Vitamin B12, also known as cobalamin, is often used for its purported benefits on brain and nervous system function. In older adults, it may fend off the symptoms of Alzheimer’s disease, whereas in younger people, it is commonly used as an energy booster. However, high doses of this supplement can cause outbreaks of rosacea and acne on the upper torso and face.
Recommended Daily Allowance
The recommended dietary allowances, or RDA, of vitamin B12 are: 2.4 micrograms daily for adults and teens aged 14 years and older; 2.6 micrograms daily for pregnant females; and 2.8 micrograms daily for nursing females. However, 10 to 30 percent of seniors do not absorb vitamin B12 effectively from food, therefore those over 50 years old should meet the RDA guidelines by eating B12-fortified foods or through vitamin B12 supplements. Supplementation of 25 to 100 micrograms daily is suggested to maintain adequate vitamin B12 levels in older people.
Rosacea Fulminans
Rosacea fulminans is a skin condition characterized by redness and occasionally acne on the forehead, cheeks and nose that typically affects women of northern European descent. A study in the September 2001 issue of the “Journal of the European Academy of Dermatology and Venereology” reported a case of rosacea fulminans in a 17-year-old girl who had revealed that her daily intake of vitamin B6 was 80 mg and a vitamin B12 intake of 20 mg, approximately 10 times greater than the RDA. The authors stated that the onset of the condition was sudden and improved upon the discontinuation of the vitamin supplementation; a regimen of isotretinoin and methylprednisolone was begun. The study concluded that exacerbating facial eruptions may be triggered by large doses of vitamins B6 and B12.
Acne Rosacea
Acne rosacea is a condition similar to rosacea fulminans, as both conditions present with the same symptoms -- redness of the face accompanied by pimples. A case of acne rosacea was described by a physician from the Bowman Gray School of Medicine in Winston-Salem, North Carolina in a 1991 issue of “Cutis.” The physician stated that the patient’s condition was brought on through the use of vitamin B supplementation and she failed to respond to usual treatments for rosacea. The study noted that the young women’s condition immediately improved when the vitamin supplement was discontinued.
Isotretinoin
Isotretinoin is a medication originally designed as a chemotherapy agent for the treatment of cancer, but was later found to be effective for skin disorders due to its ability to prevent cells from multiplying. A study in the April 2004 issue of the “Journal of Dermatological Treatment” found that isotretinoin treatment increases the concentration of blood homocysteine levels, which has been linked to an increased risk of cardiovascular disease. To investigate the effects of isotretinoin, researchers recruited 74 patients with cystic acne and measured their levels of homocysteine, vitamin B12 and folate before and after a 45-day isotretinoin trial. The study found increased levels of homocysteine due to either liver dysfunction or the inhibition of a key enzyme in the metabolism of the drug. Counter-intuitively, the researchers recommended vitamin B12 and folate supplementation to lower isotretinoin levels, as they are required by the liver to metabolize the compound.
References
- “Journal of Dermatological Treatment”; Plasma Homocysteine Level Is Elevated in Patients on Isotretinoin Therapy for Cystic Acne: A Prospective Controlled Study; P. Muhterem, et al.; April 2004
- “Cutis”; Acneiform Eruption Due to "Megadose" Vitamins B6 and B12; E. Sherertz; August 1991
- “Journal of the European Academy of Dermatology and Venereology”; Rosacea Fulminans Triggered by High-Dose Vitamins B6 and B12; T. Jansen, et al.; September 2001
- Mayo Clinic; Vitamin B12; August 2011
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