Evaluating the impact of high-dose vitamin D3, vitamin C, vitamin E, and zinc supplementation on inflammatory cytokines, lesion severity, and symptom management in hidradenitis suppurativa

Authors

  • Grace Herrick Alabama College of Osteopathic Medicine, Dothan, AL, USA
  • Sriya Kakarla UTHealth Houston McGovern Medical School, Houston, TX, USA
  • Kelly Frasier Department of Dermatology, Northwell Health, New Hyde Park, NY, USA
  • Mahnoor Mukarram Midwestern University Arizona College of Medicine, Glendale, AZ, USA
  • Evadne Rodriguez University of Missouri School of Medicine, Columbia, MO, USA
  • Milena Dragovic California Health Sciences University College of Osteopathic Medicine, Clovis, CA, USA
  • Julia Vinagolu-Baur Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
  • Hannah Welp Lincoln Memorial University, Debusk College of Osteopathic Medicine, Harrogate, TN, USA

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20250443

Keywords:

Integrative, Holistic review, Vitamins C and E

Abstract

This integrative, holistic review critically evaluates the impact of high-dose vitamin D3, vitamin C, vitamin E, and zinc supplementation on inflammatory cytokine levels, lesion severity, and symptom management in patients with hidradenitis suppurativa (HS). By integrating data from recent clinical trials and observational studies, we explore how these supplements influence key aspects of HS pathology. High-dose vitamin D3 has been shown to significantly reduce levels of inflammatory cytokines and decrease lesion severity, suggesting its role in modulating immune responses and improving disease outcomes. Similarly, the antioxidant properties of vitamins C and E are assessed for their ability to reduce oxidative stress and inflammation, which may lead to improved symptom management and reduced severity of HS lesions. Zinc supplementation, particularly in the form of zinc sulfate, is examined for its effects on enhancing skin barrier function and decreasing the frequency of disease flares. Collectively, these nutritional interventions may offer a multifaceted approach to HS management, highlighting the potential for combining these supplements to optimize therapeutic outcomes. The findings underscore the need for further research to determine the optimal dosing, duration, and interaction of these supplements with standard HS treatments to establish comprehensive management protocols.

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References

Marks JG. Lookingbill and marks’ principles of dermatology (sixth edition). Elsevier Masson. 2019. DOI: https://doi.org/10.1016/B978-0-323-43040-1.00003-8

Ingram JR. Hidradenitis suppurativa: Pathogenesis, clinical features, and diagnosis. 2023. Available at: https://www.uptodate.com/contents. Accessed on 12 November 2024.

Jafri A. Prevalence of hidradenitis suppurativa. JAMA Dermatol. https://jamanetwork.com/journals. Accessed on 23 November 2024.

Prens E, Deckers I. Pathophysiology of hidradenitis suppurativa: an update. J American Acad of Dermatol. 2015;73(5):8-11. DOI: https://doi.org/10.1016/j.jaad.2015.07.045

Campione E, Lanna C, Diluvio L, Cannizzaro MV, Grelli S, Galluzzo M, et al. Skin immunity and its dysregulation in atopic dermatitis, hidradenitis suppurativa and vitiligo. Cell Cycle. 2020;19(3):257-67. DOI: https://doi.org/10.1080/15384101.2019.1707455

Chu YL, Yu S. Hidradenitis suppurativa: an understanding of genetic factors and treatment. Biomedicines. 2024;12(2):338. DOI: https://doi.org/10.3390/biomedicines12020338

Traber MG, Stevens JF. Vitamins C and E: beneficial effects from a mechanistic perspective. Free radical biology and medicine. 2011;51(5):1000-13. DOI: https://doi.org/10.1016/j.freeradbiomed.2011.05.017

Weir SA, Roman B, Jiminez V, Burns M, Sanyi A, Elewski B, Mayo T. Hidradenitis Suppurativa and Five Key vitamins and minerals. Skin Appendage Disorders. 2023;9(3):153-9. DOI: https://doi.org/10.1159/000528122

