Vitamin D Analogues for Psoriasis

Medically Reviewed by Stephanie S. Gardner, MD on April 08, 2022
4 min read

If you have mild or moderate psoriasis, your doctor may mention vitamin D analogue as a possible treatment option. This isn’t the same as vitamin D supplements you can buy at the local drug store. Vitamin D analogues have been tweaked to affect your psoriasis differently.

Also known as synthetic vitamin D, Europeans have used this prescription medicine since the 1990s. The FDA has approved its use for mild to moderate plaque psoriasis.

Synthetic vitamin D analogue is a topical medication. That means it’s available as a cream or ointment that you put directly on affected skin. It binds with vitamin D receptors on specific genes to slow down the rapid skin cell production and buildup that triggers itchy and scaly psoriatic patches. Synthetic vitamin D analogue also stimulates keratinocytes, a major cell type found in the outermost layer of skin called the epidermis, to correct the fast cell turnover that leads to psoriasis.

Vitamin D analogues can:

Medications that contain vitamin D analogue:

Calcipotriene. It’s the most common prescription medication to treat psoriasis. When used alone, twice daily, it’s shown to improve psoriasis symptoms in 60% to 70% of people with chronic plaque psoriasis. It’s available as a cream or ointment.

Calcitriol. It’s available as an ointment and can be safely used by children over the age of 2.

While the topical drug can be used alone to treat mild to moderate psoriasis, studies have found that synthetic vitamin D can be safely combined with corticosteroids if a person requires stronger medication. Using them together can make it more effective, along with easing skin inflammation and the possible side effects that using corticosteroids alone may cause.

The combination of drugs can also be safely used for longer periods of time unlike when you use corticosteroids alone. You can use the combination for 4 weeks. Stop it for at least 4 weeks before you start again. This gives your skin a chance to heal and recover more effectively. The combination can be used on all affected areas all over your body and your scalp.

Besides possible skin irritation, the risk of side effects is low. But if you notice any bad reactions or allergies, let your doctor know immediately.

Unlike naturally occurring vitamin D or the type that comes in pill form to boost your vitamin D intake, synthetic vitamin D rarely affects the calcium levels in your blood.

This reduces the risk of:

  • Hypercalcemia, high levels of calcium in your blood
  • Hypercalciuria, high levels of calcium in your urine

Vitamin D analogues are available as cream, solution, ointment, or foam. You can directly apply it on psoriasis-affected skin. You can use it on your skin twice daily -- morning and evening. Gently rub on the cream until no medication is visible. It’s best to wash your hands with soap and water after each time.

Here’s what you need to know before you apply vitamin D analogues:

  • It’s important to use it exactly as your doctor directs you to
  • Apply it at the same time each day
  • For children between ages 2 and 6, don’t use more than one tube (100 gm) per week
  • For people aged 7 and above, don’t use more than two tubes (100 gm) per week
  • Only apply it to areas affected by psoriasis
  • Don’t swallow or eat the medicine

Vitamin D analogues are considered safe and effective against psoriasis for both adults and children ages 2 years and older.

Benefits include:

  • It’s a topical drug so it’s minimally absorbed by the whole body
  • It’s easy to use
  • Does not stain
  • Has fewer side effects compared with corticosteroids
  • Clears psoriasis in some patients
  • It’s effective for people who have scalp psoriasis
  • It can improve your psoriasis after 2 weeks of use

While the risk is low, vitamin D analogues may cause side effects. To avoid the risk, use it only as directed.

Possible common side effects include:

  • Irritated skin
  • Burning
  • Itching
  • Swelling
  • Peeling
  • Dryness
  • Redness

Usually, side effects fade as you continue to use the medicine. But if the side effects are bad and don’t seem to get better within 4 to 6 weeks after use or your psoriasis worsens, tell your doctor about it.

While vitamin D analogues are relatively safe for use for anybody with psoriasis, it’s not recommended if you have a certain medical condition or take a certain medication. It can cause possible drug interactions. Check with your doctor to see if it’s right for you.

Take a look at the ingredient list for any possible allergies. Ask your pharmacist if you’re not sure. Tell your doctor if you’re taking any calcium supplements, vitamin D supplements, or water pills. These drugs may interact with calcitriol and other vitamin D analogues. Your doctor may have to adjust the dose to better fit your needs.

If you have kidney stones or any condition that affects the calcium levels in your blood or urine, tell your doctor. If you’re pregnant, breastfeeding, or planning to get pregnant, ask your doctor if it’s OK. If you’re breastfeeding, avoid applying the cream or ointment on your nipple and areola.