Nutritional supplements are becoming increasingly popular among patients as an attempt to improve baseline health. Patients are also more frequently inquiring about supplements to treat chronic conditions, including psoriasis.
To determine the available body of evidence on supplement use to treat psoriasis, Jillian W. Millsop, MD, of the University of California, San Francisco, and colleagues conducted a MEDLINE literature review in June 2013.
The primary outcome evaluated was a statistically significant reduction in Psoriasis Area and Severity Index (PASI) score and secondary outcomes were other reported clinical measures of improvement, according to the review published in the Journal of the American Academy of Dermatology.
The investigators reviewed data on some of the most common nutritional supplements including oral vitamin D, vitamin B12, selenium, and omega-3 fatty acids.
The search revealed that although there is a significant amount of patient interest, “synthesized evidence-based information regarding the role of nutritional supplementation in psoriasis is lacking,” wrote Millsop and colleagues.
Fish oil showed the highest evidence of benefit in randomized, controlled trials. Several studies suggested that omega-3 fatty acids may be beneficial as monotherapy or in combination with other therapeutic regimens.
Oral vitamin D showed promise in open-label studies. However, additional controlled trials are needed on the effects of vitamin D on psoriasis. There was little evidence of any clinical benefit for selenium or B12 supplementation, according to the study findings.
“Given high popular interest, clinicians should familiarize themselves with the efficacy and safety of nutritional supplements in psoriasis to assist their patients in making informed decisions,” the researchers concluded.
There were several limitations to this review: 1) Not all of the studies were controlled or randomized; 2) not all studies included a primary outcome of PASI score improvement; 3) there was significant variability in the populations studied in terms of their psoriasis severity and concurrent therapies.