoin therapy.

Although Fish Oil supplements are an easy way to maintain a steady level of dietary Fish Oil, eating fish itself will accomplish the same thing. Some experts believe that part of the reason why people in certain regions of the world (eg. Mediterranean) have lower frequencies of acne is because their diets are high in fish and other foods that are rich in certain types of fatty acids.

Fish Oil Images

References

Fish Oil @ Wikipedia
Acne vulgaris, mental health and omega-3 fatty acids: a report of cases. Rubin, et al. 2008.
Omega-3 fatty acids and acne. Logan. 2003.
Effects of fish oil supplementation on inflammatory acne. Khayef, et al. 2012.
Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Jung, et al. 2014.
Effect of dietary fish oil on hyperlipidaemia due to isotretinoin and etretinate. Marsden, et al. 1987.

Cod Liver Oil

Cod Liver Oil and Acne

Cod Liver Oil, like the name implies, is oil derived from the liver of Cod fish (Gadus spp). Cod Liver Oil has been used for centuries to treat various ailments and is widely lauded for its perceived anti-inflammatory effects. Cod Liver Oil is rarely used on its own as a treatment for acne, but it is often included as a nutritional supplement in holistic Naturopathic ance treatment regimens.

Atlantic Cod
Atlantic Cod

Cod Liver Oil contains high levels of Vitamins A and D, as well as many important fatty acids. There is some research that suggests Cod Liver Oil can reduce blood triglyceride levels and help improve blood pressure. The high levels of Vitamin A are one of the reasons why Naturopathic practitioners  use the Cod Liver Oil to relieve their acne symptoms. Vitamin A is a retinoid and structurally-similar to anti-acne pharmaceuticals, such as Isotretinoin (Accutane) and Tretinoin (Retin-A). Vitamin A supplementation may help reduce sebaceous gland activity, which can help reduce acne symptoms in some individuals. Vitamin D supplementation may help overall immune function, especially in the winter.

Overall, there is very little clinical research on the efficacy of Cod LIver Oil for the treatment of acne. There are some people who have reported positive improvements in their acne symptoms after starting a supplement regimen that contained Cod Liver Oil. Although the available evidence suggests that Cod Liver Oil supplements are safe when used as directed, these supplements are unlikely to dramatically improve acne symptoms for most people.

Cod Liver Oil Images

References

Cod Liver Oil @ Wikipedia
Effect on blood lipids and haemostasis of a supplement of cod-liver oil, rich in eicosapentaenoic and docosahexaenoic acids, in healthy young men. Sanders, et al. 1981.
Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients’ experiences and perceptions. Magin, et al. 2006.
Effects of ethyl arachidonate, cod-liver oil, and corn oil on the plasma-cholesterol level: a comparison in normal volunteers. Kingsbury, et al. 1961.
Nutritional skin care: health effects of micronutrients and fatty acids. Boelsma, et al. 2001.

Chromium Picolinate

Chromium Picolinate Tablets

Chromium Picolinate Supplements help raise the amount of chromium present in the body. Small levels of dietary chromium are essential for normal metabolic function. Chromium-deficient patients have problems with blood sugar regulation and other essential metabolic processes. Chromium picolinate is a semi-popular supplement for athletic training. Chromium Picolinate supplements are also occasionally used in Naturopathic medicine for the treatment of some skin diseases, such as acne.

Chromium Picolinate Structure
Chromium Picolinate Structure

Chromium is naturally present in small concentrations in many unprocessed foods and most people are not chromium deficient. There is little evidence that dietary supplementation with Chromium Picolinate has significant effects in people who already have healthy levels of chromium. Since there is a link between blood glucose (sugar) levels and inflammation, people have attempted to use chromium picolinate to improve their acne symptoms. The idea being that an increase in the amount of Chromium Picolinate will decrease the amount of blood glucose, which leads to decreased inflammation. This would then cause an improvement in acne symptoms. However, there does not appear to be any reliable evidence that indicates Chromium Picolinate supplements are effective as an acne treatment.

