Vitamin D and Eczema

Eczema

Eczema, also known as atopic dermatitis, is a chronic skin disorder that causes inflammation and red, dry, rough, and itchy skin. Eczema is most common in infants and young children, but you can also develop the disorder as an adult and continue to have it as an adult. Scientists are not sure what exactly causes eczema, but they think it’s a combination of genetics and the environment. People with eczema have immune systems and skin barriers that don’t work properly. Some studies have found that both children and adults with eczema are more likely to have low levels of vitamin D. Lower vitamin D levels are also linked to more severe skin symptoms. Research has found that people who have eczema and low levels of vitamin D are more likely to get infections on their skin.

More experiments need to be done to determine if vitamin D is an effective treatment for people with eczema. Doctors don’t know yet whether taking a vitamin D supplement, or getting more sun exposure, can help to prevent or treat eczema. If you have eczema and want to take vitamin D, it is unlikely to make your eczema worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help to treat your eczema. It is also not proven that taking vitamin D will reduce your risk of developing eczema. If you have eczema, you shouldn’t take vitamin D in place of your treatment medications. Talk to your physician for more advice about taking supplements.

What is eczema?

Eczema, also known as atopic dermatitis, is a chronic, but not contagious, skin disorder that causes inflammation and results in red, dry, rough, and itchy skin. Usually, eczema develops in infants during the first year of life. eczema is the most common skin condition in infants. The majority of children with eczema go into remission as adults. However, about 10% of people who have eczema as a child will continue to have it later in life. When you have eczema, there are periods of flare-ups, when your skin is very itchy and inflamed, and periods of remission, which is when you don’t experience symptoms of the disease. About half of all children with eczema will also develop asthma and/or allergies. People with eczema are also more likely to get skin infections. Constant itching and scratching can damage the barrier of the skin and allow bacteria to get past the surface of the skin¹.

What are the symptoms of eczema?

Symptoms of eczema include:

• Red or grayish patches on the skin
• Severe itching
• Small bumps on the skin, which may leak fluid
• Cracked and scaly skin
• Sensitive or raw skin

Usually, eczema causes you to develop itchy patches on your hands, feet, elbows, behind the knees, face, neck, and ankles. However, these patches can occur anywhere on your body. eczema can affect your eyes, causing itchy, red and swollen areas around them¹.

How common is eczema?

About 10-20% of children and 3% of adults have eczema². There are some factors that can increase your risk of developing eczema, including^3,4:

• Higher socioeconomic status and higher education level.
• Family history. People who have a family member with eczema are more likely to develop it.
• Gender. Females are more likely to have eczema.
• Your mother’s age when you were born. Children who are born to older women are more likely to develop eczema.

Where you live might also affect whether or not you develop eczema. People who live in urban areas, cold climates, industrialized countries, or northern latitudes are more likely to have eczema⁵.

What causes eczema?

Scientists are not sure what exactly causes eczema, but they think it’s a combination of the genes you are born with and the environment that you live in. When you have eczema, there are certain triggers that can make your eczema flare up and become worse, including^4,6:

• Soaps, perfumes and makeup
• Dust and sand
• Chlorine
• Cigarette smoke
• Pollution
• Stress
• Illnesses or infections

Eczema develops when the barrier of your skin and your immune system don’t work properly. This causes dryness of the skin and allows bacteria to get inside your skin, causing irritation and itchiness. When you have eczema you experience an ongoing cycle of skin infections, leading to inflammation and itchiness, which then leads to more skin infections⁵. Overall, there is some combination of genetics and the environment that causes eczema to develop.

What is the link between vitamin D and eczema?

Vitamin D is an important part of the immune system. When you have eczema, your immune system and skin barrier don’t work properly. Some studies have found that people with eczema are more likely to have lower levels of vitamin D^7,8. Lower vitamin D levels are also linked to more severe eczema symptoms⁹. Vitamin D receptors are found on the surface of a cell, where they receive vitamin D. By attaching themselves to a receptor, vitamin D directs a cell to act in a certain way, such as to divide or die. There are vitamin D receptors found on cells in the immune system and the skin, and vitamin D can bind to these receptors. Vitamin D works in the immune system by reducing levels of inflammatory proteins called cytokines, as well as increasing amounts of good antimicrobial proteins in the skin, which destroy invading germs and viruses. This combination of lowering inflammation and increasing antimicrobial defenses can help your immune system fight infections better. Vitamin D also helps to strengthen the barriers of your skin. Having enough vitamin D in your body could help to prevent infection and lower inflammation in people with eczema¹⁰. However, some studies have also shown that having high levels of vitamin D may increase your risk of allergic skin diseases, including eczema. Researchers of these studies think that perhaps both very low and very high levels of vitamin D in infancy could increase your chances of developing eczema^11,12. Since these results are conflicting, it is clear that more research needs to be done to determine the role that vitamin D plays in the development of eczema.

What does the research say in general about vitamin D and eczema?

