099: Vitamin D For Skin Rashes: Topical vs Oral Supplementation

Is Vitamin D helpful for skin rashes? That’s a good question that I hope to answer today!

What’s most interesting is that research seems to point towards an increase in rash severity the lower the Vitamin D level.

This is significant because vitamin D isn’t checked as often as it should be. And then the question is “what should your vitamin D level be”?

I’d like to answer those questions AND introduce you to the concept of using Vitamin D topically.

Wait… topically?

Yes, you can use vitamin D topically to help with psoriasis, eczema and even dandruff.

Let’s dive in!

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In this episode:

• What is Vitamin D & how you can get it (skin production vs food sources)
• What Vitamin D does to help support healthy skin?
• Ideal blood serum level of Vitamin D & how often should you test
• Topical Vitamin D — can it be helpful?
• Studies looking at topical Vitamin D for psoriasis, eczema & seborrheic dermatitis

Quotes:

No matter how vitamin D gets into your body, you can't just use it at a cellular level until it’s activated by your liver and kidneys.

Topical vitamin D is considered to be “steroid-sparing” meaning it reduces the need for topical steroids and could be helpful for rashes on the face or groin.

Vitamin D For Skin Rashes: Topical vs Oral Supplementation (FULL TRANSCRIPT)

Welcome back to episode #99 of the Healthy Skin Show!

In this episode, I want to talk about vitamin D. And why it's not just important for your general health, but how it can be really important for your skin.

Plus I’m going to talk about how it can be used topically.

As you probably already know from listening to the show, your skin is very nutrient-hungry. And what's equally interesting to me is how the skin can absorb certain nutrients topically.

One of those nutrients includes vitamin D. It’s not just that your skin can synthesize it from sun exposure. There are topical versions of Vitamin D that have some interesting research behind them.

So let's do a brief overview of vitamin D, where you can find it in food, and how it could be helpful when used topically.

I’ll frame this information around some very specific research psoriasis, seborrheic dermatitis (aka. dandruff), and eczema.

What Is Vitamin D & Where Does Your Body Get It

The first thing you need to know about vitamin D is that it is a steroid hormone.

When you are out in the sun without sunscreen, your exposed skin will begin producing this steroid hormone known as Vitamin D.

It serves a bunch of interesting purposes when it comes to your skin that includes (1):

• helping to regulate cellular function within the cells
• the capacity to inhibit cellular proliferation
• decrease pro-inflammatory cytokines
• increase antimicrobial peptide expression
• support barrier integrity and permeability
• increase the synthesis of ceramides (which are important for hydration in your skin)

As far as the nutrient vitamin D is concerned, it's a fat-soluble nutrient. This means that it has to be absorbed with fats in your diet. As a result, it requires proper fat digestion and the presence of lipase and bile to be absorbed.

So if your gallbladder was previously removed, that can be a major barrier preventing you from absorbing vitamin D.

Speaking of food sources, there are actually two types of vitamin D — vitamin D2 and vitamin D3!

Vitamin D2 is predominantly found in vegetarian sources like mushrooms. It’s not nearly as potent as Vitamin D3.

Vitamin D3 is found in predominantly animal sources such as (1):

• fatty fish like salmon
• egg yolks
• Liver
• cod liver oil
• Ghee (I also love ghee for its butyrate content.)
• sardines

Those are some great options or sources for vitamin D in your diet.

Now your skin will produce its own vitamin D3 when exposed to sunlight.

What’s Your Liver Got To Do With Vitamin D?

No matter how your body gets its vitamin D (through food, supplementation or sunlight), there’s a process that it must go through to be used at a cellular level.

That’s where your liver and kidneys come into play! They actually have very important roles in terms of vitamin D.

That’s because vitamin D must be activated by these two organs before it can be used within your cells as a hormone.

Upon absorption or creation (in the skin), vitamin D is sent to your liver to be converted to another form. Then it heads to your kidneys where it is finally activated. Now vitamin D can be used within your cells.

I point this out for a couple of reasons.

First, your genes can influence your body's ability to convert the inactive forms to the active form. Genetic SNPs that impact enzymes in your liver can reduce your body’s ability to activate Vitamin D.

It’s also worth noting that some research exists demonstrating a SNP that results in “a decreased expression of VDR” gene in those with psoriasis.(1)

Second, because your liver is a necessary step in the activation process, it underscores the importance of a healthy liver.

It’s well-known that those with psoriasis have an increased risk of Non-Alcoholic Fatty Liver Disease.

