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.^[1] 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.^[2] 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

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.^[3] 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.^[6] 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

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.^[7] 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.^[8] 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.^[10] However, the other study did not show improvement with 3 weeks of injections in psoriasis patients.^[11] 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.^[12] 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.^[12] 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.