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Skin SIGNS OF LOW VITAMIN D. Skin symptoms of low vitamin D. Vitamin D and skin problems. Skin disease and low vitamin D. #skincare #vitaminD #dermatologist

Well hey guys in this video i’m going to be talking about the skin signs of low vitamin d i’m going to be going into what it is that vitamin d does for our skin and how low levels may be implicated in certain skin issues skin is both a source of vitamin d as well as a target organ for the bioavailable forms of vitamin d vitamin d is a fat soluble vitamin there are

Two forms ergo calciferol which comes from plants like mushrooms and coal calciferol that you can get from animal foods like fatty fish for humans our skin is actually a major source of vitamin d seven dehydrocholesterol plus uvb rays from the sun lead to the production of pre-vitamin d3 which is converted to coal calciferol now it doesn’t matter if you’re getting

Vitamin d from the skin or from your diet it has to go to your liver and then it has to go to your kidney in order to be processed to the bioavailable form and these pathways that lead to vitamin d synthesis are all very tightly regulated by various factors such as vitamin d levels themselves parathyroid hormone fibroblast growth factor calcium and phosphorous levels

Vitamin d is critical for the health of our bones our musculoskeletal system children who are vitamin d deficient develop something called rickets and in older adults it can lead to brittle bones osteopenia and an increased risk of fractures to have poor vitamin d but the past decades we have learned of various extraskeletal functions of vitamin d it’s important

For regulating cell division differentiation cell death and it’s also really really important for the health of our immune system so what are the skin signs of low vitamin d truthfully there are none there is no specific skin rash manifestation skin finding that is a clue to vitamin d deficiency and the symptoms of vitamin d deficiency they’re not even specific

To vitamin d deficiency they include muscle weakness pain fatigue depression and anxiety so if you have any of those it is not it doesn’t mean that you’re vitamin d deficient so i felt compelled enough to sit down and make a video talking about vitamin d even though there are no specific skin findings of vitamin d insufficiency so why does it even matter for your

Skin we have learned that vitamin d plays a major role in the health of your skin it’s really important for the growth and differentiation of the main cell in your skin the keratinocyte your epidermis consists of several layers of skin cells keratinocytes in different phases of differentiation the final end result is what is called the stratum corneum where

You have those keratinocytes enmeshed in a proteinaceous lipid milieu that really functions to protect you from the outside world that’s what creates a barrier that whole differentiation cycle of the epidermis is really the end result of that is to form a barrier so we know that vitamin d is really important for the differentiation of those skin cells it’s also

Really important for those skin cells dying when you are exposed to uv rays it triggers a lot of dna damage and your skin cells should do your do you a favor and decide to commit suicide it’s called apoptosis programmed cell death otherwise if they didn’t it could lead to skin cancers down the road vitamin d is really important for that process as well and it’s

Really important for the control of what’s called innate immunity basically the first phase of the immune system kind of coming in in response to pathogens and environmental stressors that trigger dna damage vitamin d is important we have learned in in that process as well so having low levels of vitamin d and being vitamin d deficient it definitely can translate

To health problems including for your skin but to be clear there is no skin problem for which low levels of vitamin d are causative nor is there a skin problem for which taking a vitamin d supplement is curative so what skin conditions are more likely to be impacted by your vitamin d levels a skin condition called psoriasis psoriasis is a complex disease it’s not

Due to one particular thing it has to do with your genetics there is a genetic predisposition to developing psoriasis and it has to do with your immune system and what it is is actually a total systemic disease where you have high levels of inflammation you develop a specific type of rash but you can also develop a type of arthritis that can be very debilitating

And people who have psoriasis are at increased risk for a variety of other health effects namely cardiovascular disease obesity depression anxiety so it’s not just a skin problem it is a total body health issue there are multiple problems in psoriasis besides just the skin lesions themselves but if you have psoriasis you know firsthand of the skin lesions it can

Have a tremendous impact on your quality of life your emotional health so we started looking more into how vitamin d plays a role in psoriasis and honestly the studies they’re conflicting it’s really hard actually to to isolate vitamin d levels and correlate them with a disease outcome because there are a lot of different factors that go into your vitamin d levels

Where you live you know your what latitude you live at dictates your relative exposure to those uvb rays that contribute to the skin synthesis your diet body surface area your lifestyle people who are obese or overweight they tend to have lower vitamin d levels and that is thought possibly to be due to the fact that vitamin d is a fat soluble compound and perhaps