Third, underlying hidden infections can also be a factor here. Chronic hidden infections (which some describe as stealth infections) can trigger what’s known as the Cell Danger Response. where the body suppresses vitamin D levels on purpose in an effort to try to protect you. and you might want to talk to your doctor or a nutritionist before starting a vitamin D supplement regimen.(2)

Research Showing Vitamin D Helpful For Psoriasis, Eczema & Dandruff

Now that we've established a basic understanding about vitamin D, let's talk about how vitamin D supplementation could be helpful for skin rash conditions.

In one study of moderately severe plaque psoriasis, researchers worked with 277 individuals over an 8-week period. Participants applied a synthetic vitamin D3 analog called Calcipotriene to their rashes. 70% of the participants showed a 75% or better improvement in their psoriasis compared to the control group.(3)

In another small study of 10 individuals with seborrheic dermatitis, topical vitamin D triggered a “major improvement or even complete clearance after an average of eight days.”(4)

And last but not least, another study that I found looking at chronic hand eczema suffers.

Researchers compared two different treatment plans on 13 individuals. They tested Calcipotriol (the topical vitamin D3 analog that I already mentioned) versus a steroid cream called Desoximetasone.

They ultimately found was that topical Calcipotriol was just as effective as the steroid cream for hand eczema.(5)

In fact, 70% reported an improvement of over 75% in their eczema symptoms. How cool is that?

One other point to consider — topical vitamin D is considered to be “steroid-sparing” meaning it reduces the need for topical steroids. This could be advantageous in certain sensitive areas (like the face or groin) where thinning of the skin is a serious problem.(1)

Optimal Vitamin D Level For Skin Rashes

I’m often asked, “what should my vitamin D level be”?

The answer to that question really depends on what source you look at.

Most sources agree that serum levels below 20 are considered an outright deficiency.(6)

Serum vitamin D between 21 and 29 is considered insufficiency.(6)

Above 30 is generally considered an appropriate level of vitamin D in your blood from a conventional standpoint.(6)

But from an integrative perspective, I like to see vitamin D a little bit higher. The optimal range for serum vitamin D is considered to be between 50 to 80.

The majority of my chronic skin rash clients have deficient levels of vitamin D.

And research corroborates what I see in my clinical nutrition practice. For example, it's actually pretty common for people with psoriasis to have low levels of vitamin D compared to the general population.(1)

And that in comparing vitamin D levels in those with psoriasis, women tend to have lower levels than men. And we tend to see low vitamin D more frequently in psoriatic arthritis.(1)

When it comes to the ideal supplementation, it’s not always straightforward.

If you're considering topical application of vitamin D, it will impact your serum levels. That means you’ll need to decrease oral vitamin D because having too much vitamin D isn’t necessarily a good thing.(7)

Oral supplementation dosages really depend on a few factors. You really should find out what your serum vitamin D level is first before you begin supplementing. Then check with your doctor or nutritionist that there aren’t any potential interactions with medication or your health that would make oral supplementation contraindicated.

As a clinical nutritionist, I always recommend taking vitamin D3 rather than D2.(8)

AND to be more specific, I suggest getting a combo of vitamin D3 and vitamin K2. This combination helps to support calcium absorption to the bones because of their synergistic relationship. Ideally, you do not want calcium ending up in your arteries and calcifying soft tissues.

Once you begin supplementing, get your serum levels rechecked about every six to eight weeks especially if you’re using megadoses (with the support of a practitioner).

And since we are talking about supplementation, discuss supplementing vitamin D (orally and topically) with your doctor or practitioner first before you take any actions.

Your situation is not the same as someone else. You could be taking medications or have conditions that could make vitamin D supplementation less than ideal for you.

It's my hope that this conversation around vitamin D and the importance of it is helpful. I want to make sure you can ask better questions of and have more informed conversations with your doctor and practitioner team.

If you have any questions or comments about this whole vitamin D thing, leave your thoughts below!

And make sure to share this episode with someone you know who could use this information. How neat is it that you could potentially utilize vitamin D topically to help reduce your symptoms of psoriasis, eczema, or even seborrheic dermatitis?

I promise you we will dive into this topic deeper in upcoming episodes — stay tuned!

In the meantime, I appreciate you so much for tuning in and I look forward to seeing you in the next episode!

REFERENCES

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486909/
2. https://www.sciencedirect.com/science/article/pii/S1567724913002390
3. https://www.jaad.org/article/0190-9622(95)90186-8/pdf
4. https://www.tandfonline.com/doi/abs/10.3109/09546639809160691?journalCode=ijdt20
5. https://www.ncbi.nlm.nih.gov/pubmed/31070845
6. https://www.hindawi.com/journals/drp/2019/5237642/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976443/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349454/