Condition
Acne
Acne happens when hair follicles clog with oil and dead skin cells, letting bacteria thrive and the skin become inflamed, and hormones that boost oil explain why it often flares in puberty. The evidence is strongest for nicotinamide and zinc, and in three nicotinamide studies, acne symptoms improved. Those trials were fairly small and mostly compared a nicotinamide gel with an antibiotic gel, while tea tree oil and selenium have only limited evidence.
Sources: PMID 23786503; PMID 7657446
- Supplements studied
- 11
- Graded outcomes
- 8
- Trials
- 12
- People studied
- 1,156
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 3 studies | 331 people | ||
| Erythema Small Improvement | Improves (the measure goes up) | Small effect | 1 study | 175 people | ||
Studies that measured erythema | ||||||
| Wound Healing | Improves (the measure goes up) | 175 people | ||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Lesion Count Moderate Decrease | Improves (the measure goes down) | Moderate effect | 300 people | |||
| Sebum Production Moderate Decrease | Improves (the measure goes down) | Moderate effect | 200 people | |||
| Pore Size Small Decrease | Improves (the measure goes down) | Small effect | 150 people |
L-Carnitine
- Blood Carnitine: improves
- Urine Carnitine: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Carnitine Large Increase | Improves (the measure goes up) | Large effect | 2 studies | 230 people | ||
| Urine Carnitine | Improves (the measure goes up) | 230 people | ||||
Tea Tree Oil
- Acne Lesions: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Lesions 5% tea tree oil similar efficacy to 5% benzoyl peroxide but slower onset (fewer side effects) | Changes; see studies | Moderate effect | 200 people |
Selenium
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 56 people |
Zinc
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 4 studies | 462 people | |||
Studies that measured acne symptoms
| ||||||
Vitamin D
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 1 study | 44 people | |||
Studies that measured acne symptoms | ||||||
Resveratrol
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 1 study | 20 people | |||
Studies that measured acne symptoms | ||||||
Cocoa Extract
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 1 study | 13 people | |||
Studies that measured acne symptoms | ||||||
N-Acetylcysteine
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 56 people |
Milk Thistle
- Acne Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Acne Symptoms | Improves (the measure goes down) | 56 people |
What the published studies found
1 automated reading
Zinc: acne
The best available review (2026) found an improvement in acne. That review studied patients with acne vulgaris. All 7 studies read agree. The evidence is limited.
7 studies counted of 10 read: 4 reviews and 3 trials (108 people in the trials).
- Systematic review, 2026; patients with acne vulgaris: improves (the review the verdict rests on).
available data support a potential clinical benefit
Oral Zinc Supplementation in Acne Vulgaris and Hidradenitis Suppurativa: An Updated Comprehensive Review - Systematic review, 2020; 22 studies; patients with inflammatory dermatologic conditions: improves.
beneficial in ten of 14 studies evaluating its effects on acne vulgaris
Effects of Zinc Supplementation on Inflammatory Skin Diseases: A Systematic Review of the Clinical Evidence - Meta-analysis, 2020; patients with acne vulgaris: improves.
significant improvement in mean inflammatory papule count
Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis - Systematic review, 2013; patients with acne vulgaris: improves.
zinc has antibacterial and anti-inflammatory effects
The clinical effects of zinc as a topical or oral agent on the clinical response and pathophysiologic mechanisms of acne: a systematic review of the literature - Randomised trial, 1989; patients with inflammatory acne: improves.
significantly different result between zinc and placebo groups
Low doses of zinc gluconate for inflammatory acne - Randomised trial, 1980; 54 people; 54 patients with acne vulgaris: improves.
Compared to placebo this result is slightly better
Clinical evaluation in acne - Randomised trial, 1978; 54 people; patients suffering from acne vulgaris: improves.
Clinical comparison with placebo showed the result of zinc sulphate therapy to be slightly, but …
Oral zinc in acne vulgaris: a clinical and methodological study
- Systematic review, 2026; patients with acne vulgaris: improves (the review the verdict rests on).
