Topical vitamin B12--a new therapeutic approach in atopic de

[prryjones]

Topical vitamin B12--a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial.

Stucker M, Pieck C, Stoerb C, Niedner R, Hartung J, Altmeyer P.

Clinic for Dermatology and Allergology, Ruhr University Bochum, Germany. m.stuecker@derma.de

BACKGROUND: Vitamin B(12) is an effective scavenger of nitric oxide (NO). As the experimental application of a NO synthase inhibitor, N omega-nitro-L-arginine, led to a clear decrease in pruritus and erythema in atopic dermatitis, it would be reasonable to assume a comparable effect of vitamin B(12). OBJECTIVES: The efficacy and tolerability of a new vitamin B(12) cream as a possible alternative to current therapies was examined. METHODS: A prospective, randomized and placebo-controlled phase III multicentre trial, involving 49 patients was conducted. For the treatment duration of 8 weeks, each patient applied twice daily (in the morning and evening) the vitamin B(12)-containing active preparation to the affected skin areas of one side of the body and the placebo preparation to the contralateral side according to the randomization scheme. RESULTS: On the body side treated with the vitamin B(12) cream, the modified Six Area Six Sign Atopic Dermatitis score dropped to a significantly greater extent than on the placebo-treated body side (for the investigational drug 55.34 +/- 5.74 SEM, for placebo 28.87 +/- 4.86 SEM, P < 0.001). At the conclusion of the study, the investigator and patients awarded mostly a 'good' or 'very good' rating to the active drug (58% and 59%, respectively) and a 'moderate' or 'poor' rating to the placebo (89% and 87%, respectively). CONCLUSIONS: Topical vitamin B(12) is a new therapeutic approach in atopic dermatitis. These results document a significant superiority of vitamin B(12) cream in comparison with placebo with regard to the reduction of the extent and severity of atopic dermatitis. Furthermore, the treatment was very well tolerated and involved only very low safety risks for the patients.

[bethanne]

This is interesting. The quickest way for me to develop a facefull of papules and cystic acne is to take orally Vitamins b12 and or b6. One wonders if this has a completely different mechanism when applied topically.

Beth

[irishgenes]

Germany does a lot of useful studies on herbs and vitamins, which they would never do over here in the US. Beth, I am surprised that oral B6 and B12 cause you to get cystic acne. Have you take those vitamins singly? I was thinking that maybe you were taking them as part of a B complex which has niacin in it, and that could be causing flushing and papules.

I imagine one problem with a B12 cream for people with acne or rosacea would be the vehicle. They always seem to add something to the active ingredient which is problematic.

[bethanne]

Hi Irishgenes,

No I never did take a B-complex containing niacin. The only time I ever used Niacin was to deliberately induce a flush for IPL. My B-complex that I used for years had niacinimide, which I learned can cause flushing also at high enough levels. I read on the RSG board a year or so ago a comment from Dr. Nase that high amounts of B6 and B12 can cause acne and flushing problems. I looked it up at pubmed also and saw something written about it there. For years, I didn't have problems with it, but when I discontinued the B-complex my Rosacea improved dramatically. It was definitely an issue for me over time.

Beth

[Malay]

I have friends (who don't have rosacea) who have developed acne due to B12 supplements. I also found this article on Pubmed:

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

[irishgenes]

Wow, this is really interesting. I used to take high doses of B6 for PMS when I was younger, and I had a lot of acne problems. I found this on the Mayo Clinic website: "Acne, skin reactions, allergic reactions, and photosensitivity have been reported. High-dose pyridoxine (80mg/day) and vitamin B12 (20micrograms/day) has been associated with rosacea fulminans characterized by intense erythema with nodules, papules, and pustules."

We sure don't want rosacea fulminans! I would be very leery of using a B12 cream on acne or rosacea-prone skin after hearing this. Atopic dermatitis is a different condition, so it might be good for that.

[Bonnie]

So which B vitamins are good for you? I was told to take vitamin B for my hair breakage. Now I am wondering if I should.

[Rick]

I agree -- very interesting information here.

I just completed a complete endocrinological workup for understanding of what is causing my flushing.

Everything was within normal limits, except I had a very pronounced deficiency in B12 levels. My expert was slighly concerned about this, not from a flushing perspective, but because such low levels are considered to be of signicant concern if left unabated. He speculated that this could be tied to flushing (there is no literature here that either he nor I could identify), if only because it was the only reading seriously out of whack. The key aspects typically tied to flushing, like seratonin and blood histamine, were completely normal. Bottom line is he wants me to do B12 supplements, which I will do, but with some caution given the posts here.

Rick

[GJ]

I read on the RSG board a year or so ago a comment from Dr. Nase that high amounts of B6 and B12 can cause acne and flushing problems. I looked it up at pubmed also and saw something written about it there. For years, I didn't have problems with it, but when I discontinued the B-complex my Rosacea improved dramatically. It was definitely an issue for me over time.

Even further back in the deep past, Dr Sy suggested that B6 - her suggested dose was not spectacularly high - may help flushing. Forget the mechanism. I tried it. If it did not lead to a spectacular improvement, it certainly did not hurt.

Over the years, a few people (males?) have said the supplement ZMA (zinc+magnesium+B6) helped their flushing/blushing. They thought the supplement impacted on testosterone production (and/or engendered a healthier hormonal balance).

It might simply have been the B6.