Does Biotin Make Acne Worse?
There is no direct evidence that biotin supplementation causes or worsens acne in the medical literature. However, biotin is grouped among dietary supplements that have been associated with acne, though the specific mechanism and strength of this association remains unclear.
Evidence Regarding Biotin and Acne
The only guideline-level evidence addressing biotin in relation to acne comes from a 2020 review on dietary supplement-related acne, which lists biotin alongside vitamins B6/B12, iodine, whey protein, and anabolic steroids as supplements linked to acne 1. However, this review does not provide specific case reports, mechanistic data, or clinical descriptions of biotin-induced acne patterns 1.
Key Limitations in the Evidence
- No specific clinical descriptions exist for biotin-related acne lesions, unlike the detailed descriptions provided for B6/B12 (monomorphic lesions), iodine (inflammatory pustules on face and trunk), or whey protein (papulonodular acne on trunk) 1
- No case reports or clinical trials directly demonstrate biotin causing or exacerbating acne
- The 2016 American Academy of Dermatology guidelines for acne management make no mention of biotin as a causative or exacerbating factor 2
Biotin's Safety Profile
Biotin has an excellent safety profile with no established upper tolerable limit and no adverse effects reported at doses up to 5 mg/day for prolonged periods 3, 4. High doses up to 300 mg/day have been used in parenteral nutrition without toxicity 3, 4.
Clinical Context
- A 2021 study of 60 acne patients treated with isotretinoin found that biotin supplementation (10 mg/day) actually improved skin parameters including maintaining skin hydration and improving hair health 5
- This suggests biotin does not worsen acne even in patients actively being treated for the condition 5
Clinical Recommendation
For patients with acne who are taking or considering biotin supplementation:
- Do not routinely discontinue biotin based on acne concerns, as there is insufficient evidence linking biotin to acne development or worsening
- Directly ask patients about all dietary supplement use including biotin, as approximately half of US adults use supplements 1
- If acne develops or worsens temporally with biotin initiation, consider a trial discontinuation for 4-8 weeks to assess for improvement, though this association would be uncommon
- Warn patients about laboratory interference: Biotin >5 mg/day should be discontinued at least 72 hours before laboratory testing, particularly thyroid function tests and troponin levels 3, 6
Important Caveat
The grouping of biotin with other acne-associated supplements 1 may reflect incomplete evidence rather than established causation. The lack of specific case reports, clinical descriptions, or mechanistic data distinguishes biotin from other supplements with clearer acne associations.