Topical vitamin A provides no benefit in treating atopic dermatitis, whereas topical vitamin D may actually exacerbate symptoms, according to an evidence-based review. Biologic Treatments for Moderate to Severe Atopic Dermatitis.
Topical vitamin A provides no benefit in treating atopic dermatitis, whereas topical vitamin D may actually exacerbate symptoms, according to an evidence-based review. In contrast, topical formulations of vitamins B, C, and E appear to help the disease.
The study was published in the journal Dermatologic Therapy. They also found that three trace elements magnesium, zinc, and iodine seem to improve atopic dermatitis, due to their anti-inflammatory and antimicrobial effects.
Atopic dermatitis is a common and burdensome disease with complex etiologies, but we have limited treatment options. Historically, out of frustration and the need for more effective treatment, over 50% of caregivers and patients use nonprescription or complementary treatments.
One of these nonpharmacologic treatments is micronutrients, such as vitamins and trace minerals. Much of the evidence and attention have been paid to oral micronutrient supplementation in atopic dermatitis.
However, topical micronutrients are also important adjuvant treatments, yet have received much less attention. The goal of the review was to compile existing evidence on the mechanism and benefit (or the lack thereof) of using topical micronutrient formulations in treating atopic dermatitis.
Dr. Shi was inspired by her patients and their caregivers to undertake the review. As a medical dermatologist specializing in atopic dermatitis, I encourage my patients to be well-read on their skin condition and treatment options. They often come in with stimulating questions.
Topical micronutrients have long been thought to have anti-inflammatory, antimicrobial and anti-oxidative properties, and therefore, in theory, should help atopic dermatitis. “We wrote this review to highlight what we do and still do not know about the benefits of topical micronutrients for the disease. Hopefully, our review can motivate future research directions.
Evidence indicates that topical vitamin B12 and B3 formulations can improve the skin barrier function and severity of atopic dermatitis patients. Conversely, there is only one study of topical vitamin B5 that did not find any benefit between a 5% vitamin B5 formulation and a hydrocortisone 1% cream in children with atopic dermatitis.
Overall, the topical formulations reviewed are well tolerated with very few to no reported side ef-fects. Additionally, zinc and magnesium appear to play an anti-inflammatory and anti-oxidative role in atopic dermatitis skin.
The studies highlighted in the review used different formulations, such as varying concentrations of the active micronutrient, and even more commonly varying excipient/inactive ingredient compositions. Hence, it is not easy to make conclusions about the overall effect of a particular micronutrient.
Benefits And Safety
Some of the studies reviewed were not randomized blinded control trials while many had a relatively short study duration and small sample size. While topical micronutrients hold some promise in improving atopic dermatitis, we still need higher quality studies to confirm their benefit and safety.
They also need additional research to see how these compounds can be compounded into existing formulations/topical prescriptions to augment their effects. Simultaneously, mechanistic research to better understand how these compounds work on a molecular, cell and tissue level in atopic dermatitis skin is needed.