|Grade||Level of Evidence|
|A||Multiple double-blind, controlled clinical trials.|
|B||1 double-blind, controlled clinical trial.|
|C||At least 1 controlled or comparative clinical trial.|
|D||Uncontrolled, observational, animal or in-vitro studies only.|
|Grade||Effect||Size of Effect||Comments|
Hygroscopic and can therefore attract moisture to the skin in addition to reducing water loss.
5% panthenol appears to be as effective as 1% hydrocortisone at treating childhood atopic dermatitis, but is less effective for diaper dermatitis.
Restores the skin barrier of irritated skin and reduces transepidermal water loss (TEWL)
Can reduce the damage caused by UV radiation, especially when used as a stabilizer for cerium dioxide nanoparticles.
Accelerates the healing of acute wounds and can also treat slight burns and skin ulcers.
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Table of contents:
- 1. Sources
- 2. Bioavailability
- 3. Effects on the skin
- 4. Safety
Panthenol is a viscous hygroscopic liquid and the stable alcoholic analog of vitamin B5, also known as pantothenic acid. Because it is a precursor to vitamin B5, it is sometimes also referred to as provitamin B5. Panthenol exists as 2 enantiomers, D-panthenol and L-panthenol, but only D-panthenol (dexpanthenol) is biologically active. DL-panthenol, which appears as a creamy white, crystalline powder, is a racemic mixture of both enantiomers.
Panthenol must cross the stratum corneum in order to provide its skin benefits. Panthenol is said to be an effective skin penetrator that can lead to high local concentrations when administered in appropriate vehicles such as water-in-oil emulsions. It is also known to be absorbed through the human nail.[^title=In vitro human nail penetration and kinetics of panthenol.
In one experiment, a hydrophilic gel containing 10% panthenol was applied to porcine skin with or without the use of ultrasound. Panthenol was found in the receptor solution for both experimental groups, but the amount of penetrated panthenol was significantly enhanced in the ultrasound group.
Panthenol appears to increase the rate at which progesterone permeates through excised rat skin.
3. Effects on the skin
3.1 Improved barrier function
Panthenol-containing creams (Verum and Bepanthol Handbalsam) significantly accelerated the repair of the stratum corneum barrier of sodium lauryl sulphate-irritated skin in 2 separate studies. Its effect on the regeneration of the skin barrier accounts for its use as a skin protectant and why it has been found to provide relief for dry and irritated skin.
In a pilot trial, a topical hydrating and emollient lotion containing 10% urea + panthenol (Ureadin Rx 10) significantly improved skin scaling, roughness, redness, cracks and itching in 15 haemodialysis patients, for whom dry skin and pruritus are common complications in end-stage renal disease.
Emulsions containing panthenol as an active ingredient have demonstrated the ability to reduce UV-induced damage to keratinocytes and fibroblasts compared to untreated cells. Moreover, panthenol-stabilized cerium dioxide nanoparticles protect cells against UV irradiation and reactive oxygen species more effectively than either individual panthenol or cerium dioxide.
3.3 Increased hydration
Panthenol's improvement of the skin's barrier function contributes to its moisturizing effect. In a randomized, double-blind and placebo-controlled study, 7 days' treatment with topical panthenol led to reduced transepidermal water loss (TEWL), suggestive of a reinforced barrier, and an increase in the hydration of the stratum corneum that were statistically different from the vehicle.
When formulations containing 0.5%, 1% and 5% panthenol were applied daily to the forearms of human volunteers, all produced increases in stratum corneum moisture 15 and 30 days. The increases were significant compared to baseline values and the untreated controls, but may not have been significant relative to the vehicle, which also contained other moisturizing ingredients. The formulations supplemented with 1% and 5% panthenol also lowered TEWL after 15 and 30 days, but not the 0.5% formulation, indicating that higher concentrations of panthenol are required to have long-term effects on the skin barrier function.
The hydrating effect of 3% glycerin is enhanced with the addition of 2% panthenol. This implies that the glycerin content in moisturizers can be reduced in favour of panthenol, which makes the formulation less sticky and more cosmetically acceptable.
3.4 Other age-related improvements
Formulations of 0.5%, 1% or 5% panthenol did not improve skin elasticity after daily applications for 15 and 30 days.
