Water Soluble Vitamins to Improve Psoriasis
This is the first part of a two-part series that reviews water-soluble and fat-soluble vitamins for psoriasis.
Psoriasis is a chronic skin condition affecting 3% of the adult population in the United States. Patients often require the daily application of strong steroids to their lesions and may require additional topical therapies. When topical therapies cannot control the condition, patients end up using oral, injection or infusion medications that alter the immune system. Although light therapy is a relatively safe and effective treatment for some patients, it is difficult to access and requires two to three weekly sessions.
Growing Interest in Vitamins
If more topical or nutritional alternatives were available, patients might find a treatment regimen that worked for their psoriasis prior to turning to systemic medications. One area of interest pertaining to nutrition is vitamins. Vitamins are compounds that have a variety of different roles in our bodies. They occur naturally in various foods.
Vitamins fit into two major categories: fat-soluble and water-soluble. There is growing scientific evidence on the effects of fat-soluble vitamins and their impact on psoriasis. The focus of this article is water-soluble vitamins like vitamin C and vitamin B12.
Vitamin C is important for collagen formation, a substance found in many different tissues and organs throughout the body. Vitamin C also plays a role in the immune system. Vitamin C is a known antioxidant, meaning it protects our cells by stopping free radical formation and propagation. Many fruits and vegetables are rich in vitamin C. Various studies have attempted to show that vitamin C supplementation and deficiency can affect a variety of autoimmune conditions including rheumatoid arthritis and type 1 diabetes mellitus.[4,5] However, information on vitamin C’s impact on psoriasis has not been well elucidated.
VitabridC12 is a new topical blend that combines vitamin C and a special combination of lamellar, hydrated zinc oxide. One study used VitabridC12 on psoriasis-like lesions in mice. They found that the topical combination improved the lesions. They also demonstrated that there was a decrease in inflammatory markers known to be involved in psoriasis, notably IL-1β, IL-6, TNF-α, IL-17A, and IL-22. Although encouraging, more research is needed to determine if topical vitamin C combinations will be useful in the treatment of psoriasis for humans.
Vitamin B12 is a vitamin important for blood cells and the nervous system. It can be found in almost every animal product including meat, chicken, fish, eggs, and dairy products. Many cereals are fortified with B12, giving those who do not eat meat or dairy an alternative source. Vitamin B12 is not a vitamin commonly discussed when it comes to psoriasis. Little information on its association with the skin condition exists, but there is some data to suggest it may positively affect psoriasis.
A few studies have shown that some psoriasis patients may be deficient in vitamin B12.[8,9] One of those studies also looked at two other autoimmune conditions, rheumatoid arthritis and lupus. They found low vitamin B12 levels in those patients as well, which suggests there may be some association between B12 and immune function. If patients are shown to be low in vitamin B12, it would make sense that supplementation would improve psoriasis.
Two studies have evaluated the effectiveness of vitamin B12 injections in psoriasis. One study showed improvement with 10 days of vitamin B12 injections and a maintenance oral dose thereafter, which improved psoriasis in one-third of patients. However, the other study did not show improvement with 3 weeks of injections in psoriasis patients. Both of these studies are much older and included only a small group of patients. The information remains unclear on vitamin B12 supplementation and the information we have is mainly from older studies; therefore, more updated research is necessary to give us a definitive answer.
Topical vitamin B12 has also been studied. In a small study containing 13 patients, vitamin B12 cream containing avocado oil was compared to topical vitamin D, a common therapy for psoriasis. Each was used for 12 weeks. While both showed improvement, vitamin D was quicker to show results, but its effects leveled off at 4 weeks. Vitamin B12 was slower to take effect, but achieved the same level of psoriasis improvement and was tolerated better by patients. This study albeit small and non-randomized, suggests that there could be a role for topical vitamin B12 in psoriasis management.
There Is Still More to Learn
There is some low-quality evidence that suggests topical water-soluble vitamins may help in the treatment of psoriasis. Systemic supplementation has not been proven to help psoriasis in enough studies to support the addition of vitamins C and B12 to a healthy diet. Overall, a healthy diet will supply the body with enough vitamins and is important for any disease management, psoriasis included. Before patients decide to add water-soluble vitamin supplements to their diet, they may wish to speak to a nutritionist to ensure they are eating a balanced diet. At the same time, more research on the positive effects of vitamins on psoriasis is needed.
- Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol.2014;70(3):512-516; PMID: 24388724 Link to research.
- American Academy of Dermatology Work G, Menter A, Korman NJ, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol.2011;65(1):137-174; PMID: 21306785 Link to research.
- Wintergerst ES, Maggini S, Hornig DH. Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab.2006;50(2):85-94; PMID: 16373990 Link to research.
- Wilkins ES, Wilkins MG. Effect of aspirin and vitamins C and E on synovial rheumatoid arthritic and other cells. Experientia.1979;35(2):244-246; PMID: 421847 Link to research.
- Odermarsky M, Lykkesfeldt J, Liuba P. Poor vitamin C status is associated with increased carotid intima-media thickness, decreased microvascular function, and delayed myocardial repolarization in young patients with type 1 diabetes. Am J Clin Nutr.2009;90(2):447-452; PMID: 19553299 Link to research.
- Lee JH, Jeon YJ, Choi JH, et al. Effects of VitabridC12 on Skin Inflammation. Ann Dermatol.2017;29(5):548-558; PMID: 28966510 Link to research.
- Subar AF, Krebs-Smith SM, Cook A, et al. Dietary sources of nutrients among US adults, 1989 to 1991. J Am Diet Assoc.1998;98(5):537-547; PMID: 9597026 Link to research.
- Segal R, Baumoehl Y, Elkayam O, et al. Anemia, serum vitamin B12, and folic acid in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus. Rheumatol Int.2004;24(1):14-19; PMID: 12720045 Link to research.
- Brazzelli V, Grasso V, Fornara L, et al. Homocysteine, vitamin B12 and folic acid levels in psoriatic patients and correlation with disease severity. Int J Immunopathol Pharmacol.2010;23(3):911-916; PMID: 20943063 Link to research.
- Ruedemann R, Jr. Treatment of psoriasis with large doses of vitamin B12, 1,100 micrograms per cubic centimeter; preliminary clinical report. AMA Arch Derm Syphilol.1954;69(6):738-739; PMID: 13157646 Link to research.
- Baker H, Comaish JS. Is vitamin B12 of value in psoriasis? Br Med J.1962;2(5321):1729-1730; PMID: 13969145 Link to research.
- Stucker M, Memmel U, Hoffmann M, et al. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis. Dermatology.2001;203(2):141-147; PMID: 11586013 Link to research.