Vitamin A and D can help reduce all forms of psoriasis. Vitamin D plays several key roles in your body, including absorbtion of minerals, calcium and phosphrous form the foods you eat. Calcipotriene, a form of vitamin D can control the rapid growth of skin cells which occurs in psoriasis.
Vitamin D based agents in topical preparations have been used for many years now in treating psoriasis. Of these topical treatments, one of the newer and more effective options in Australia, is calcipotriol (cal-see-pot-tree-ol). Calcipotriol is a vitamin D3-derived drug specifically developed for mild to moderate psoriasis.
Calcipotriol is available in an ointment, a cream, a gel and a lotion. In these different formulations, calcipotriol can be used on the skin, the scalp and the nails. In the ointment and gel forms, calcipotriol is combined with a topical corticosteroid for even greater effect on psoriasis.
A doctor’s prescription is usually required to use these products in Australia. Most commonly prescribed topical vitamin D agents for psoriasis are made more affordable under the government’s Pharmaceutical Benefits Scheme (PBS).
Calcipotriol appears to work by binding to special receptors in cells of the skin and controls genes involved in formation of the skin. These products appear to slow down the rapid formation of skin and the immune changes in skin that occur with psoriasis.
Applied once or twice daily, calcipotriol is effective and well tolerated in most patients. It can be applied long term and the benefits can be long standing. It usually takes one to two months to see the maximum benefits from these products. Our specialists usually recommend these products be used in conjunction with other treatments to maximise the benefits on psoriasis.
These treatments are usually quite safe. The thinning of the skin sometimes seen with long-term topical steroid use is not seen with these products. At The Psoriasis Institute, our specialists will determine how much of these products you should use at any one time. A certain amount of the vitamin D agent in these products is absorbed through the skin. Using too much of these products on the skin can cause an imbalance in your body’s calcium levels which can be harmful. Our doctors will prescribe safe quantities so that the risk of harmful effects is minimised.
Side effects most commonly experienced by patients are burning, itching and irritation of the skin, particularly on the face and the body’s skin folds. These symptoms usually lessen over time as your skin adjusts to the product. Often using these products in conjunction with topical steroids can also lessen the chance of skin irritation. Calcipotriol should always be used according to your doctor’s directions as using more than 100grams in a week can be harmful.
Vitamin D suppliments can be useful for the prevention of many diseases including osteoperosis, and some forms of skin cancer. Studies have shown that increasing vitamin D intake does not clear psoriasis- unlike vitamin A tablets. Vitamin D is best delivered by either gels, creams or lotions.
It is now known that excessive drying of the skin can cause worsening or relapse of psoriasis. Long hot showers, soaps, cold dry weather and aging all cause drying of our skin. Adding moisture to the skin on a regular basis can prevent drying and help maintain remission of treated psoriasis or prevent worsening of stable psoriasis. Regular use of simple bath oils and moisturisers can also soften annoying scale and minimise cracking of the skin often experienced by psoriasis sufferers.
Generally, petrolatum or paraffin based products such as paraffin cream and emulsifying ointment provide the best moisturising action on the skin but these products are often greasy. Lighter moisturisers such as sorbolene and aqueous cream feel less greasy on the skin but are not as effective. There are many cream based products available that feel nice on the skin and are not too greasy. Finding a product that suits your lifestyle and is comfortable to wear is important to encourage regular use of these products.
Simple bath oils used in the bath can be very useful for softening the hard dry scale of psoriasis and preventing cracking. Many suitable and inexpensive over-the counter-products are available.
It is important that psoriasis sufferers use gentle non-soap cleansers for bathing. There are many over-the-counter products that are suitable for psoriasis and dry skin generally. Your dermatologist can suggest suitable products for your skin.
Vitamin D delivered in creams, gels, or lotions play an important role in the management of mild to moderate psoriasis. In fact the versatility of delivering vitamin D with different preparations enables us to treat patients with psoriasis on the body, scalp or even nails. Intergrating this treatment can reduce or in some cases prevent the use of steroids.
Dr Scott Webber - Consultant Dermatologist
Avoiding certain foods in my diet has helped keep my psoriasis under control. Thank you for the insight and guidance.