More than half of people with psoriasis say they’ve used complementary and alternative medicine to help manage their disease. Vitamins and supplements are often a staple complementary therapy. Of course, you should talk with your dermatologist before you take any vitamin or supplement for your psoriasis. They can tell you if it’s safe, effective, and won’t interfere with any of your other medications.
The following are some vitamins and supplements that may have benefits for moderate to severe psoriasis, based on recent research.
Fish Oil
Cold-water fish oil supplements are rich in omega-3 fatty acids called DHA and EPA. You can also get these nutrients from foods like salmon or shellfish. Fish oil supplements come in capsules, liquid, or pills.
Why it may work: Fish oil may help you manage psoriasis skin flares because omega-3 fatty acids are anti-inflammatory. Psoriasis is inflammation of the skin.
Does it work? One older study showed that fish oil improved psoriasis symptoms like skin redness, itching, scaly plaques, and thickening in people who took capsules for 12 weeks. Other studies showed that people who took daily fish oil supplements for 6 months had reduced skin scales, thickening, and redness.
Fish oil may be effective if it’s combined with other psoriasis treatments. In one older study of 18 people with stable plaque psoriasis, people who took fish oil supplements for 15 weeks, combined with ultraviolet-B (UVB) light therapy, reduced the body area covered with plaques compared to people who took olive oil supplements with light therapy.
Other research shows fish oil may not be that helpful for psoriasis. In one study from 1993, 145 people with moderate to severe psoriasis ate either a diet rich in fish oil or corn oil, and were told to eat fewer saturated fats. Both groups had the same mild results. Both fish oil and corn oil reduced skin scales, and those who ate more corn oil had reduced redness and skin shedding.
In 2019, the combined results of 13 different studies also found that fish oil doesn’t significantly reduce severity or spread of psoriasis symptoms.
Is it safe? Fish oil supplements are safe when taken as directed. You may have side effects like bad breath, a fishy taste, heartburn, diarrhea, nausea, or rash. High doses of fish oil supplements could cause bleeding or stroke.
Fish oil supplements could interact with some birth control, heart, blood pressure, or obesity medicines.
Vitamin D
Vitamin D is a nutrient that you can get through sunlight on your skin, as well as from foods or supplements. It’s also available as a topical skin cream.
Why it may work: People with psoriasis may have too-low levels of vitamin D, especially if you’ve had psoriasis for a long time.
Moderate to severe psoriasis is an autoimmune disease: your immune system inflames healthy skin by mistake. Vitamin D may be anti-inflammatory. It may help your immune system slow down to reduce inflammation on your skin.
Does it work? Topical creams with vitamin D may help skin symptoms of psoriasis whether used alone or in combination with other treatments. Topical vitamin D has a very low risk of side effects.
Calcipotriene (Dovonex) is a newer form of topical vitamin D that comes in a foam that’s easy to spread over your skin. It seems to slow skin cell growth in psoriasis, improve the health of skin cells called keratinocytes that are damaged in psoriasis, and have an anti-inflammatory effect on skin.
Calcipotriene may work as well as a topical steroid for mild to moderate psoriasis, but not as well as stronger steroids. You may combine this topical with stronger medications for psoriasis like methotrexate or cyclosporine for more effective results.
Calcipotriene combined with a steroid called betamethasone (Enstilar, Taclonex) is available as a cream, ointment, suspension, or foam. It reduces psoriasis redness, pain, itching, or swelling.
What about oral vitamin D supplements? In a new study, six people with moderate to severe psoriasis took high doses of anywhere from 30,000-60,000 IU (international units) of vitamin D3 daily for 2-6 months. They took no other psoriasis treatments. After a few months, high-dose, oral vitamin D brought their skin symptoms under control with no side effects. Doctors monitored each person carefully to check for hypercalcemia.
While the results of this very small study look exciting, large trials of high-dose vitamin D need to be done to show if this treatment can be safe and effective for people with moderate to severe psoriasis.