Chromium Picolinate Images

References

Chromium Picolinate @ Wikipedia
Acne vulgaris: nutritional factors may be influencing psychological sequelae. Katzman, et al. 2007.
The chromium controversy. Cronin. 2004.
The effect of chromium supplementation on polycystic ovary syndrome in adolescents. Amr, et al. 2015.
The Effects of Chromium Supplementation on Endocrine Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Jamilian, et al. 2016.
The potential value and toxicity of chromium picolinate as a nutritional supplement, weight loss agent and muscle development agent. Vincent. 2003.

Calcium

Calcium Supplement Tablets

Calcium Supplements are nutritional supplements that contain bio-available forms of elemental calcium. Calcium is an essential mineral that is most commonly used to improve bone density and limit the effects of osteoporosis. Many foods are either naturally rich in calcium (eg. Milk, Spinach) or fortified with additional calcium (eg. Breakfast Cereals). Calcium Supplements are rarely used as an acne treatment and there is no evidence that they can improve acne symptoms.

Elemental Calcium
Elemental Calcium

There are various reasons people use Calcium Supplements. They may be trying to prevent osteoporosis or even heal acne scars. However several research studies have questioned the therapeutic validity of Calcium supplementation for those ailments. Several other research studies have even linked calcium supplementation to an increased risk of cardiovascular disease and heart attacks. The increased risk could be due to the important role Calcium plays in maintaining cardiac rhythm. Hypercalcemia, or an excess of blood calcium, can even cause an ECG finding known as an Osborn Wave, which is also seen in hypothermia. Excess calcium may also cause other problems such as kidney stones or gallstones.

Nevertheless calcium is involved in many cellular processes and signaling pathways, and it is a necessary mineral. So some acne sufferers do feel that calcium supplements can maintain their skin health, control acne or even help heal acne scars. Although there is no evidence that Calcium Supplements will improve acne symptoms, they are considered quite safe when consumed at recommended levels.

Calcium Images

References

Calcium Supplement @ Wikipedia
Diet and acne. Bowe, et al. 2010.
Hypercalcemia associated with oral isotretinoin in the treatment of severe acne. Valentic, et al. 1983.
High school dietary dairy intake and teenage acne. Adebamowo, et al. 2005.
Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Thys-Jacobs, et al. 1999.

Alpha Lipoic Acid

Alpha Lipoic Acid (aLA) Capsules

Alpha Lipoic Acid (aLA) is a compound that is naturally made by animals during cellular processes. Alpha Lipoic Acid is important for the function of many enzymes involved in aerobic (oxygen) respiration. Alpha Lipoic Acid supplements are widely available and are purported to have antioxidant properties and other effects that are beneficial for overall health. Alpha Lipoic Acid is approved for use in Germany as a medical treatment for diabetic neuropathy (nerve damage), although it is unclear how effective it is. Alpha Lipoic Acid is rarely used for the direct treatment of acne. When used as an acne treatment, Alpha Lipoic acid may be ingested orally, or incorporated into topical anti-acne formulations.

Alpha Lipoic Acid Rich Foods
Alpha Lipoic Acid Rich Foods

Most people consume a significant amount of Alpha Lipoic Acid as part of their normal diet and it is unlikely that most people have Alpha Lipoic Acid deficiencies. There are a handful of research studies that indicate that consuming oral Alpha Lipoic Acid supplements can increase levels of Alpha Lipoic Acid in the blood, and that this might have beneficial effects. However, the connection between Alpha Lipoic Acid supplements and improvements in specific health conditions and diseases is largely unproven, and the evidence that does exist tends to be weak. There is no direct evidence that Alpha Lipoic Acid supplements have any effect on acne symptoms.

Perhaps the most important role for Alpha Lipoic Acid in relation to acne is its ability to raise Vitamin E levels. Vitamin E helps maintain skin health via its antioxidant properties. Some acne sufferers like to apply Alpha Lipoic Acid as a way of preventing or treating acne scars and others feel that it can reduce the occurrence of acne breakouts. However, neither oral nor topical Alpha Lipoic Acids are likely to dramatically improve acne symptoms for most individuals.

Alpha Lipoic Acid was first discovered in the 1950’s and became a nutritional supplement shortly thereafter. The biologically active form of Alpha Lipoic Acid, RLA, is an essential cellular anti-oxidant. Unlike many other supplements, oral ingestion of RLA rapidly leads to increased levels of bio-available RLA in the blood. While there is not an abundance of research on the role of Alpha Lipoic Acid in the treatment of acne, the research that does exist indicates that Alpha Lipoic Acid may be helpful in decreasing inflammation and improving the immune response to acne. Alpha Lipoic Acid is also available in topical formulations.

