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Psoriasis: Topical vitamin D improves UV treatment

Posted on: January 14, 2013   by  John Cannell, MD

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Psoriasis is an autoimmune-mediated disease that affects the skin. It is typically a lifelong condition. There is currently no cure, but various treatments can help to control the symptoms, including topical activated vitamin D. Psoriasis occurs when the immune system mistakes a normal skin cell for a pathogen, and sends out faulty signals that cause overproduction of new skin cells.

The most common form of psoriasis, plaque psoriasis, is commonly seen as red and white scaly patches appearing on the top first layer of the skin, the epidermis. Plaques frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp, palms of hands and soles of feet, and genitals. The disorder is a chronic recurring condition that varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected. Psoriasis can cause inflammation of the joints, which is known as psoriatic arthritis.

One of the treatments for psoriasis is ultraviolet radiation. It used to be that the only place psoriasis patients could get UV radiation was a dermatologist’s office, and it often cost several hundred dollars per treatment. When suntan parlors began to appear, psoriasis patients realized they could utilize commercial sunbeds and get some relief of their symptoms. Some people think that this commercial conflict — between dermatologists and suntan parlors — is the reason dermatologists have so forcefully condemned sun tan parlors.

Dermatologists have discovered that adding drugs, either topical or systemic, improves the efficacy of UV radiation. Recently, researchers at Harvard discovered that topical application of an activated vitamin D drug, calcipotriol, increased the effectiveness of UV radiation.

Maytin EV, Honari G, Khachemoune A, Taylor CR, Ortel B, Pogue BW, Sznycer-Taub N, Hasan T. Vitamin D Combined with Aminolevulinate (ALA)-Mediated Photodynamic Therapy (PDT) for Human Psoriasis: A Proof-of-Principle Study. Isr J Chem. 2012 Sep;52(8-9):767-775.

We still don’t know if physiological (5,000 to 10,000 IU/day) or pharmacological (50,000 IU/day) oral doses of vitamin D will help with psoriasis. Like all autoimmune disorders, basic science evidence suggests that such doses would help. However, if I had psoriasis, I would also find a good dermatologist, as they have many additional drugs and procedures that can help psoriasis.

8 Responses to Psoriasis: Topical vitamin D improves UV treatment

  1. Rita and Misty

    From personal experience with psoriasis, I think that treatment requires perhaps a broad nutritional approach. I encourage fellow sufferers to consider the following nutrients:

    Omega-3 fatty acids such as found in fish oil supplements and oily fish such as salmon, sardine and mackerel. Studies have found that people with chronic psoriasis who consumed 150g of oily fish a day were able to reduce the use of steroidal creams without experiencing a decline in their condition.

    Flax seeds are also valuable source of omega-3 fatty acids and they may have a similar effect to oily fish. Sunflower and sesame seeds also supply these fatty acids. Additionally, the red, itchy patches of psoriasis often respond to the essential fatty acids in flaxseed oil, which have anti-inflammatory actions and overall skin-soothing properties.

    Selenium, Zinc and folic acid may have also shown to be helpful in the treatment of psoriasis. Brazil nuts are an excellent source of Selenium… Broccoli, cabbage, Brussels sprouts, and other green leafy vegetables will supply folate (folic acid); and, shellfish is a great source of Zinc. Of course, these nutrients can also be taken in supplement form…but IMO, food is the best medicine….

    If you do suffer from psoriasis, there are certain foods you should avoid in excess.

    Red meat and dairy products should be eaten in moderation, as they contain arachadonic acid, a natural inflammatory substance that is believed to make psoriasis sores red and swollen.

    Alcohol may be a trigger factor in psoriasis.

    And, although good for your overall health, citrus fruits, may unfortunately trigger a psoriasis attack. Try to avoid fruit peels, orange marmalade, prepared juices, grapefruit, limes, lemon, lemonade, bitter lemons.

  2. Kate Saley

    Thanks for the insight, Rita! Just out of curiosity, have you ever tried topical vitamin D for treatment of your psoriasis symptoms? If so, did you notice any improvement?

  3. hlahore@gmail.com

    Personally, I have found that topical vitamin D, when mixed in a cream/ointment designed to go thru the skin (I use Penetrix) does put psoriasis in remission for about week or so. There are many articles on psoriasis and vitamin D on VitaminDWiki: vitamindwiki.com/Psoriasis

  4. kenmerrimanmd

    ? is activated Vit D available in the US & ? how is it activated in vitro

    thanks for any insight

  5. Rita and Misty

    Dear Kate (and Team D),

    I’ve had good results with the following Vitamin D Cream. I use it for everything from psoriasis outbreaks, to wrinkle treatments, to a cream for cuts and scrapes….

    Obviously, it isn’t an activated Vitamin D cream…and it does have other ingredients besides Vitamin D….

    BTW, since achieving higher end of optimal 25(OH)D levels, my outbreaks seem to be occasional…my skin is much, much healthier….

    BEST!

    Rita

    http://www.life-flo.com/optimal-health/vitamin-d3-body-cream.html

  6. Rita and Misty

    @Ken…Google is your friend….and I am a research JUNKIE–lucky for you 🙂

    So in rely to your question:

    “Until 2009, calcipotriene was the only topical vitamin D analog available in the United States. Calcipotriene is obtainable as a cream, solution, or ointment (Dovonex®, Calcitrene™), or as a combination ointment with betamethasone dipropionate (Taclonex®). Topical calcitriol ointment has been prescribed in Europe for years, and is now available in the United States (Vectical™). When compared with calcipotriene, calcitriol appears to induce less irritation in sensitive areas of the skin (eg, skin folds)”

    http://www.uptodate.com/contents/treatment-of-psoriasis

  7. kenmerrimanmd

    Rita and Misty

    much thanks for the info

    looks like that stuff is a bit expensive( Vectical)

  8. Rita and Misty

    @Ken…

    YES…expensive (sigh)….the topic of healthcare, and associated pharmaceutical costs, is definitely worth a discussion, but perhaps this blog isn’t the appropriate venue… 🙂

    (BTW–Misty agrees…she can’t understand the high cost of her thyroid meds either!)

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