Other research shows that high doses of oral vitamin D don’t have any noticeable benefit when compared to a placebo, or sham treatment.
Is it safe? Topical and oral vitamin D are safe at recommended doses. The recommended daily dose of oral vitamin D is 600 IU up to age 70 and 800 IU if you’re over 70.
Higher doses could cause side effects like nausea and vomiting, weight loss, constipation, abnormal heart rhythm, or kidney stones caused by high amounts of calcium from too much vitamin D.
Folic Acid
Folic acid is also known as folate or vitamin B9. Folic acid helps your body make red blood cells and helps all of your cells function in a healthy way. Natural food sources of folic acid include dark, leafy greens, beans, and oranges. You can also get it in supplements or enriched foods like cereal.
Why it may work: People with psoriasis often have high levels of a protein called homocysteine in their blood, and this may be due to low levels of folic acid in their diet. High homocysteine has been linked to inflammation in psoriasis.
Does it work? Some experts believe that folic acid supplements can improve moderate to severe psoriasis in people who also have low homocysteine. There’s not much evidence that this is true.
In some small studies, people who add a daily folic acid supplement to their medications reduced the severity of psoriasis. But in other studies, folic acid didn’t help.
One study from 2010 found that people with chronic psoriasis who took 15 milligrams of a daily folic acid supplement called folinate calcium had improved symptoms and no side effects.
In another study from 2014, some people who took a 5 milligram daily folic acid supplement along with adalimumab (Humira) had improved psoriasis symptoms, but others had a disease flare after they added folic acid.
Some people take folic acid supplements to help manage the side effects of methotrexate, but there’s evidence that this can make methotrexate less effective for your psoriasis.
Is it safe? Folic acid is generally safe at recommended doses. Take a daily multivitamin to get folic acid along with other B vitamins you need. Don’t take a folic acid supplement along with your psoriasis meds unless your dermatologist tells you to do so. It can interact with many other medications.
Selenium
Selenium is a trace mineral and nutrient. Your body needs a small amount of selenium from food or supplements to stay healthy, or about 55 micrograms per day for adults.
Why it may work: People with psoriasis may have low levels of selenium. Selenium is believed to help reduce inflammation and calm the immune system in people with psoriasis.
Does it work? In one study from 2009, 58 people with severe psoriasis took a combination of selenium, coenzyme Q10, and vitamin E supplements each day for 30-35 days. They had some improvements in their skin compared to people who took a placebo.
In another study from 2006, 37 people with psoriasis took 200 micrograms of daily selenium and had UVB light therapy five times a week for 4 weeks. Selenium supplements didn’t reduce their inflammation.
Is it safe? Selenium is safe. Side effects are rare unless you take more than 400 micrograms per day. If you take more than the recommended dose, selenium can cause hair loss, bad breath, nausea, diarrhea, brittle nails, rashes, fatigue, irritable mood, or tender muscles.
Shark Cartilage
Shark cartilage is a supplement made from the skeletons of sharks. It contains minerals like calcium and phosphorus.
Shark cartilage may be kind of smelly and have a bad taste. It comes in oral capsules or powders.
Why it may work: Shark cartilage is believed to slow the growth of blood vessels that feed psoriasis lesions, so they heal. Some people also believe it makes your immune system healthier.
Does it work? There is little evidence that shark cartilage is effective for psoriasis or any other health condition.
In a new study of oral shark cartilage extract called AE-941 (Neovastat), 49 people with psoriasis took the pills for 12 weeks. Up to half the people who took higher doses of AE-941 had improved symptoms like less itching. People who took lower doses of shark cartilage had no positive effects.
Some people in the study had mild side effects like nausea, diarrhea, constipation, and passing gas.
Is it safe? Shark cartilage can interact with your other psoriasis drugs like immunosuppressants. Shark cartilage may also make your immune system too active and make your psoriasis symptoms worse.