Alpha Lipoic Acid Images

References

Alpha Lipoic Acid @ Wikipedia
alpha-Lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Konrad, et al. 1999.
Modern approach to topical treatment of aging skin. Puizina-Ivić, et al. 2010.
Stability, Cutaneous Delivery, and Antioxidant Potential of a Lipoic Acid and α‐Tocopherol Codrug Incorporated in Microemulsions. Thomas, et al. 2014.
Cosmeceuticals – an evolution. Preetha, et al. 2009.
d-chiro-Inositol and alpha lipoic acid treatment of metabolic and menses disorders in women with PCOS. Cianci, et al. 2015.

Zinc

Zinc Supplement

Zinc is an essential trace mineral that is required by many human enzymes and cellular processes. Zinc is one of the most common supplements used in the Naturopathic treatment of acne. Both topical and oral Zinc formulations are used as acne treatments. Zinc is one of the most extensively researched nutritional supplements for acne, and their have been several research studies and clinical trials that have reported Zinc supplements to be effective at decreasing the severity of acne symptoms.

Elemental Zinc
Elemental Zinc

Zinc is a popular nutritional supplement is purported to help boost the immune system.  Zinc ions are essential for many key molecular processes, such as gene expression and cellular differentiation. Zinc is one of the primary ingredients in many Naturopathic cold and flu treatments. Zinc deficiency has been shown to suppress the immune system, and several studies have found that important immune functions can be enhanced through regular consumption of Zinc supplements. Although the observed effects of zinc function on the immune system tend to be relatively mild, it is clear that healthy levels of Zinc are important for a healthy immune system.

Relationship of Acne Severity and Blood Levels of Vitamin A, Vitamin E and Zinc (Ozuguz)
Relationship of Acne Severity and Blood Levels of Vitamin A, Vitamin E and Zinc (Ozuguz)

There are several different versions of oral Zinc supplement available, including zinc acetate and zinc gluconate.  A few research studies have found that individuals with moderate to severe acne symptoms tend to have lower levels of Zinc in their blood than individuals without acne symptoms. Because of this relationship, many people believe that Zinc supplements can help improve acne symptoms. In the 1970’s several clinical trials were conducted to investigate whether oral Zinc supplements were effective acne treatments. The results of these trials were mixed, but overall they did tend to find that oral Zinc supplements helped reduce the severity of acne symptoms for some patients.

Zinc can also be used topically as a treatment for acne. Zinc salts can be added to topical Naturopathic anti-acne formulations. Zinc has antimicrobial properties that may help control the growth of acne-causing P. acnes bacteria. Several Zinc acne treatment creams are available, some of which also contain antibiotics. However, most of the clinical research studies on topical Zinc acne treatments have found that they are not very effective.

Overall, oral Zinc supplements are one of the nutritional supplements that is most likely to help improve acne symptoms (according to the available evidence). Zinc supplements are not expected to completely cure acne symptoms for most people. However, they can be combined with many other types of acne treatments. Zinc supplements are generally safe when consumed at recommended dosages, but consuming large quantities of Zinc supplements can be toxic and cause permanent damage.