Preventing eczema

Not too many studies have been conducted that analyze the effect of vitamin D on preventing eczema. Some research has shown that people who have low levels of vitamin D are more likely to develop allergic diseases like eczema. Research has also found that children whose mothers had low levels of vitamin D during pregnancy are at a higher risk of developing eczema¹³. Some scientists think that fetal and early life exposures can determine someone’s risk for allergy and eczema later in life. Vitamin D status in prenatal and early life stages is one of the things that researchers think may affect someone’s chances of developing eczema¹⁴. A study done on pregnant mothers and their children found that babies with the lowest level of vitamin D at birth had the highest risk of developing eczema by age 5¹⁴. Research done on Chinese children found that having very low levels of vitamin D was strongly linked to having eczema during childhood¹⁵.

Managing or treating eczema

Most studies have suggested that vitamin D plays a role in the progression of allergic diseases, like eczema. People with eczema who have low levels of vitamin D tend to have worse symptoms. A study done on children with eczema and allergies found that those with the lowest levels of vitamin D had the most severe form of the disease¹³. Other studies have shown that children with eczema who have low levels of vitamin D are more likely to have other skin problems, such as increased infections, compared to children with eczema who had higher levels of vitamin D¹⁶. Although studies have shown a link between low vitamin D levels and increased eczema severity, more experiments need to be done to determine whether or not vitamin D can help to manage eczema.

What does recent research say?

Preventing eczema

A study done in 2012 in Australialooked at pairs of mothers and their newborn infants. The researchers looked at vitamin D levels in the mothers and newborns and whether or not the infants developed eczema. They found that¹⁷:

• About one-third of the infants had eczema.
• Vitamin D levels at birth were lowest in the infants who developed eczema in their first year of life.
• Every 4 ng/ml increase in vitamin D levels in the newborns was linked to a 13% lower risk of developing eczema.

A newborn’s vitamin D level is related to its mother’s vitamin D level. The researchers concluded that low levels of vitamin D in mothers during pregnancy may be related to their infants developing eczema. Improving vitamin D levels in pregnant women may help prevent eczema in their children.

Managing or treating eczema

An experiment done in 2012gave people over age 14 with eczema either 1600 IU of vitamin D or a dummy pill daily for 60 days. The researchers looked at eczema severity and symptoms between the 2 groups. They found that¹⁸:

• The vitamin D group showed more improvements in eczema symptoms than the dummy pill group.
• The severity of eczema was much lower after people took vitamin D supplements.

An experiment published in 2008looked at 11 children with eczema in the winter. The children either got 1000 IU of vitamin D or a dummy pill for 1 month. The researchers looked at something called the IGA score, which measures symptoms and severity of eczema. They found that¹⁹:

• The IGA score improved in 80% of the children taking vitamin D.
• The IGA score improved in only 17% of children taking the dummy pill.

The researchers stated that taking a vitamin D supplement may be helpful to manage eczema symptoms, especially in the wintertime. Many people have worse eczema symptoms during the winter months, which could be related to lower vitamin D levels from reduced sunlight exposure. A study published in 2013 in Polandgave vitamin D supplements to adults with eczema who had low levels of vitamin D. The people all got 2000 IU of vitamin D daily for 3 months in the wintertime. The researchers looked at eczema severity and symptoms before and after supplementation and found that²⁰:

• People with the lowest vitamin D levels had more skin infections.
• After supplementing with vitamin D, the eczema symptoms and severity score was much lower.
• People who took vitamin D supplements had significant improvements in skin lesions.

The researchers conclude that supplementing with vitamin D may help to manage and treat the skin symptoms associated with eczema. Vitamin D causes skin cells to make more antimicrobial proteins, which is why people with low levels of vitamin D tend to have more skin infections.

Key points from the research

• People who have eczema tend to have low levels of vitamin D.
• Vitamin D may help the immune system reduce levels of inflammation and strengthen your skin barriers.
• People who have eczema and low levels of vitamin D are more likely to get skin infections.
• Having good levels of vitamin D may be a way to help manage the severity of eczema symptoms.
• More experiments need to be done to determine if taking vitamin D supplements can help to prevent or manage eczema.

What does this mean for me?

Research has shown that there is a link between vitamin D and eczema. While most of this research has shown that having sufficient levels of vitamin D may reduce your risk of developing eczema, some studies have also shown that very high levels of vitamin D in infancy may increase your risk later in life. Research has shown that having good levels of vitamin D can help to manage eczema symptoms. People who take vitamin D supplements have lower disease activity and fewer skin infections. However, more experiments need to be done to determine if vitamin D is an effective treatment for people with eczema. Doctors don’t know yet whether taking a vitamin D supplement, or getting more sun exposure, can help to prevent or treat eczema. If you have eczema and want to take vitamin D, it’s unlikely to make your eczema worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help prevent or treat eczema. If you have eczema, you shouldn’t take vitamin D in place of your treatment medications. Talk to your physician for more advice about taking supplements.

References

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2. Silverberg JI. Atopic Dermatitis?: An Evidence-Based Treatment Update. Am J Clin Dermatol. 2014. doi:10.1007/s40257-014-0062-z.
3. ClevelandClinic. Atopic Dermatitis. 2014. Available at: https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/atopic-dermatitis/. Accessed July 20, 2014.
4. WebMD. Atopic Dermatitis (Eczema). 2014. Available at: https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-basics. Accessed July 20, 2014.
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