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Dear Dr Cannell: Vitamin D connection with alopecia areata?

Posted on: October 14, 2012   by  John Cannell, MD

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Dear Dr. Cannell:

My daughter was diagnosed with alopecia areata 2 years ago when she was 10. There seems to be a vit D connection. She loses her hair in late winter and then begins to regrows some hair in the early fall. Her vit D level is in the 30’s with about 1000 IU/day supplementation.

I read that some people have vit D receptor problems and cannot absorb vit d.

Have you come across this in your experience?

Thanks.

Jennifer, Virginia

Dear Jennifer:

Alopecia areata (AA) is an inflammatory medical condition in which hair is lost, usually from the scalp in different spots, thus it is known as spot baldness. Most researchers believe it is an autoimmune disorder in which the body attacks some component of the hair follicles, the area of your scalp that grows hair.

In my opinion, the fact that it is seasonal in your daughter is an important clue. While I have no personal experience or letters about it, a recent open access paper reported that a potent topical activated vitamin D analog, calcipotriol, was successful in treating AA in one patient with dramatic before and after pictures.

Kim DH, Lee JW, Kim IS, Choi SY, Lim YY, Kim HM, Kim BJ, Kim MN. Successful  treatment of alopecia areata with topical calcipotriol. Ann Dermatol. 2012 Aug;24(3):341-4.

However, I know another paper showed no effect with calcipotriol but I cannot locate the study on PubMed. The above paper showed that calcipotriol increased the number of vitamin D receptors (VDR) and discusses the VDR’s connection to AA. As with male pattern baldness, AA is connected to the VDR in a complicated way, suggesting the VDR is locked up in baldness. However, in the above case calcipotriol stimulated growth of VDR in the scalp.

As your daughter’s vitamin D level is only in the 30s — low normal by most labs and low to us here at the Vitamin D Council — I would do four things.

  1. First, start her on 3,000 IU per day, not 1,000 IU. (3,000 IU/day will cause her levels to be in the natural range.
  2. If she were my child, I would make sure she gets plenty of sunshine during the sunny months.
  3. Lastly, find a dermatologist that will prescribe her topical calcipotriol or Daivonex, 50µg/ml and have her apply it to her scalp. The above paper is only a single case report but why not try it? It is open access so you can print the entire paper and take the paper with you to the dermatologist. If she is a good doctor, she will try Daivonex knowing that AA can be psychologically devastating to a young girl.
  4. Start her on 100 mg/day of resveratrol, as some studies show this phytoestrogen upregulates the expression of the VDR.

 Source:

Wietzke JA, Welsh J. Phytoestrogen regulation of a Vitamin D3 receptor promoter and 1,25-dihydroxyvitamin D3 actions in human breast cancer cells. J Steroid Biochem Mol Biol. 2003 Feb;84(2-3):149-57.

1 Response to Dear Dr Cannell: Vitamin D connection with alopecia areata?

  1. Rebecca Oshiro
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