Synthetic Vitamin D For Psoriasis

Magnesium And Vitamin D

Noteworthy in the metabolism of vitamin D is magnesium. Dai et al18 reported that magnesium supplementation increased vitamin D serum levels and improved levels in those previously unable to be elevated.18 They noted that previous studies indicated a correlation between magnesium status and concentrations of cytochrome P450 enzymes. These enzymes are capable of not only activating, but also inactivating 25-hydroxylase and 1?-hydroxylase and 24-hydroxylase, respectively. In-vivo and in-vitro studies have shown that 1?-hydroxylase and 24-hydroxylase are dependent on magnesium. Therefore, magnesium deficiency decreases vitamin D metabolism and synthesis.

Topical Vitamin D In Psoriasis Treatment

The therapeutic effects of topical vitamin D occur via a VDR mediated genomic mechanism resulting in inhibition of keratinocyte proliferation and mediated non-genomic mechanisms inducing keratinocyte differentiation by increasing intracellular calcium levels . The anti-inflammatory effects may also result from inhibition of production of IL-2, IL-6, and interferon-gamma . Further, topical calcipotriol inhibits human beta defensin and proinflammatory cytokines which are found in increased levels in psoriatic lesions . Allelic variations in individual VDR genes may determine a different response to treatment: the isoform A of VDR is associated with a greater therapeutic response in psoriatic patients .

What Is Salicylic Acid

keratolytic agent , which means it can help the skin shed its outer layers.

People with psoriasis often use salicylic acid alongside other medicated creams because the salicylic acid allows the other creams to penetrate the skin more effectively.

Some products will need a prescription, but others are available over the counter.

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Try A Vitamin D Ointment

Vitamin D topical ointments are often used to counteract the abnormally fast regeneration of skin cells that can lead to psoriasis plaques. Prescription ointments or creams that contains active or synthetic vitamin D3 include Dovonex and Vectical , says the NPF.

If you put something on the skin that slows growth, it may cause the plaques to become thinner and less scaly, says Richard Gallo, MD, PhD, the founding chairman of the dermatology department at the University of California in San Diego.

Apply a thin layer to psoriasis plaques once or twice a day, or as recommended by your doctor. These medications can be used alone or with topical corticosteroids. Most people notice an improvement after using them for two weeks, according to the American Academy of Dematology.

Vitamin D3 Derivatives/ Analogues

Vitamin D3 derivatives or analogues, such as calcipotriol, are available as creams, ointments and solutions typically for the treatment of mild to moderate psoriasis.Vitamin D3 derivatives are corticosteroid-sparing they enable you to use less topical corticosteroid. They are usually applied once or twice daily for about 8 weeks. When combined with topical corticosteroids, they can often work better in people with plaque psoriasis than either medication alone.

Potential side effects

Potential side effects include burning, itchiness, swelling, peeling, dryness and rash. They should not be used on the face. In patients who spread larger doses over much of their body, vitamin D3 derivatives may cause a rise in blood calcium levels, which reverses when the medication is stopped. They may also cause light sensitivity and may cause a burning sensation if applied before UVB phototherapy.Calcitriol ointment, an active form of vitamin D, is also presently available.

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People At Risk Of Vitamin D Deficiency

To no surprise, Vitamin D deficiency is a global epidemic. About one billion people suffer from insufficiency or deficiency in the vitamin.

To obtain 10,000 IU of Vitamin D, you must spend 20-30 minutes in the sun with most of your body uncovered without sunscreen. When done every day, you should have normal levels of the vitamin. However, this is easier said than done.

So, who is at risk of developing a Vitamin D deficiency?

Darker skin requires more sun exposure. This is because melanocytes, the cells that produce pigment, act as sun blockers. Therefore, they require more sun exposure.

• Overweight people
• Those who have undergone bariatric surgery

While regular exposure to the sun would be ideal to improve levels, there is a concern for skin damage and cancer. In this case, supplements are the second-best option.

