A recent small study reported that vitamin D supplementation was an effective form of therapy in the management of ichthyosis.
Ichthyoses are a group of skin diseases caused by an abnormality in skin growth that results in dry and scaly skin. The severity of ichthyosis ranges enormously. The mildest form is often mistaken for extremely dry skin; while, the more severe forms can accumulate thick scales and cracks that are painful and bleed.
Patients with skin disorders are at an increased risk for vitamin D deficiency, because they often avoid the sun. Researchers began to study the relationship between vitamin D and skin disorders to understand the complications of sun avoidance and how to combat these challenges.
Previous research has discovered a high prevalence of vitamin D deficiency among patients with ichthyosis. In addition, researchers have found that low vitamin D levels were linked to the severity of ichthyosis.
There is no known cure for ichthyosis, so the goal of treatment is to control the condition. Due to the link between vitamin D and ichthyosis, researchers recently conducted a small trial to see whether vitamin D supplementation may help manage ichthyosis.
The trial consisted of seven children with ichthyosis (5 with autosomal recessive congenital ichthyosis; 2 with epidermolytic ichthyosis) and severe vitamin D deficiency. The researchers administered 60,000 IU of vitamin D for 10 days. This was followed by daily supplementation of 400 to 600 IU of vitamin D. All children also received 40 mg/kg of calcium daily.
The researchers evaluated whether the children experienced a reduction in skin scaling and stiffness. Here is what they discovered:
- All children had severe vitamin D deficiency with levels less than 4 ng/ml and secondary hyperparathyroidism.
- Six patients showed symptoms of rickets.
- Significant improvement in scaling was noticeable by day 5, showing further improvement by day 10 in all cases except one.
- Reduction in stiffness was also observed in all children.
- After one month, the skin had become near normal.
- In one case, the caregiver stopped supplying the 400 to 600 IU of vitamin D for four weeks, and the scaling reappeared. The scaling cleared again within two weeks of restarting supplementation.
The researchers concluded,
“Our report clearly shows that correction of severe vitamin D deficiency with short-term high-dose cholecalciferol (vitamin D3 ) in children with congenital ichthyosis results in significant reduction in skin scaling.”
While the results of vitamin D supplementation were very impressive, it’s important to emphasize the very small sample size. All children involved in this trial were severely deficient in vitamin D, so much so that six out of the seven showed evidence of rickets. Thus, these results may not be replicable in all patients with ichthyosis. In addition, the trial was not blinded and did not include a placebo group, meaning the placebo effect may have occurred.
The Vitamin D Council does not recommend children supplement with such high dosages of vitamin D unless under a doctor’s close supervision. Instead, we recommend that children receive 1,000 IU of vitamin D3 for every 25 pounds of body weight.
Tovey, A. & Cannell, JJ. Small trial finds vitamin D supplementation managed symptoms of ichthyosis in children. The Vitamin D Council Blog/Newsletter, January 2016.
Sethuraman, G. et al. Vitamin D: A New Promising Therapy for Congenital Ichthyosis. Pediatrics, 2016