In another study, 246 Indian women with facial hyperpigmentation were recruited to evaluate the effects of a moisturizing lotion containing 4% niacinamide, 0.5% panthenol, 0.5% tocopheryl acetate, glycerin and sunscreen, in addition to the other ingredients that made up the control lotion. The women first cleaned their faces with the same commercial face wash (Olay Foaming Face Wash) for a 2-week period, following which they were randomly assigned to use either the moisturizing lotion or the control lotion twice daily after washing with the face wash, for 10 weeks. After 6 weeks, women using the moisturizing lotion had experienced significant reductions in the level of pigmentation in hyperpigmented spots, greater skin lightening and improved skin tone evenness compared to women using the control lotion. Skin texture, skin integrity and fine lines and wrinkles were also improved in the group using the moisturizing lotion, but it was not clear if these changes were statistically significant compared to those induced by the control lotion. Most of the improvements were not attributable to panthenol.
3.5 Dermatitis treatment
Panthenol may be an alternative treatment for some forms of dermatitis. 5% panthenol is a water-in-oil formulation was statistically as effective as a 1% hydrocortisone ointment at treating childhood atopic dermatitis in one study. However, when panthenol was combined with zinc oxide, the resulting ointment was not superior to the ointment base in improving irritant diaper dermatitis, though it was more efficacious in decreasing TEWL.
3.6 Improved healing
Panthenol speeds up the healing of acute wounds and inhibits their colonization by physiological skin flora. Its wound healing effect is comparable to that of the beta blocker nebivolol and stronger than those of the retinoids tretinoin and acitretin (which delay wound healing) but weaker than those of a Eisenia foetida earthworm extract and its precursor panthenyl triacetate. Panthenol is also useful in treating slight burns and cutaneous ulcers.
A panthenol foam spray in particular has shown efficacy in treating wounds and chemical burns in various case reports. PedyPhar ointment, which is prepared from royal jelly and panthenol, has also been found to be effective in treating diabetic foot ulcers and infections. It completely cured 96% of such patients with full-thickness skin ulcers, 92% of those with deep tissue infection and suspected oseomyelitis within 6 months. All patients with gangrenous lesions in the foot were also healed following debridement of necrotic tissue and conservative treatment with the ointment.
The molecular mechanisms underlying panthenol's healing action remains to be understood, but it is known to modulate gene expression in injured skin and may promote collagen synthesis by means of fibroblast activation after being converted to pantothenic acid in the skin.
3.7 Protection against radiation-induced skin side effects
Panthenol has been used as a therapy for cutaneous X-ray reactions since at least the 1950s, but there is little evidence to support its use in favour of other treatment options.
Although Bepanthol lotion, which contains panthenol, appeared superior to Thêta-Cream, which contained CM Glucan, Hydroxyprolisilane C and Matrixyl, in inhibiting radiation-induced skin toxicity in one study, it was less effective than a hydroactive colloid gel in reducing the risk of developing moist desquamation, a severe form of radiation dermatitis, in patients undergoing radiotherapy for breast cancer in another.
In a prospective clinical trial, a commercial panthenol cream (Bepanthen) was applied on randomly selected parts of treatment fields in 16 laryngeal and 63 breast cancer patients, with each patient acting as his/her own control. The cream did not appear to confer any clinical benefit for ameliorating adverse skin reactions.
Another prospective trial, which was double-blinded, compared treatment with topical 0.1% methylprednisolone versus 0.5% dexpanthenol in a cohort of patients undergoing fractionated radiation therapy for breast cancer. Neither treatment reduced the incidence of radiation dermatitis, but both delayed the emergence of the most pronounced clinical symptoms and TEWL until approximately 5-6 weeks after the start of radiation therapy. The clinical symptoms and TEWL were less severe with 0.1% methylprednisolone however.
3.8 Other effects and uses
In its 1987 safety assessment, the Cosmetic Ingredient Review Expert Panel came to the conclusion that panthenol and pantothenic acid were safe as used in cosmetics, since they did not induce significant skin irritation or sensitization and their low levels of use suggested that dietary exposure levels would greatly exceed the amount that could be absorbed from cosmetic use. The Panel also reaffirmed its original conclusion in 2004 after assessing available new data.
4.1 Adverse skin reactions
Creams containing low concentrations (<1%) of panthenol were not toxic when applied daily for 3 months to the shaved skin of rabbits, though they did result in slight to moderate erythema, edema, and desquamation. When skin care preparations containing 0.5% panthenol were applied on human volunteers, the results indicated that they were not allergic contact sensitizers at were at most mild irritants. Hence, while there are numerous reports of contact allergy and contact dermatitis to panthenol in the literature, these should probably not be considered a serious cause for concern.
In the rare cases of allergic contact reactions to panthenol, microsomal metabolism is thought to play a role, as microsomes contain drug metabolizing enzymes and an increase in lymphocyte proliferation has been observed after pre-incubation with dexpanthenol-modified microsomes but not after pre-incubation with panthenol in the absence of microsomes.
4.2 Pulmonary edema
There is a solitary report of pulmonary edema caused by inhalation of a panthenol spray.
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