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The Potential Connection Between Seborrheic Dermatitis and Vitamin D

This article attempts to decipher the potential role of vitamin d in seborrheic dermatitis progression. Emphasis is made on the following questions:

  • Is vitamin D deficiency responsible for seborrheic dermatitis?
  • Can correcting deficiency lead to symptom relief?
  • What role does vitamin D play in skin health?

The discussion starts with a general review of seborrheic dermatitis; followed by evaluation of the evidence for the role vitamin d may play; and ends with an emphasis on the importance of adequate vitamin d in overall health.

Hope you find the article helpful! 🙂 And if you have any questions that come up along the way or would like to discuss any of the topics further, please use the contact form at the bottom.

Quick Recap of the Basics and Current Understanding of Seborrheic Dermatitis

Seborrheic dermatitis has been reviewed in-depth through several sections of this website. Most notably, you can find a detailed description of the condition in the:

  • Section

However, if you don’t feel like spending too much time reading into the details or already pose significant knowledge, here is a recap of the primary attributes of seborrheic dermatitis

  • A condition that affects roughly 3% of the adult population
  • Occurrence rates are much higher among individuals affected by either HIV or Parkinson’s
  • Skin symptoms include flaking, inflammation, itch, and either excessive or insufficient sebum production (dry or oily seborrheic dermatitis)
  • The scalp is the most commonly affected area and more moderate forms at this area are simply referred to as dandruff
  • Commonly affected facial regions include the nose, cheeks, forehead, ears, and eyebrows
  • Can also affect other areas of skin dense in sebaceous glands (lower back, chest, etc)
  • Malassezia yeast get the most attention for causing seborrheic dermatitis, but more recent evidence suggests that overall skin flora may play a more important role
  • Oleic free fatty acids have been demonstrated to be the specific by-product of the microflora that leads to the majority of reported symptoms
  • Topical anti-fungal agents are the most commonly used for treatment, but corticosteroids, lithium salts, and several other medications have shown to be effective as well
  • No established cure exists and most dermatologists recommend ongoing treatment to maintain remission

In summary, the condition really has no clear answers as to what the underlying mechanism driving its progression is. For most, regular treatment does usually lead to relief, but most sufferers acknowledge that flare-ups could occur at any time and may at times show a reluctance to respond to the usual treatment.

Those of us who are unfortunate enough to be affected are still searching for answers and hope to one day be able to control symptoms without dependence on on-going treatment.

Is There a Relationship Between Seborrheic Dermatitis and Vitamin D Deficiency?

Some online reports of people resolving their seborrheic dermatitis with Vitamin D supplements (or increased exposure to natural sunshine) exist. However, the facts on this subject are not quite clear and there is a general lack of medical literature/research evaluating this potential treatment approach.

Separating the facts from the anecdotal reports should help us decide whether it’s worthwhile to pursue Vitamin D supplementation in the first place. And if it can really be helpful in reducing seborrheic dermatitis symptom severity.

Accordingly, let’s take a moment to review the evidence that does exist and what it tells us.

Review of the Medical Literature

As of today, a quick academic search pulls up three papers that briefly allude to the use of vitamin d in seborrheic dermatitis.

The relevant information is outlined below:

Possible nutrient mediators in psoriasis and seborrheic dermatitis. II. Nutrient mediators: essential fatty acids; vitamins A, E and D; vitamins B1, B2, B6, niacin, and biotin; vitamin C selenium; zinc; iron [1]

  • Paper published in 1988 that briefly alludes to a single case of successful usage of Vitamin D3 in the treatment of psoriasis [2]
  • No mention of its use in seborrheic dermatitis
  • Also mentions the rising success of PUVA (psoralen – used to make the skin more sensitive to UV rays – and ultraviolet A exposure) in the treatment of various skin disorders – via its ability to suppress the immune response

The effect of vitamin d supplementation on recurrences of seborrheic dermatitis [3]

