Dr. Leung's acne hypothesis
In 1995, the journal Medical Hypotheses printed a hypothesis by Dr. Lit-Hung Leung, a physician from Hong Kong, which attempted to link vitamin B5 (pantothenic acid) deficiency with acne formation.1Then, in 1997, the Journal of Orthomolecular Medicine printed an article by Dr. Leung on the same topic.2The hypothesis was just that, a hypothesis—an initial suggested explanation, in this case without any reputable studies to back up the claim. We have no evidence supporting the hypothesis, but many companies (Vilantae is perhaps the most well known) market B5 to acne sufferers. This is not to say that anyone is certain that B5 does not help with acne. The truth of the matter is that no research exists. As you read the summary of Dr. Leung's hypothesis below, keep in mind that this is essentially guesswork. To make educated conclusions, double-blind, controlled research will be required.
Summary of B5 hypothesis
Vitamin B5 (pantothenic acid) is a component of Coenzyme A. Coenzyme A is necessary for hormone production as well as fatty acid metabolism. During puberty, as hormone production increases, the body chooses to use coenzyme A to produce hormones and neglects fatty acid metabolism. Because the body uses coenzyme A for hormone production instead of fatty acid metabolism, sebum (skin oil) levels rise and acne follows. Supplementing with megadoses of vitamin B5 allows for enough circulating B5 to address both bodily processes, thus curing acne.2
Upon first reading of Dr. Leung's hypothesis, the reasoning seemed to make common sense. However, I became heavily skeptical when Dr. Leung mentioned a study he performed on this topic using 100 Chinese patients between the ages of 10-30.2First, there was no control group in the study. Next, participants were given both internal (10g/day) and topical (20% cream 4-6X/day) B5, so the vehicle of administration was not controlled.2Furthermore, no baseline lesion count was established, nor were lesion count results presented. Improvement was presented in general terms. In short, this study is littered with holes."
The proof is in the pudding
I carefully looked through many of your reviews on B5 in the reviews and ratings section of acne.org. No real consensus seems evident. Some people are claiming great results, while others see no improvement. Keep in mind that placebo tends to work (about 30%) in clearing acne. Side effects seem low and tolerable.
The bottom line
Before we begin buying and taking megadoses of B5, we've got to see some real science backing up the efficacy of such supplementation.