The skin is the largest organ of the human body and is comprised of three main layers: the epidermis, dermis, and hypodermis. There are many different types of cells within these layers, including keratinocytes. Keratinocytes are involved in many skin functions, including maintaining a barrier, providing an appropriate immune response, healing wounds, and creating proteins like keratin. The skin uses keratin to reinforce strength and support structure. 

Another type of cell in the skin is called sebocytes, which produce sebum (or oil). They are cells that are found in oil glands that surround hair follicles. Sebum is a fat-rich substance that nourishes, moisturizes, and protects the skin. Too much sebum production may be one of the factors that contribute to a worsened appearance of the skin. For example, too much sebum production may contribute to conditions such as clogged pores, blackheads, whiteheads, and inflammatory acne. 

In fact, the National Institutes of Health reports that nearly 80% of individuals aged 11 to 30 will develop some form of acne outbreak – an inflammatory skin condition that can affect people of all ages. Acne has been described by some researchers as “a condition of Western civilization” because indigenous populations are not commonly affected by this skin condition. Acne is one of the most common skin conditions worldwide and has various contributing factors. Among the main culprits are altered sebum production and sebum fatty acid composition, hormone dysregulation, hyperkeratinization of follicles, immune dysfunction, and unhealthy inflammatory responses. Hand in hand with these are altered insulin metabolism and altered skin and intestinal microflora. 

Two nutrients may work together to promote clear skin by supporting normal sebum production: pantothenic acid and carnitine. 

Pantothenic acid, also known as vitamin B5, is a water-soluble vitamin that helps support keratinocyte maintenance. Research shows that when this vitamin is depleted, keratinocyte growth is suppressed. A double-blind, randomized controlled trial (n = 48) showed that individuals with acne who received pantothenic acid supplementation (2.2 g/day for 12 weeks) displayed significantly reduced total lesion count versus the placebo group. A secondary analysis revealed that the group that received pantothenic acid had significantly reduced non-inflammatory blemishes.

Pantothenic acid also works to transport fats across cell membranes, assisting in supporting lipid metabolism, which gets disrupted during acne breakouts. When inflammatory acne occurs, trapped bacteria cause inflammation in skin pores blocked with sebum. With proper lipid metabolism, there is a decrease in the excretion of sebum, which may support the normalization of pore size and the factors contributing to acne. 

Carnitine is a compound that is used by the cell (specifically, by the mitochondria) to help support the conversion of fats into energy. Data published in 2024 suggest genes that influence fat metabolism, such as phospholipase A2 (PLA2) and fatty acid desaturase 2 (FADS2), may be associated with acne. In a small split-face study, participants (n = 21) who were given a 2% carnitine cosmetic formulation and told to apply it to one side of their face exhibited significantly decreased sebum production compared to the non-treated side. These results are not far-fetched as carnitine has demonstrated anti-inflammatory properties, may support immune function, and helps support glucose metabolism, which may promote clearer-looking skin. 

In conclusion, the skin is the largest organ of the body and is complex. It is made up of many cell types that all have a specific function. Acne is one of the most common skin conditions in the world and is more prevalent in societies that have adopted a Westernized lifestyle. Many factors contribute to the formation of acne, including keratinocyte hyperproliferation, excessive sebum production, the presence of specific bacterial species, and an altered immune response. Recently, it’s been shown that genes that affect fat metabolism may contribute to acne and altered skin health. Finally, research highlights two promising nutraceuticals that may work together to normalize sebum production, help support keratinocytes, and promote normal glucose metabolism, potentially helping to promote clear skin.

Learn more about nutrients and skin health: 

Skin Health is Gene Deep

Clear Evidence: The Role of Spore-Based Probiotics in Healthy-Looking Skin

Why Does Nutrition Belong at the Center of Every Aesthetic Practice?

10 Nutrients to Help Your Skin Glow from the Inside Out 

By Bri Mesenbring, MS, CNS, LDN; Caitlin Higgins, MS, CNS; and Danielle C. Male, MS, CNS, LDN