Vitamin C for Psoriasis: Evidence-Based Assessment
Vitamin C is not recommended as a treatment for psoriasis based on current evidence from clinical guidelines and research studies. While various topical treatments and alternative therapies have been extensively studied for psoriasis management, vitamin C is notably absent from evidence-based recommendations.
Established Treatments for Psoriasis
Topical Therapies with Strong Evidence
- Topical corticosteroids are first-line agents for mild to moderate psoriasis, with high-potency agents showing greater efficacy than lower-potency options 1
- Vitamin D analogues (calcipotriene/calcipotriol) are effective first-line treatments for mild to moderate psoriasis with strong evidence supporting their use 1
- Combination therapy with vitamin D analogues and topical corticosteroids is more effective than either agent alone 1
- Tazarotene (topical retinoid) is recommended for 8-12 weeks for mild to moderate psoriasis 1
- Tacrolimus and pimecrolimus (calcineurin inhibitors) are effective for facial and intertriginous psoriasis 1
Treatment Approach by Body Region
- For facial and intertriginous areas: calcineurin inhibitors (tacrolimus 0.1% ointment) or low-potency steroids are recommended 1, 2
- For body plaques: vitamin D analogues alone or in combination with topical steroids 1, 2
- For scalp psoriasis: calcipotriene foam or calcipotriene plus betamethasone dipropionate gel for 4-12 weeks 1, 2
Alternative Medicine and Nutritional Supplements
- Fish oils (omega-3 fatty acids) have the highest evidence of benefit among nutritional supplements for psoriasis 3
- Other studied supplements include vitamin D (oral), vitamin B12, and selenium, but these require additional large randomized clinical trials to establish efficacy 3
- Vitamin C is not mentioned in any of the major clinical guidelines or research studies as an effective treatment for psoriasis 1
- Mediterranean diet, gluten-free diet, and vegetarian diets have been suggested by some authors to have positive effects on psoriasis course 4
Recommended Treatment Algorithm
Initial Approach
- For mild-moderate psoriasis: Begin with topical corticosteroids (potency based on location) combined with vitamin D analogues 1, 2
- For facial/intertriginous areas: Use tacrolimus 0.1% ointment or pimecrolimus 1% cream 1, 2
Maintenance Phase
- Long-term maintenance can include calcipotriene alone or calcipotriene on weekdays with topical steroid on weekends 2
- For facial and intertriginous areas, calcineurin inhibitors can be used for maintenance 2
Important Considerations and Precautions
- Maximum dosage limit for calcipotriene is 100g/week to avoid hypercalcemia 2
- Salicylic acid should not be used simultaneously with calcipotriene as the acidic pH inactivates calcipotriene 1, 2
- Topical steroid use should be gradually tapered to prevent rebound effects 2
Conclusion
Based on current clinical guidelines and research evidence, vitamin C is not recommended for the treatment of psoriasis. Patients seeking alternative or complementary approaches should consider evidence-based options like vitamin D analogues, topical corticosteroids, or fish oil supplements, and should discuss these options with their healthcare provider.