It is sequestered peripherally in fat stores leading to a lower plasma level of bioavailable vitamin d and people who are overweight or obese and i already mentioned that people who have psoriasis they have a greater likelihood of being overweight or obese possibly due to their genetics or just the underlying inflammation at the root of psoriasis makes them their

Hormonal profiles skewed to hold on to fat stores more readily making it more difficult to lose weight or maybe it has to do with the fact that they can develop a pretty debilitating arthritis that maybe limits their mobility probably multiple things now we have some studies that show an association between low levels of vitamin d and psoriasis we also have some

Studies that correlate inversely vitamin d levels with the severity of a psoriasis meaning the lower the vitamin d the more severe the psoriasis however we also have studies that contradict these findings so it it’s not clear at this point i know that’s an unsatisfactory answer but i’m not here to bs you interestingly enough though one of the treatments for

Psoriasis is a topical vitamin d analog we have a few of them for example calcipotrial can help clear up the psoriasis and whether or not that has to do with helping to control the proliferation of skin cells because psoriasis is actually a hyper proliferative skin disease where the those keratinocytes they’re dividing too rapidly and that’s why you get those

Thick scaly plaques in psoriasis so maybe a topical vitamin d helps with that or helps with the immune response and a treatment for psoriasis that works quite well for the skin problem for the skin lesions for clearing those up is actually narrow band uvb uvb is what comes from the sun along with other things like uva and visible light and infrared radiation but

You can just isolate the uvb rays and use it as a treatment for psoriasis uvb suppresses the immune system so that is one reason why it may help but another reason why it may help at least in the case of psoriasis possibly is due to maybe vitamin d synthesis in the skin from the uvb from the treatment so that may possibly underscore one of the reasons why that

Treatment is so particularly effective for psoriasis one of the main functions of your skin is acting as a barrier keeping irritating things out keeping pathogens out and keeping hydration in and water in you know when you lose the integrity of the skin you lose more water and if it’s impaired enough you can actually lose a lot of water and develop electrolyte

Abnormalities and become critically ill and when the barrier is impaired you’re more at risk for skin infections things getting in to the skin causing infections things like staph bacteria we have learned that vitamin d plays a major role in barrier function for the skin it’s really important for synthesis of the lipids in the skin as well as the protein milieu that

Those keratinocytes the cornea sites at the top dead layer are kind of enmeshed in when i think of barrier defect the hallmark skin disease that is due to a defect in the skin barrier is atopic dermatitis otherwise known as eczema where you can develop weepy oozy itchy rashes very easily it’s a chronic condition it comes and goes flaring with things like stress

The weather over bathing and we know that underlying atopic dermatitis is a defect in the skin barrier so vitamin d may import be important in that there are some studies that show that people who have atopic dermatitis do you have lower plasma levels of vitamin d in addition to its role in helping with the skin barrier for people with eczema another thing you

Can’t ignore is in immune regulation part of what underlies eczema in addition to the barrier defect is immune dysregulation and the immune profile is kind of skewed abnormally and it’s thought that vitamin d may help in in leveling things out and controlling that and giving a more normal immune response controlling that dysregulation that leads to up regulation

Otherwise of inflammatory mediators it’s that immune dysregulation that drives eczema flares and the symptoms of itch and people who have eczema so perhaps vitamin d may play a role there in lower latitudes there is an increased prevalence of atopic dermatitis speculate that perhaps it has to do with getting less uvb exposure for skin synthesis of vitamin d but

That also could reflect genetic differences and in some populations there’s more of a genetic risk for atopic dermatitis at those locations now it’s obvious from the research that is growing that vitamin d does play a major role in skin health how the barrier recovers and remains intact immune responses but we simply don’t have the data to show that vitamin d

Insufficient insufficiency or deficiency causes any skin disease nor is it curative for any skin disease now as dermatologists we treat not only the skin but we also treat the hair i do have a video on how hair loss may be due to low levels of vitamin d so don’t forget to check that out if you were dealing with hair loss vitamin d has been implicated in the health

Of the hair follicle and in some patients who have low levels of vitamin d and hair loss supplementing their vitamin d may help with their hair loss what is the best way to get vitamin d that is a difficult question to answer it probably varies from person to person depending on their genetics certain risk factors for low levels of vitamin d that maybe we haven’t

Quite figured out yet now you can get vitamin d from your diet fatty fish fortified foods mushrooms you can get it from supplements and your skin can help you out in synthesizing it using uvb rays from the sun so questions i always get are are you worried about vitamin d deficiency because you protect your skin from the sun no there is no safe level of uvb exposure