Talk to your doctor about evaluating and correcting Vitamin D deficiency. The best way to find the optimal dose is to check the blood levels of 1,252D and supplement accordingly. Generally speaking, the typical dose for adults is 1,000-2,000 IU daily. The upper limit dose considered safe is 10,000 IU daily. Since Vitamin D is fat-soluble, it accumulates in the body and very high doses could become toxic.

There are some foods that contain Vitamin D. These include:

• Cod liver oil

Talk To Your Doctor About Vitamin D Supplements

The NPF says the evidence that vitamin D supplements can ease psoriasis symptoms is weak, and that the best way to get more vitamin D is through food. But if you find you cant bump up your intake of vitamin Drich foods, or if you have psoriatic arthritis, ask your doctor if taking a vitamin D supplement might make sense.

Just be sure not to turn a vitamin deficiency into vitamin overload. Excessive amounts of vitamin D can affect your blood pressure, cause muscle weakness, and lead to gastrointestinal problems.

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How Should Vitamin D Analogue Be Used

Vitamin D analogues are available as cream, solution, ointment, or foam. You can directly apply it on psoriasis-affected skin. You can use it on your skin twice daily — morning and evening. Gently rub on the cream until no medication is visible. Itâs best to wash your hands with soap and water after each time.

Hereâs what you need to know before you apply vitamin D analogues:

• Itâs important to use it exactly as your doctor directs you to
• Apply it at the same time each day
• For children between ages 2 and 6, donât use more than one tube per week
• For people aged 7 and above, donât use more than two tubes per week
• Only apply it to areas affected by psoriasis
• Donât swallow or eat the medicine

Risks And Shortcomings Of Vitamin D

Vitamin D can help many people with psoriasis. Still, its often not an effective long-term treatment on its own. Some people will need topical medications with other active ingredients, including corticosteroids. Vitamin D also wont work for everyone, regardless of what form its taken in.

The biggest risk of taking vitamin D is taking too much. Vitamin D in moderation is good for you, but taking too much can hurt you. It causes a condition called hypervitaminosis D, or vitamin D toxicity. This condition can cause a buildup of too much calcium in the blood, which can cause frequent urination, weakness, and eventually kidney problems. Its typically only caused by excessive doses of vitamin D supplements. It almost never occurs from diet or sunlight exposure.

As long as you take vitamin D in moderation, you should be able to avoid vitamin D toxicity. Your risk increases, though, if you have liver or kidney conditions already.

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Why Dermatologists Prescribe Synthetic Vitamin D To Treat Psoriasis

Synthetic vitamin D can:

• Slow rapidly growing skin cells

• Flatten thick psoriasis

• Synthetic vitamin D is considered safe for most patients, including children

• It clears psoriasis in some patients, including patients who have scalp psoriasis

• Most people notice an improvement after using it for two weeks

• If a patient needs stronger medicine, synthetic vitamin D can be safely combined with a strong corticosteroid

Studies show that using both tends to be more effective than using either medication alone.

• Using both synthetic vitamin D and a corticosteroid can also reduce the possible side effects that come with using a strong corticosteroid

• The combination can be used for much longer than a strong corticosteroid alone

What Are Psoriasis Medications

Psoriasis medications are used in the treatment of psoriasis, a skin condition that can also affect the eyes or joints in some people. Several classes of medications are used to treat psoriasis depending on the type, extent and stage of the disease.

Psoriasis medications are prescribed to relieve symptoms, reduce inflammation and regulate an overactive immune system. Psoriasis medications are available as topical applications, injections and oral formulations. Medications for psoriasis include:

• Ointments and creams to relieve the skin symptoms of psoriasis, smoothen the skin and reduce scale formation that characterizes psoriasis.
• Eye drops and ointments to treat eye conditions such as blepharitis and conjunctivitis that can arise from psoriasis.
• Medications to manage psoriatic arthritis, a painful condition that typically affects peripheral joints such as fingers, wrist, toes, ankles and knees.

