Deficiency is almost nonexistent. High doses have been used for acne in limited studies.
Some high-dose trials suggest improvement; limited evidence.
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Vitamin B5, or pantothenic acid, is a water-soluble B vitamin whose name derives from the Greek "pantothen," meaning "from everywhere," an etymology that reflects its ubiquitous distribution in animal and plant foods: virtually all unprocessed foods contain modest to moderate amounts of B5, which makes clinical deficiency extremely rare in humans with varied diets, an unusual nutritional situation among vitamins that explains why B5 receives less clinical attention than other B vitamins.
Its biological function is central but discreet: it is the essential component of coenzyme A (CoA), a key molecule in energy metabolism that participates in more than 70 biochemical reactions, including fatty acid oxidation, the synthesis of cholesterol and steroid hormones, carbohydrate metabolism, and the synthesis of neurotransmitters; it is also part of acyl carrier protein (ACP), involved in fatty acid synthesis; these biochemical functions explain why its deficiency produced, in the classic controlled-deprivation experiments, a picture of fatigue, general malaise, headache, paresthesias, and the characteristic "burning feet syndrome," all reversible with supplementation.
The most popular indication in the world of aesthetic supplements is acne vulgaris, based mainly on a Chinese-Hong Kong study by Leung published in 1995 that documented notable improvements in moderate to severe acne with very high doses (10 grams per day divided into 4 doses for months) in men and women; although the original results were impressive (50-70 percent reductions in inflammatory lesion counts), later independent studies have been limited and heterogeneous, and the indication has not entered conventional dermatology guidelines.
A more recent randomized trial published in 2014 with high-dose oral dexpanthenol for 12 weeks showed significant improvements in moderate acne, partially replicating the original findings and reopening clinical interest in this indication; the doses used are far higher than usual for B5 in general supplements (10 g/day vs. 5-10 mg/day) and should be considered to be in the pharmacological rather than the nutritional range.
Dexpanthenol (the provitamin alcohol of B5) is a classic ingredient of healing creams (Bepanthol, Bepanthen, and similar) with very widespread use for skin irritation, diaper rash, post-sun dryness, minor burns, and superficial epithelial lesions; the clinical data in topical use are reasonable and the safety profile exceptionally good, which justifies its presence in standard pediatric and dermatological pharmacopoeias.
The use of B5 as an aid against chronic stress is better supported by marketing than by rigorous clinical data: usual nutritional doses are perfectly adequate to cover coenzyme A needs regardless of stress level, and there is no evidence that high doses of B5 improve the adaptive response to stress in people with a normal diet and no deficiency; commercial claims linking B5 to "adrenal health" or "anti-stress" are extrapolations not supported by solid clinical trials.
Nutritional doses are 5 milligrams per day in adults as an adequate intake (no fixed dietary recommendation has been established); multivitamins typically contain 5-10 mg of B5; for dermatological indication at high doses, 5-10 grams per day divided into 4 doses for months have been used; these supra-pharmacological doses require specific capsules or powder and are several times higher than usual.
It is one of the vitamins with the best safety profile: virtually no adverse effects at usual or moderate nutritional doses; at very high doses (several grams per day) mild digestive discomfort (diarrhea) may appear; no significant toxicities have been described with prolonged use at reasonable doses; it has no known specific contraindications; topical use of dexpanthenol is safe even in pediatrics and on mucous membranes; in pregnancy and breastfeeding, usual nutritional and dermatological doses are perfectly safe and are part of the standard vitamin intake; clinical deficiency is extremely rare and almost never justifies specific supplementation with isolated B5 in people with a varied diet.
Information, not medical advice. Scientific evidence reflects the quality of the studies.