  • A 2017 article that describes the use of vitamin D in a group of 36 individuals affected by seborrheic dermatitis
  • Supplementation was in the form of 1600 IU cholecalciferol per day
  • The study lasted 3 months and was carried in the fall/winter to reduce the influence of natural sunlight exposure (in the months from September to May )
  • Prior to starting supplementation testing showed all the participants had a vitamin D level lower than 21ng/l (considered as a deficiency)
  • Findings and conclusions were based on patient submitted self-reports of flare-up frequency and severity during the study period
  • 21 (65.5%) patients reported a reduced number of recurrences, 7 (22%) no change, and 4 (12.5%) had an increase in symptoms during the period
  • Authors noted that individuals with the lowest initial levels of vitamin D appeared to report the best outcomes from supplementation

Study of the level of 25-hydroxyvitamin D in patients with seborrheic dermatitis []

  • Paper published in 2013 by the same author as the above
  • Evaluated the level of 25-hydroxyvitamin D in 22 individual affected by seborrheic dermatitis
  • 4 individuals showed serum levels in the range of 29-21 ng/mL, 13 in the 20-10 ng/mL range, and 2 females were below the 10 ng/mL range
  • It was noted that levels below 30ng/mL are commonly considered as insufficiency, under 20ng/mL as a deficiency, and below 10ng/mL as severe deficiency
  • Authors brought up the increased use of Vitamin D analogs in the treatment of psoriasis and vitamin D’s role in immunomodulation as two of the primary reasons for the investigation

Deficiency rates in the general popular
General adult population rates of vitamin d deficiency (below 30ng/mL ) in the United States have been estimated to be somewhere around 6-8% [4].

Off-Label Uses of Topical Vitamin D in Dermatology: A Systematic Review [5]

  • A 2014 review paper investigating the off-label usage of topical vitamin D analogs in the treatment of various skin disorders
  • Describes the primary mechanism behind the effectiveness of topical Vitamin D analogs
    • Regulate the calcium homeostasis and influence the expression of vitamin d receptors at the skin surface
    • Vitamin d receptors regulate keratinocyte (skin cells) production, T-cell regulation(immune cells), and cytokine levels (proteins used for cellular communication)
  • Preliminary small scale studies showed promise for topical vitamin D analogs for seborrheic dermatitis [6]
  • Follow-up larger scale randomized controlled studies contradicted these outcomes
    • These studies concluded that corticosteroids are superior and have a lower chance of inducing skin irritation [7, 8]
  • The final conclusion by the authors was that topical vitamin D analogs are not recommended for the treatment of either facial nor scalp seborrheic dermatitis

In the end, the research on this topic primarily focuses on the use of topical Vitamin D analogs (as opposed to supplements) and even then the outcomes are mixed. The two papers from Jenya Dimitrova do hint that a potential exists for supplementation, but the lack of specific conclusions and documented treatment outcomes leaves a lot of unanswered questions.

Online Forum Review

Now that we’ve reviewed the medical literature, let’s briefly go over the online discussion that claims vitamin d may be the answer to seborrheic dermatitis.

  • Several individuals discussing this topic over on a reddit mentioned Vitamin D supplementation failed to provide any relief
    • One individual reports taking 10,000 IU per day for a whole a year without any improvements
    • Others add that digestive issues and abnormal nutrient absorption are likely more important for the majority of sufferers
  • Another user from reddit mentions that vitamin d and zinc tablets are two supplements that she believes help keep her seborrheic dermatitis under control
  • An old post from a forum participant over at CureZone suggests that vitamin D, calcium, and caprylic acid are three supplements that she believes help keep her symptoms in check (the biggest benefit was actually attributed to regular consumption of homemade kefir)

Apart from that, there really isn’t too much further discussion on this topic that remains published online.