Topical formulations with corticosteroids and vitamin D constitute the primary treatment for mild to moderate psoriasis. Topical formulations of vitamin A known as retinoids are used to treat severe skin psoriasis.

Systemic medications such as methotrexate are antimetabolites which prevent excessive skin cell growth in psoriasis. Methotrexate is also a disease-modifying antirheumatic drug , useful for treating psoriatic arthritis. DMARDs work by modifying cellular activity.

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Vitamin D Analogue And Corticosteroids

While the topical drug can be used alone to treat mild to moderate psoriasis, studies have found that synthetic vitamin D can be safely combined with corticosteroids if a person requires stronger medication. Using them together can make it more effective, along with easing skin inflammation and the possible side effects that using corticosteroids alone may cause.

The combination of drugs can also be safely used for longer periods of time unlike when you use corticosteroids alone. You can use the combination for 4 weeks. Stop it for at least 4 weeks before you start again. This gives your skin a chance to heal and recover more effectively. The combination can be used on all affected areas all over your body and your scalp.

Besides possible skin irritation, the risk of side effects is low. But if you notice any bad reactions or allergies, let your doctor know immediately.

Vitamin D For Psoriasis

• Takeaway

Overview

Plenty of people with psoriasis use different combinations of medications to treat the condition. For some, the psoriasis symptoms may improve significantly just by increasing their vitamin D.

Vitamin D, which your body can make when exposed to sunlight, has many health benefits that may help treat psoriasis. Vitamin D deficiencies have been linked to psoriasis. While a deficiency doesnt seem to cause psoriasis outright, it may impair the bodys ability to keep the skin healthy. This may increase flares. When taken in healthy doses, vitamin D can help treat psoriasis. Heres how.

Vitamin D possesses different health benefits that can help treat several types of psoriasis, including scalp psoriasis.

A study from 2011 found that vitamin D can strengthen the immune system. Because psoriasis is an autoimmune response, this effect could help treat the condition internally.

Topical oils and ointments for psoriasis containing vitamin D can also help treat flares. Vitamin D can slow the growth of new cells, so vitamin D oil applied directly to the flare can help thin the plaque.

There are different forms of vitamin D that you can use to help treat your psoriasis.

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Home Remedies For Facial Psoriasis

At-home self-care is about the basics — trying not to scratch affected areas, avoiding the things that seem to trigger flare-ups, using cold compresses and moisturizer to soothe affected areas , and keeping up with your treatment.

No supplements or herbal remedies have been proven to treat psoriasis on the face or any other part of the body.

The Nutritionists Point Of View

Severe psoriasis has been associated with nutritional deficiencies because of an accelerated loss of nutrients, in particular of vitamin D, from the hyperproliferation and desquamation of the epidermal layer of skin . Vitamin D supplementation is of particular interest to Nutritionists for two important reasons. First, besides its topical use, oral vitamin D supplementation represents an important adjunctive treatment option for psoriatic patients second, vitamin D supplementation might be very important for the prevention of psoriasis-related comorbidity , hypertension and metabolic syndrome .

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Effects Of Vitamin D On The Cutaneous Immune System

Psoriasis pathogenesis implicates the innate and adaptive segments of the immune system. In particular, it is centrally controlled by T cells, in which an important role is played by T-helper 1, Th17 and Th22, interplaying with numerous cell types via different cytokines, including tumour-necrosis factor- , IL-6 and IL-17 . The activity of these cells is modulated by specific T lymphocytes, named regulatory T cells . Regulatory T cells are able to inhibit the immunological response and to preserve the cutaneous immunological homeostasis, preventing autoimmune response against self-antigens .

Taking Vitamin D Supplements For Psoriasis

Multiple studies confirmed an association between psoriasis and Vitamin D deficiency. Studies also reported an improvement in psoriasis with Vitamin D supplements. We need more research to fully understand the connection and how the nutrient helps.

