Does Biotin Make Acne Worse?
Biotin supplementation does not typically worsen acne and may actually help in specific contexts, particularly for comedonal acne with high seborrhea or when used alongside isotretinoin treatment to reduce mucocutaneous side effects. 1, 2
Evidence for Biotin's Role in Acne
Potential Benefits in Specific Acne Types
Biotin may be useful for comedonal acne characterized by high seborrhea, as it intercepts metabolic pathways underlying sebum production and can help control the pathogenesis of seborrheic conditions 1
When acne is treated with topical retinoids, biotin supplementation may help control flaking and irritation, making it a supportive adjunct rather than an acne trigger 1
In patients receiving isotretinoin (0.5 mg/kg/day), adding 10 mg/day biotin significantly improved hair parameters and maintained skin hydration without worsening acne outcomes, suggesting biotin does not interfere with acne treatment efficacy 2
Lack of Evidence for Acne Exacerbation
Unlike other B vitamins (B6/B12), biotin is not listed among dietary supplements that cause or aggravate acne in comprehensive reviews of supplement-induced acne 3
The supplements most clearly associated with acne exacerbation include high-dose vitamins B6/B12, iodine/kelp, whey protein, and anabolic steroids—but biotin is notably absent from this list 3
Clinical Context and Caveats
Appropriate Use
Biotin administration is most rational when deficiency is detected based on careful patient history, clinical examination, and serum biotin levels—not as routine supplementation for all acne patients 1
Biotin has excellent tolerability with no risk of hypervitaminosis even at high doses, making it safe when medically indicated 1
Important Warnings
High-dose biotin (≥5 mg daily) interferes with multiple laboratory tests including thyroid function, troponin, β-HCG, hepatitis serology, HIV serology, and vitamin D levels, which can lead to incorrect diagnoses 4
Patients should discontinue biotin prior to laboratory testing, though nearly half of physicians surveyed failed to ask patients to do this 4
Despite widespread consumer use (27.2% of Amazon reviewers reported hair improvement), there is limited evidence supporting biotin for hair, skin, or nail disorders in those without deficiency 5
Practical Recommendation
For teenagers or young adults with oily or hormonal acne, biotin supplementation is unlikely to worsen their condition and may provide modest benefit if seborrhea is prominent. However, it should not replace evidence-based acne treatments. The American Academy of Dermatology recommends topical retinoids and benzoyl peroxide as first-line therapy for mild-to-moderate acne, with oral antibiotics or hormonal therapy for moderate-to-severe cases 6. Biotin can be considered as adjunctive support, particularly when retinoid irritation is problematic, but always ensure patients are aware of laboratory test interference 1, 4.