Zinc Images

References

Zinc @ Wikipedia
Low doses of zinc gluconate for inflammatory acne. Dreno, et al. 1989.
Serum zinc in acne vulgaris. Amer, et al. 1982.
Oral zinc in acne vulgaris: a clinical and methodological study. Göransson, et al. 1977.
Topical erythromycin and zinc therapy for acne. Schachner, et al. 1990.
Topical zinc therapy for acne vulgaris. Cochran, et al. 1985.
Clinical evaluation in acne. Liden, et al. 1979.
Effects of oral zinc and vitamin A in acne. Michaelsson, et al. 1977.
Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Hillstrom, et al. 1977.
Multicenter Randomized Comparative Double-Blind Controlled Clinical Trial of the Safety and Efficacy of Zinc Gluconate versus Minocycline Hydrochloride in the Treatment of Inflammatory Acne vulgaris. Dreno, et al. 2001.
Evaluation of serum vitamins A and E and zinc levels according to the severity of acne vulgaris. Ozuguz, et al. 2014.
Zinc in skin pathology and care. Nitzan, et al. 2006.
Acne treatment with topical erythromycin and zinc: effect on Propionibacterium acnes and free fatty acid composition. Strauss, et al. 1984.
The role of zinc in acne and prevention of resistance: have we missed the “base” effect. Sardana, et al. 2014.
Oral zinc sulphate therapy in acne vulgaris: a double-blind trial. Verma, et al. 1979.
The role of zinc in rosacea and acne: further reflections. Gessert, et al. 2014.
Correlation between the severity and type of acne lesions with serum zinc levels in patients with acne vulgaris. Mogaddam, et al. 2014.
Zinc therapy in dermatology: a review. Gupta, et al. 2014.
Therapeutic evaluation of 2% tea lotion in comparison with 5% zinc sulfate solution in the treatment of acne rosacea. Sharquie, et al. 2014.

Vitamin K

Vitamin K Capsules

Vitamin K is a fat soluble dietary nutrient that is essential for the binding of proteins to calcium. Vitamin K deficiencies can lead to bone weakening and blood coagulation problems. Vitamin K is rarely used as a Naturopathic treatment for acne. There is no reliable evidence that indicates Vitamin K supplementation has a significant effect on acne symptoms in otherwise healthy people.

Vegetables are a good source of Vitamin K
Vegetables are a good source of Vitamin K

Vitamin K is generally obtained through the dietary intake of leafy green vegetables. After consumption, bacteria in the digestive tract convert Vitamin K into several structurally similar molecules with important functions. Due to the ability of vitamin K to increase protein binding to calcium, connective tissues in skin may be more flexible and softer with an adequate supply of the vitamin. Because of this effect, some people think that Vitamin K supplements can help improve the appearance of acne scars, but this has not been proven.

Overall, Vitamin K supplements are safe when consumed in recommended concentrations, but are unlikely to be effective treatments for acne. 

 

Vitamin K Images

References

Vitamin K @ Wikipedia
Uses of vitamins A, C, and E and related compounds in dermatology: A review. Keller, et al. 1998.

Vitamin E

Vitamin E Supplements and Acne

Vitamin E is a fat soluble dietary nutrient that is found in many types of plant-based oils, nuts, vegetables and fish. Vitamin E refers to a group of tocopherol and tocotrienol compounds, which have antioxidant properties and are essential for many important biological functions. Vitamin E is one of the most popular vitamin supplements. Vitamin E is widely used as an oral and topical treatment for active acne and acne scars. However, most scientific studies on Vitamin E and acne have found that Vitamin E supplements have little to no effect on acne symptoms.

Almonds are a rich source of Vitamin E
Almonds are a rich source of Vitamin E

Most people who eat a reasonably well-balanced diet do not have a Vitamin E deficiency. Vitamin E is found in fairly high concentrations in nuts and plant-based oils, and it is also added to many processed foods. Vitamin E supplements have been investigated as treatment for a wide range of health problems, from acne to cardiovascular disease. Almost every study conducted has found that Vitamin E supplements do not have significant health benefits for otherwise healthy people. This is most likely because the majority of people already consume abundant amounts of Vitamin E in their diet. In fact, consuming large amounts of Vitamin E supplements can be toxic because excess Vitamin E can not be easily eliminated from the body in the urine.

One of the most common misconceptions about Vitamin E is that topical application of Vitamin E is an can accelerate skin healing and reduce the appearance of acne scars. Many people break open Vitamin E capsules and apply the solution directly to acne scars and other problem areas. Vitamin E is commonly added to moisturizers and other skin creams. However, several clinical research studies have found that topical Vitamin E is not an effective treatment for acne scars. Vitamin E supplements are also an ineffective strategy for decreasing the symptoms of certain acne drugs that can irritate the skin, such as Isotretinoin (Accutane).

Overall, most people have sufficient levels of Vitamin E in their diet and do not significantly benefit from Vitamin E supplements. However, topically application of Vitamin E is safe and has few side effects. Oral Vitamin E supplements are also safe, when consumed in recommended quantities. Vitamin E is an important antioxidant that helps protect cell membranes from oxidative damage. It is possible that Vitamin E may help support healthy skin, but it is unlikely to have a significant effect on active acne symptoms or acne scars.

