Group B vitamins and their usefulness in hair care
The use of vitamin supplements is very common to help with skin and hair problems. There are many reasons to think that vitamin supplementation may be helpful in hair problems, as some micronutrients play a role in metabolism and hair bulb matrix cell turn over; on the other hand, the prescription of vitamins is an act historically expected by the patient from the trichologist.
Recent literature reviews have revealed still controversial aspects in the rationale of using supplements for the treatment and prevention of hair problems. In this article we will analyse the available data for B vitamins.
Group B vitamins: What are they and what are they used for?
The B-vitamin complex includes 8 water-soluble vitamins: vit B1 (thiamine), vit B2 (riboflavin), vit B3 (niacin), pantothenic acid (vit B5), vitamin B6, biotin (vit B7), folate and vit B12. They are involved in various ways in cellular metabolism.
A balanced and varied diet usually ensures a proper intake of B vitamins, in fact only biotin can be produced by the human body, but all the other vitamins have to be introduced through the diet.
In trichology, riboflavin deficiency, biotin deficiency, folate deficiency and vitamin B12 deficiency have been associated with hair loss problems.
Riboflavin deficiency is extremely rare, but as a molecule involved in fat metabolism and energy production for the cell, its deficiency can lead to hair problems.
Vitamin B7 or biotin, on the other hand, is a cofactor in carboxylases, enzymes involved in multiple metabolic steps (production of sugars, fats and amino acids). Biotin is contained in food proteins, which are taken up with food and then broken down into free biotin, which is then stored in the intestine and liver.
Biotin deficiency: reasons and consequences for our hair
Biotin deficiency can have either genetic or acquired causes.
Genetic deficiency manifests itself in the first 6 weeks of a newborn baby’s life with severe dermatitis and alopecia (absence of hair vellus and terminal hair on the scalp) but can also involve eyelashes, eyebrows and downy hair.
Acquired deficiency, i.e. from poor dietary intake of biotin, is very rare in Western countries and may be due to excessive consumption of raw eggs (the avidin present in them sequesters biotin and prevents its absorption), malabsorption, alcoholism, prolong use of antibiotics causing intestinal dysbiosis, pregnancy or interaction with drugs such as valproic acid and isotretinoin.
Signs of biotin deficiency are hair loss, skin rash, brittle nails; while it is true that biotin deficiency causes hair problems, it is not yet clear whether supplementation in trichology is always beneficial.
There are a few published case reports in which biotin supplementation for 3-4 months has been shown to be helpful in improving hair health in Impettinable Hair Syndrome (pili trianguli et canaliculi).
In larger studies, conducted on samples of more than 500 women of various age groups who complained of hair loss, low plasma biotin levels were found in 38% of subjects, including 38% of patients with secondary causes of biotin deficiency (intestinal dysbiosis, use of valproic acid and isotretinoin…) and coexisting seborrhoeic dermatitis.
Holates and vitamin B12: an important role
Folates are another type of B group vitamin that act as a coenzyme for the synthesis of nucleic acids and amino acids. In plasma, folates are present in the form of 5-methyl-tetrahydrofolate, while their storage organ is the liver..
Acquired conditions such as malnutrition, alcoholism, malabsorption can lead to folate deficiency.
Vit B12 is another B vitamin involved in DNA synthesis, neurological homeostasis, red blood cell formation, etc…
The role of folate and vit B12 in nucleic acid synthesis has suggested their activity in cells with high turnover (hair and skin), i.e. cells that replicate rapidly.
Specifically in patients with Alopecia Areata, a higher prevalence of the mutation in the MTHFR (methyltetrahydrofolate reductase) gene has been identified, mutations in which are widespread in the population and often become apparent when studying the causes of female infertility.
Group B vitamin supplements: useful in trichology?
At present, therefore, there is no clear data in the literature on the benefit of using B-vitamin supplements to treat hair problems.
However, we can say that if a deficiency is present, it certainly deserves to be treated.
We must also consider the increased prevalence of malabsorption conditions (Irritable Bowel Disease, prolonged use of antibiotics, etc.) in the general population, as well as the use of drugs or the pursuit of deprivation diets which can effectively reduce the bioavailability of B vitamins.
It is therefore reasonable to have the trichological patient conduct a first level screening for micronutritional deficiencies, to investigate with a thorough history any factors that predispose to a deficiency and to reasonably supplement what is deficient or borderline.
Finally, reference levels for supplementation of each micronutrient are suggested by the LARN (Reference Intake Levels for Nutrient and Energy) and the publications of the EFSA (European Food Safety Authority).
Skin Appendage Disord 2017 A Review of the Use of Biotin for Hair Loss Deepa P. Patel Shane M. Swink Leslie Castelo-Socci
Dermatol Ther (heidelb) 2019 Review The role of Vitamin and Minerals in Hair Loss Hind M Almohanna, Azhar A Ahmed, Jonh P Tsatalis A Tosti
EFSA (European Food Safety Authority), 2017. Dietary Reference Values for nutrients. Summary Report. EFSA supporting publication 2017:e15121. 98 pp. doi:10.2903/sp.efsa.2017.e15121.