Key findings
- Acne SymptomsImproves (the measure goes down)
- Acne Lesion CountImproves (the measure goes down)
- Sebum ProductionImproves (the measure goes down)
The Acne Vulgaris protocol
2 primary supplements · 2 supporting supplements
- Nicotinamide (Vitamin B3)750–1,500 mg daily (or 4% topical)
- Zinc30–45 mg daily (gluconate or picolinate)
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- Grade B
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Studies cited
100 studies from PubMed
- Effect of vitamin D supplementation for major adverse cardiovascular events: a meta-analysis based on randomised controlled trials.
- Resveratrol: A Potential Therapeutic Natural Polyphenol for Neurodegenerative Diseases Associated with Mitochondrial Dysfunction
- Resveratrol: An Overview of Clinical Trials in Human Cancer Prevention and Treatment
- Resveratrol and Its Analogs: Potent Agents to Reverse Epithelial-to-Mesenchymal Transition in Tumors
- Resveratrol and Sirtuins: A Story of Living Long Healthy Life
- Therapeutic Potential of Resveratrol in Alzheimer's Disease: A Review of the Evidence
- Resveratrol as a Chemopreventive Agent: A Promising Molecule for Fighting Cancer
- Resveratrol and Health - A Comprehensive Review of Human Clinical Trials
- Resveratrol: A Double-Edged Sword in Health Benefits
- Resveratrol and Caloric Restriction: The Role of Sirtuins in Aging and Age-Related Diseases
- The Multitarget Activity of Natural Bioactive Compounds in Parkinson's Disease: Role of Resveratrol
- Resveratrol: A New Treatment for Diseases Associated with Oxidative Stress
- Resveratrol-Based Compounds and Neurodegeneration: Recent Insight in Multitarget Neuroprotection
- An Overview of the Anticancer Properties of Resveratrol
- Optimal Vitamin D Status: Evidence and Guidelines
- Vitamin D and Cancer Prevention: A Comprehensive Review
- An Update on Resveratrol and Diabetes: From Metabolism to Clinical Trial Results
- Vitamin B5 and Wound Healing: A Systematic Review
- B Vitamins in the Treatment of Diabetic Complications: A Review
- Vitamin B5 for Acne: Evidence from Clinical Studies
- Panthenol (Provitamin B5) in Skin Care: A Review
- Pantothenic Acid and Athletic Performance: A Review
- Effects of Vitamin D Supplementation on Musculoskeletal Health: A Systematic Review and Meta-Analysis
- Vitamin D and Prevention of Respiratory Tract Infections: A Systematic Review and Meta-Analysis
- Effects of Vitamin D Supplementation on Depression: A Systematic Review and Meta-Analysis
- Vitamin D and Immune Function: A Review
- Vitamin D Supplementation for Prevention of Mortality: A Meta-Analysis
- Vitamin D Supplementation During Pregnancy: Safety and Efficacy Review
- Pantothenic Acid: Physiological Functions and Clinical Applications
- Pantothenic Acid Deficiency: Rare but Clinically Significant
- Dietary Requirements for Pantothenic Acid: Current Evidence
- Vitamin D Supplementation: A Comprehensive Review of Efficacy for Various Health Outcomes
- Vitamin D Deficiency: Global Health Perspective
- Vitamin D and Cardiovascular Disease: A Review of Evidence
- Vitamin D and Bone Health in Adults: A Systematic Review
- Selenium and Preeclampsia: a Systematic Review and Meta-analysis
- Pantothenic Acid and Coenzyme A: Metabolism and Functions
- Pantothenic Acid and Lipid Metabolism: Mechanisms and Evidence
- Vitamin D3 supplementation does not modify cardiovascular risk profile of adults with inadequate vitamin D status
- Resveratrol Blunts the Positive Effects of Exercise Training on Cardiovascular Health in Aged Men
- Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey
- Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey
- L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study
- L-Carnitine's Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy
- Comparative study to evaluate the effect of l-carnitine plus glimepiride versus glimepiride alone on insulin resistance in type 2 diabetic patients
- Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus
- Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients
- Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients
- L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes
- Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus
- Effect of carnitine-orotate complex on glucose metabolism and fatty liver: a double-blind, placebo-controlled study
- Efficacy and tolerability of combined treatment with L-carnitine and simvastatin in lowering lipoprotein(a) serum levels in patients with type 2 diabetes mellitus
- Blood Pressure and Metabolic Effects of Acetyl-l-Carnitine in Type 2 Diabetes: DIABASI Randomized Controlled Trial
- The effects of oral L-carnitine treatment on blood lipid metabolism and the body fat content in the diabetic patient
- The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus
- The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis.
- Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial
- Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients
- The effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis.
- L-carnitine improves glucose disposal in type 2 diabetic patients
- Caloric restriction and L-carnitine administration improves insulin sensitivity in patients with impaired glucose metabolism
- Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes
- Acetyl-l-carnitine versus placebo for migraine prophylaxis: A randomized, triple-blind, crossover study
- The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis
- Effects of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis.
- Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial
- Effects of Carnitine Administration on Carotid Intima-media Thickness and Inflammatory Factors in Patients with Polycystic Ovary Syndrome: A Randomized, Double-blind, Placebo-controlled Trial
- Effects of L-carnitine supplementation for women with polycystic ovary syndrome: a systematic review and meta-analysis
- Effect of glycine propionyl-L-carnitine on aerobic and anaerobic exercise performance
- Influence of L-carnitine administration on maximal physical exercise
- Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males
- l-Carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middle-aged men and women
- Glycine propionyl-L-carnitine produces enhanced anaerobic work capacity with reduced lactate accumulation in resistance trained males
- Chronic oral ingestion of L-carnitine and carbohydrate increases muscle carnitine content and alters muscle fuel metabolism during exercise in humans
- The effect of oral supplementation with L-carnitine on maximum and submaximum exercise capacity
- Effect of intravenous L-carnitine on carnitine homeostasis and fuel metabolism during exercise in humans
- Effects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effort
- l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function
- Effects of L-carnitine L-tartrate supplementation on muscle oxygenation responses to resistance exercise
- The effects of L-carnitine L-tartrate supplementation on hormonal responses to resistance exercise and recovery
- Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue
- Oxidative stress in response to aerobic and anaerobic power testing: influence of exercise training and carnitine supplementation
- Effect of L-carnitine on submaximal exercise metabolism after depletion of muscle glycogen
- Androgenic responses to resistance exercise: effects of feeding and L-carnitine
- Carbohydrate, protein, and fat metabolism during exercise after oral carnitine supplementation in humans
- Effects of four weeks L-carnitine L-tartrate ingestion on substrate utilization during prolonged exercise
- L -Carnitine and the recovery from exhaustive endurance exercise: a randomised, double-blind, placebo-controlled trial
- Effects of carnitine coingested caffeine on carnitine metabolism and endurance capacity in athletes
- Effects of L-carnitine supplementation on physical performance and energy metabolism of endurance-trained athletes: a double-blind crossover field study
- Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View.
- L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study
- Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial
- L-carnitine infusion does not alleviate lipid-induced insulin resistance and metabolic inflexibility
- Effects of acute versus chronic L-carnitine L-tartrate supplementation on metabolic responses to steady state exercise in males and females
- Liver-Oriented Acute Metabolic Effects of A Low Dose of L-Carnitine under Fat-Mobilizing Conditions: Pilot Human Clinical Trial
- The effects of L-carnitine supplementation on glycemic control: a systematic review and meta-analysis of randomized controlled trials
- The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials
- Single dose administration of L-carnitine improves antioxidant activities in healthy subjects
- Comparison of pre-workout nitric oxide stimulating dietary supplements on skeletal muscle oxygen saturation, blood nitrate/nitrite, lipid peroxidation, and upper body exercise performance in resistance trained men