Could Vitamin D Be Used to Treat Seborrheic Dermatitis

Based on the evidence reviewed in this article, vitamin D does not appear to be an effective treatment approach to seborrheic dermatitis. Specifically, neither vitamin D supplements nor topical vitamin D analogs have been verified with empirical evidence and even anecdotal reports generally refute the notion.

Nonetheless, it does appear to be that lower levels of vitamin D are common amongst individuals affected by seborrheic dermatitis. Thus, if you suffer from seborrheic dermatitis, it is probably in your best interest to at-least undergo medical testing to ensure your vitamin D levels do not put you at risk for other health conditions. And if your vitamin D levels happen to be within deficient ranges, your doctor will make the corresponding suggestions.

Low levels of Vitamin D have been found in numerous skin conditions
Psoriasis [9, 10, 11], acne [12, 13, 14], alopecia (hair loss) [15, 16], vitiligo [17, 18, 19], atopic dermatitis (eczema) [20, 21].

The Importance of Vitamin D

The importance of Vitamin D often goes unnoticed, however, taking this vitamin for granted could lead to serious consequences.

Deficiency has been linked to increased risk of autoimmune disease, cancer, bone issues, and cardiovascular disease [22]. Because of its importance, maintaining adequate vitamin d levels throughout life is essential.

Vitamin D on its own is a topic far outside the scope of this article. Nonetheless, a vast amount of information can be obtained online for those interested. A good starting point would be this review paper from 2005:

Benefits and requirements of vitamin D for optimal health: a review.

Vitamin D’s Role in Skin Health

Now, since humans obtain roughly 80% of our required Vitamin D trough UV-induced skin production [23] (the rest usually comes from diet), its role in skin physiology become evident. And despite any clearly established relationship between vitamin d deficiency and seborrheic dermatitis, it may be worthwhile to review its role in overall skin health.

Roles that vitamin D and it’s receptor play:

  • Regulate growth and production of skin cell types – including keratinocytes (epidermal cells which produce keratin) [24]
  • Regulate the production of long-chain glycosylceramides that are critical to stable skin barrier formation [25]
  • Stabilize the skin’s innate immune response – potentially down-regulating an over-active response and protecting from auto-immunity [26, 27, 28, 29]
  • Increase availability of regulating T cells (Tregs) [29, 30]
  • Regulate the production of certain antimicrobial peptides [31, 32, 33]
  • Protect against UV damage [34, 35, 36]

The skin’s immune response can itself modulate local vitamin d production
Monocytes (a primary defender of our cells) have been seen to selectively promote localized activation of vitamin D when exposed to certain microbial threats [31, 32]

Taken together, these factors underline the importance of ensuring adequate vitamin D levels. And most importantly, the importance of stimulating local production at the skin level when possible.

Summary

This article reviewed and summarized the evidence relating to the potential relationship between seborrheic dermatitis and vitamin d. Key points discussed include:

  1. The primary cause of seborrheic dermatitis is still highly debated, but malassezia yeast have received the majority of attention from the medical community
  2. There is speculation across the internet that vitamin d may facility the progression of seborrheic dermatitis and resolving deficiency could lead to relief
  3. The limited evidence that exists to date, suggests that the majority of individuals affected by seborrheic dermatitis are in-fact deficient in vitamin D
  4. One small scale study did manage to show a small benefit from supplementation, however, some had reported an increase in symptoms and there was no mention of complete remission
  5. A few success stories can be found scattered through online discussions, but even here the majority of individuals report a lack of efficiency
  6. Despite the general lack of evidence specifically for seborrheic dermatitis, sufficient vitamin d levels are very important for skin health, overall immune system stability, and protection from chronic disease
  7. If you suffer from seborrheic dermatitis, it may be worthwhile to evaluate your vitamin d status and make necessary changes (adequate UV exposure being the most recommended approach) if you are found to be deficient

Hope you’ve found this article discussing the ambiguous relationship between seborrheic dermatitis and vitamin d helpful. If you have any questions, have something to add to the discussion, would like to share your experience, or really anything else, drop a comment below.

