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

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.

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]

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:

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.