From the sun that you can get that will not simultaneously put you at risk for skin damage and skin cancer those same rays they also cause dna damage in our skin that can put us at risk for skin cancers so there’s no safe level of sun exposure that will raise your vitamin d levels while not simultaneously putting you at risk for skin cancer and sun exposure alone may

Not simply be enough to get many people to a good level of vitamin d anyway it likely has to do with not only body surface exposed latitude time of day genetics race pigmentation etc there are studies looking at populations that live in very sunny areas and they still have vitamin d insufficiency and deficiency honolulu for example 58 of people have low levels

Of vitamin d pretty darn sunny there they’re getting a good amount of sun exposure likewise a study done on women in santiago chile showed that 27 percent of premenopausal women had low levels of vitamin d despite sun exposure and 60 of postmenopausal women had vitamin d levels less than 20. what about all that sunscreen that you wear aren’t you worried that that

Is going to make you low in vitamin d no good news studies show that wearing sunscreen does not impact your skin’s ability to produce good vitamin d sunscreen helps protect our skin from those uv rays but it doesn’t block them out entirely and we have a recent study showing that on under maximal use conditions which almost nobody uses sunscreen on maximal use

Conditions as it’s meant to be used at two milligrams per centimeter square still allows for vitamin d synthesis to occur and in fact many argue that wearing a broad spectrum sunscreen that also protects you from those uva rays which are really harsh to the skin they damage collagen suppress the immune system and put you at risk for skin cancers many argue that

Wearing a broad spectrum sunscreen that protects against both uvb and uva may actually help your skin with the vitamin d synthesis why uva rays from the sun actually can compromise vitamin d synthesis and the skin rendering it inefficient and so having a sunscreen that blocks those may allow you know that little amount of uvb that gets in is it seems to be enough

And the uva protection may actually help your skin out in the long run i do not advocate getting seeking out unprotected sun exposure as a means to raise your vitamin d because as i said there’s no safe level of sun exposure that’s going to increase your vitamin d levels now i know i don’t advocate for sun avoidance that is a one of the most common misconceptions

Among many about me is that i promote that everybody stay indoors in a cave yeah i mean i don’t know if you watch my vlogs or not i’m always out and about i do not advocate sun avoidance but it is important to protect your skin from those uv uv rays that damage the collagen in your skin lead to immune suppression and ultimately those uva rays can compromise the

Ability of your skin to create good vitamin d and you can still get vitamin d synthesis from the sun when you’re wearing sunscreen in fact it may help you make vitamin d better in the skin so that is that is not something i have i don’t advocate total sun avoidance and staying indoors you cannot argue the health effects of you know being outdoors so i that’s not

Something that i have ever told anyone to do just stay inside all day in a cave but i don’t recommend unprotected sun exposure in an effort to raise your vitamin d levels of course i’m in no way saying that vitamin d is not important for human health but it is important to be mindful of the fact that some of what you hear about the increasing rates of low levels

Of vitamin d they can reflect a detection bias not only have we changed the threshold for vitamin d insufficiency but people are coming in in droves requesting vitamin d testing which actually is not recommended to just test vitamin d on otherwise healthy people but people come in requesting the test so more tests are being ordered more people are being labeled

Vitamin d insufficient and everyone’s freaking out but we don’t really have good evidence that vitamin d insufficiency leads to or is causative of many of these diseases for what you’re hearing about it may simply be guilty by association it may be that unhealthy people or people who are at risk for these things have lower levels of vitamin d as a marker of poor

Health we don’t have the full picture yet all right you guys so in summary vitamin d is critical for bone health yes the sun is a major source of vitamin d you can also get vitamin d from your diet and from supplements if necessary now vitamin d plays a major role in the health of the skin in terms of keratinocyte proliferation differentiation apoptosis it plays

A major role in immune regulation within the skin as well as throughout the body in general and it’s critical for barrier function in the skin which is one of the main reasons we have skin is to keep us protected from the outside world and to keep things in namely fluids and electrolytes so it is a very important ingredient in total body health now i hope this

Video was helpful to you guys on the end slate i’m going to put my video on vitamin d and hair loss so check that out if you missed it and in the description box i’ll link that video as well as my video on sunscreen and vitamin d so check those out but if you like this video give it a thumbs up share it with your friends and as always don’t forget sunscreen and

Subscribe i’ll talk to you guys tomorrow bye you

Transcribed from video