 

Vitamin E Images

References

Vitamin E @ Wikipedia
Concomitant administration of vitamin E does not change the side effects of isotretinoin as used in acne vulgaris: a randomized trial. Strauss, et al. 2000.
Topical vitamins. Burgess. 2008.
Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Juhlin, et al. 1981.
Erythrocyte glutathione peroxidase activity in acne vulgaris and the effect of selenium and vitamin E treatment. Michaelsson, et al. 1983.
Does the plasma level of vitamins A and E affect acne condition? El‐akawi, et al. 2006.
Safety of oral intake of vitamin E. Bendich, et al 1988.
Why don’t we use vitamin E in dermatology? Pehr, et al. 1993.
Lipid mediators in acne. Ottaviani, et al. 2010.
Vitamin E does not reduce the side‐effects of isotretinoin in the treatment of acne vulgaris. Kus, et al. 2005.
The role of vitamin E in normal and damaged skin. Nachbar, et al. 1995.

Vitamin D

Vitamin D and Acne

Vitamin D is a fat soluble vitamin that is important for many biological systems, including the immune system. Vitamin D is not naturally present in many foods, but it is commonly added to certain types of food (eg. Milk, Breakfast Cereal). In humans, Vitamin D is synthesized in the skin when it is exposed to ultraviolet (UV) light from the sun or UV tanning beds. Vitamin D is rarely used as a direct treatment for active acne or acne scars, but it is often incorporated into the dietary component of comprehensive acne treatment plans.

Mushrooms are a rich source of Vitamin D
Mushrooms are a rich source of Vitamin D

Vitamin D is very important in maintaining serum calcium and phosphate levels, which are needed for normal bone mineralization. There are numerous other functions that vitamin D regulates, such as cell growth, neuromuscular and immune function and the reduction of inflammation. However, there is limited evidence that Vitamin D supplementation is beneficial for otherwise healthy people that are do not have a Vitamin D deficiency. Most people obtain significant Vitamin D in their diet, but people living in areas with low levels of sunlight in the winter may benefit from Vitamin D supplements.

Vitamin D3 Solution
Vitamin D3 Solution

Due to the beneficial effects vitamin D has on the immune system, people with acne will benefit from an adequate supply of vitamin D in their diet. Vitamin D may have some anti-inflammatory properties that can help reduce the symptoms associated with acne. However, these effects are likely to be very modest. Vitamin D supplementation is unlikely to dramatically improve acne symptoms for most individuals. There have only been a few clinical research studies on the effectiveness of Vitamin D supplements as treatments for acne. However, some studies from the early 20th century found that Vitamin D supplements were helpful at reducing the number of acne lesions. Overall, more research is needed to understand the relationship between Vitamin D and the development of acne symptoms.

There are a handful of dietary sources of Vitamin D, such as Fish, Mushrooms and Liver. Cod Liver and Fish Oil supplements also contain significant concentrations of Vitamin D.

Vitamin D Images

References

Vitamin D @ Wikipedia
Vitamin D in the Treatment of Acne Vulgaris. Doktorsky, et al. 1933.
Propionibacterium acnes induces an IL-17 response in acne vulgaris that is regulated by vitamin A and vitamin D. Kim, et al. 2014.
High school dietary dairy intake and teenage acne. Adebamowo, et al. 2005.
Vitamin D and the skin: an ancient friend, revisited. Reichrath. 2007.
Benefits and requirements of vitamin D for optimal health: a review. Grant, et al. 2005.
Vitamin D, disease and therapeutic opportunities. Plum, et al. 2010.
Vitamin D in Acne: a comparison with X-ray treatment. Maynard. 1938.
A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Schwalfenberg. 2011.
Serum levels of vitamin D metabolites in isotretinoin-treated acne patients. Rødland, et al. 1991.
Characterization of the vitamin D endocrine system in human sebocytes in vitro. Kramer, et al. 2009.
Vitamin D and innate immunity. Miller, et al. 2010.
Sunlight, tanning booths, and vitamin D. Lim, et al. 2005.