100% of readers found this article helpful

References

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  2. S Morimoto, Y Kumahara "A patient with psoriasis cured by 1 alpha-hydroxyvitamin D3." Medical journal of Osaka University 35.3-4 (1986): 51-4. PubMed
  3. Jenya Dimitrova, "The effect of vitamin d supplementation on recurrences of seborrheic dermatitis" Current Research 6.3 (2017): 2446-2448. doi.org
  4. Anne C Looker, Clifford L Johnson, David A Lacher, Christine M Pfeiffer, Rosemary L Schleicher, Christopher T Sempos "Vitamin D status: United States, 2001-2006." NCHS data brief.59 (2011): 1-8. PubMed
  5. Heidi Wat, Marlene Dytoc "Off-label uses of topical vitamin D in dermatology: a systematic review." Journal of cutaneous medicine and surgery 18.2 (2014): 91-108. PubMed
  6. J Nakayama "Four cases of sebopsoriasis or seborrheic dermatitis of the face and scalp successfully treated with 1a-24 (R)-dihydroxycholecalciferol (tacalcitol) cream." European journal of dermatology : EJD 10.7 (2000): 528-32. PubMed
  7. J Berth-Jones, P I Adnitt "Topical calcipotriol is not effective in facial seborrhoeic dermatitis." The Journal of dermatological treatment 12.3 (2002): 179. PubMed
  8. P Y Basak, S Ergin "Comparative effects of calcipotriol and betamethasone 17-valerate solution in the treatment of seborrhoeic dermatitis of the scalp." Journal of the European Academy of Dermatology and Venereology : JEADV 15.1 (2002): 86-8. PubMed
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  10. Jacinto Orgaz-Molina, Agustín Buendía-Eisman, Miguel A Arrabal-Polo, José Carlos Ruiz, Salvador Arias-Santiago "Deficiency of serum concentration of 25-hydroxyvitamin D in psoriatic patients: a case-control study." Journal of the American Academy of Dermatology 67.5 (2013): 931-8. PubMed
  11. Hesham Abd El-Moaty Zaher, Mohamed Hussein Medhat El-Komy, Rehab Aly Hegazy, Heba Amr Mohamed El Khashab, Hanaa Hamdy Ahmed "Assessment of interleukin-17 and vitamin D serum levels in psoriatic patients." Journal of the American Academy of Dermatology 69.5 (2013): 840-842. PubMed
  12. Parviz Toossi, Zahra Azizian, Hassan Yavari, Tannaz Hoseinzade Fakhim, Seyed Hadi Sadat Amini, Ramin Enamzade "Serum 25-hydroxy vitamin D levels in patients with acne vulgaris and its association with disease severity." Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases 12.3 (2016): 238-42. PubMed
  13. Seul-Ki Lim, Jeong-Min Ha, Young-Ho Lee, Young Lee, Young-Joon Seo, Chang-Deok Kim, Jeung-Hoon Lee, Myung Im "Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial." PloS one 11.8 (2017): e0161162. PubMed
  14. Mustafa Turgut Yildizgören, Arzu Karatas Togral "Preliminary evidence for vitamin D deficiency in nodulocystic acne." Dermato-endocrinology 6.1 (2015): e983687. PubMed
  15. Mark J Bolland, Ruth W Ames, Andrew B Grey, Anne M Horne, Barbara H Mason, Greg D Gamble, Ian R Reid "Does degree of baldness influence vitamin D status?" The Medical journal of Australia 189.11-12 (2009): 674-5. PubMed
  16. H Rasheed, D Mahgoub, R Hegazy, M El-Komy, R Abdel Hay, M A Hamid, E Hamdy "Serum ferritin and vitamin d in female hair loss: do they play a role?" Skin pharmacology and physiology 26.2 (2013): 101-7. PubMed
  17. Jonathan I Silverberg, Arnold I Silverberg, Edmond Malka, Nanette B Silverberg "A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris." Journal of the American Academy of Dermatology 62.6 (2010): 937-41. PubMed
  18. Hanan M A Saleh, Nermeen S A Abdel Fattah, Heba-Tullah M M Hamza "Evaluation of serum 25-hydroxyvitamin D levels in vitiligo patients with and without autoimmune diseases." Photodermatology, photoimmunology & photomedicine 29.1 (2013): 34-40. PubMed