You can check your levels of Vitamin D through readily available tests. Vitamin D supplements are also very cost-effective and available in any pharmacy.

Synthetic Vitamin D is a more expensive supplement option. It is available by prescription and is a common drug to manage psoriasis.

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How Is Vitamin D Analogue Different From Vitamin D

Unlike naturally occurring vitamin D or the type that comes in pill form to boost your vitamin D intake, synthetic vitamin D rarely affects the calcium levels in your blood.

This reduces the risk of:

• Hypercalcemia, high levels of calcium in your blood
• Hypercalciuria, high levels of calcium in your urine

The Sitch With Supplements: How Much Vitamin D Should You Take For Psoriasis

An easy way to get a daily dose of D are supplements that come in both liquid and pill forms. Just make sure you chat with your doctor before adding a supplement to your routine. They can test your vitamin D levels and help you pick the right dosage.

For adults, the daily recommended dietary allowance for vitamin D is 15 micrograms .

Its best to opt for a lower dose at first and gradually increase your amount over time with your docs blessing. Just make sure youre not exceeding the upper limit of 100 micrograms a day. Too much vitamin D can be toxic.

Supplements not your thing? You can also get that sweet D through foods, like:

• tuna or other fatty fish

• gels
• lotions

According to the American Academy of Dermatology topicals in general can be helpful in treating psoriasis for those with less than 5 percent of the body affected. If you have more severe psoriasis, they suggest combining topicals with other psoriasis treatments.

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What To Discuss With Your Dermatologist

During your next dermatology appointment, be sure to mention if you have any of the following:

• Side effects

• You fail to see any change after using the medicine for four to six weeks

Image

Cordoro KM. Management of childhood psoriasis. Adv Dermatol. 2008 24:125-69.

Feldman SR. Treatment of psoriasis. UpToDate 2015 Jul, Wolters Kluwer Health. Last accessed November 2015.

Menter A, Korman NJ, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol 2009 60:643-59.

U.S. Food and Drug Administration. Taclonex ointment. Posted December 2014. Last accessed January 2016.

All content solely developed by the American Academy of Dermatology

The American Academy of Dermatology gratefully acknowledges the support from Bristol Myers Squibb.

Treatments For Specific Areas

Eyelids

To treat this area, your doctor may recommend:

• Special corticosteroids to treat scaling. But donât overuse them. If they get into your eyes, they can lead to glaucoma or cataracts.
• The eczema drugs crisaborole ointment, pimecrolimus , or tacrolimus . They don’t cause the side effects of steroids. They can sting the first few days you use them.

Be careful when you treat psoriasis around your eyes. The skin on eyelids is delicate and gets damaged easily. Tell your doctor about any problems you have.

Psoriasis in the eye is very rare. If you have it, your eyes can be painfully dry. You may need antibiotics to treat an eye infection if you get one.

Ears

Psoriasis medications can put your eardrum at risk, so be cautious when you apply any inside the ear. Your doctor may recommend:

• A prescription corticosteroid you can drip in your ear or apply to the outside of your ear canal
• Calcipotriene or tazarotene usually mixed with a corticosteroid cream or ointment

Mouth and Nose

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What Are The Benefits Of Vitamin D For Psoriasis

Psoriasis is considered an autoimmune condition, and vitamin D is known to help keep your immune system running smoothly.

Its not fully clear why vitamin D can help treat certain types of psoriasis. But studies suggest its probably due to how vitamin D can help strengthen a weakened immune system that comes with psoriasis.

Vitamin D is often hailed as a miracle vitamin to prevent illness and even help skin. But when it comes to psoriasis, can it actually help? Good news, it just might.

Some Side Effects Can Be Serious If You Experience These Symptoms Call Your Doctor Immediately:

• rash
• irritation of the treated or nearby area of skin

Calcipotriene may cause other side effects. Call your doctor if you have any unusual problems while taking this medication or if your symptoms get worse.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .

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