  19. Xin Xu, Wen-Wen Fu, Wen-Yu Wu "Serum 25-hydroxyvitamin D deficiency in Chinese patients with vitiligo: a case-control study." PloS one 7.12 (2013): e52778. PubMed
  20. Krishna Mutgi, John Koo "Update on the role of systemic vitamin D in atopic dermatitis." Pediatric dermatology 30.3 (2014): 303-7. PubMed
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  30. Walter Royal, Younus Mia, Huifen Li, Kerry Naunton "Peripheral blood regulatory T cell measurements correlate with serum vitamin D levels in patients with multiple sclerosis." Journal of neuroimmunology 213.1-2 (2009): 135-41. PubMed
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  32. Adrian F Gombart, Niels Borregaard, H Phillip Koeffler "Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxyvitamin D3." FASEB journal : official publication of the Federation of American Societies for Experimental Biology 19.9 (2006): 1067-77. PubMed
  33. Philip T Liu, Steffen Stenger, Huiying Li, Linda Wenzel, Belinda H Tan, Stephan R Krutzik, Maria Teresa Ochoa, Jürgen Schauber, Kent Wu, Christoph Meinken, Diane L Kamen, Manfred Wagner, Robert Bals, Andreas Steinmeyer, Ulrich Zügel, Richard L Gallo, David Eisenberg, Martin Hewison, Bruce W Hollis, John S Adams, Barry R Bloom, Robert L Modlin "Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response." Science (New York, N.Y.) 311.5768 (2006): 1770-3. PubMed
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  35. J Lee, J I Youn "The photoprotective effect of 1,25-dihydroxyvitamin D3 on ultraviolet light B-induced damage in keratinocyte and its mechanism of action." Journal of dermatological science 18.1 (1998): 11-8. PubMed
  36. K M Dixon, S S Deo, A W Norman, J E Bishop, G M Halliday, V E Reeve, R S Mason "In vivo relevance for photoprotection by the vitamin D rapid response pathway." The Journal of steroid biochemistry and molecular biology 103.3-5 (2007): 451-6. PubMed
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About Michael Anders

After being affected by seborrheic dermatitis, I have made it my goal to gather and organize all the information that has helped me in my journey.

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3 Comments

  1. Mike
    Mike -

    I’ve had issues with s. dermatitis for the last 3 years or so strictly on my scalp. Recently, I switched to a multivitamin with a higher dose of vitamin D (1600 IU, actually the dose referenced in the one of the studies above) and after about three months of daily use my scalp is about 85% improved! Still occasional itchiness but no more scabs and inflammation. It’s completely clear. Can I prove it’s the vitamin D which is causing the improvement? Of course not. But in the process of trying to figure out what I was doing differently I remembered the change in multivitamin and googled about vitamin d and s. dermatitis and I’m intrigued by what I’ve found. Could be worth looking for sufferers as 1600 IU is a very modest dose of vitamin D. Good luck!

  2. Mario
    Mario -

    UV rays are effective to treat seborrheic dermatitis.
    Maybe vitamin D deficiency and seborrheic dermatitis are not causally linked. Maybe it is just that people who don’t receive enough sunlight, get affected by both. Both get worse in winter.

    • Khalid
      Khalid -

      Maybe its is vitamin K2. Or a combination of Vitamin D3 and K2. There is a study about atopy and k2 from Tokyo but in kids.

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