Abdulhameed EA, Rani KA, AlGhalban FM, Abou Neel EA, Khalifa N, Khalil KA, et al. Managing oxidative stress using vitamin C to improve biocompatibility of polycaprolactone for bone regeneration in vitro. ACS omega. 2024;9(29):31776-88. DOI: https://doi.org/10.1021/acsomega.4c02858

Molinelli E, Brisigotti V, Campanati A, Sapigni C, Giacchetti A, Cota C, Offidani A. Efficacy of oral zinc and nicotinamide as maintenance therapy for mild/moderate hidradenitis suppurativa: a controlled retrospective clinical study. J American Acad Dermatol. 2020;83(2):665-7. DOI: https://doi.org/10.1016/j.jaad.2020.04.092

Lackner L, Zyriax BC, Stephan B. To what extent does vitamin d and its serum levels influence the severity of hidradenitis suppurativa: a literature review. Acta dermato-venereologica. 2024;104:40321. DOI: https://doi.org/10.2340/actadv.v104.40321

King S, Benghuzzi H, Moore LR, Tardy F. 25-Hydroxyvitamin D Deficiency, the Neglected Culprit: A Case Report. American Soc Clin Lab Sci. 2018;31(3):164-9. DOI: https://doi.org/10.29074/ascls.2018001214

Heldayani I, Hidayat W. Vitamin D deficiency as a risk factor of recalcitrant recurrent intraoral herpes (RIH). Dentino: Jurnal Kedokteran Gigi. 2023;8(2):193-8. DOI: https://doi.org/10.20527/dentino.v8i2.17541

Michelucci A, Janowska A, Granieri G, Margiotta FM, Morganti R, Romanelli M. Advanced wound management approaches in Hidradenitis Suppurativa postsurgical lesions. Health Sci Rep. 2023;6(10):1582. DOI: https://doi.org/10.1002/hsr2.1582

Bryce G, MacBeth N. Vitamin D deficiency as a suspected causative factor in the failure of an immediately placed dental implant: a case report. J Royal Naval Med Ser. 2014;100(3):328-32. DOI: https://doi.org/10.1136/jrnms-100-328

Shen AS, Johnson JS, Kerns ML. Dietary factors and hidradenitis suppurativa. Dermatol and Therapy. 2023;13(12):3007-17. DOI: https://doi.org/10.1007/s13555-023-01056-1

Razzaghi R, Pourbagheri H, Momen-Heravi M, Bahmani F, Shadi J, Soleimani Z, et al. The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. J Diab Comp. 2017;31(4):766-72. DOI: https://doi.org/10.1016/j.jdiacomp.2016.06.017

Siregar FD, Hidayat W. The role of vitamin D on the wound healing process: a case series. Int Med Case Reports J. 2023;31:227-32. DOI: https://doi.org/10.2147/IMCRJ.S402005

Ding J, Kwan P, Ma Z, Iwashina T, Wang J, Shankowsky HA, Tredget EE. Synergistic effect of vitamin D and low concentration of transforming growth factor beta 1, a potential role in dermal wound healing. Burns. 2016;42(6):1277-86. DOI: https://doi.org/10.1016/j.burns.2016.03.009

Smith K, Hewlings S. Correlation between vitamin D levels and hard-to-heal wounds: A systematic review. J Wound Care. 2020;29(7):24-30. DOI: https://doi.org/10.12968/jowc.2020.29.Sup7.S24

Wimalawansa SJ. Vitamin D deficiency: effects on oxidative stress, epigenetics, gene regulation, and aging. Biology. 2019;8(2):30. DOI: https://doi.org/10.3390/biology8020030

Montero-Vilchez T, Diaz-Calvillo P, Rodriguez-Pozo JA, Cuenca-Barrales C, Martinez-Lopez A, Arias-Santiago S, et al. The burden of hidradenitis suppurativa signs and symptoms in quality of life: systematic review and meta-analysis. Int J of Environ Res and Public Health. 2021;18(13):6709. DOI: https://doi.org/10.3390/ijerph18136709

Kimball AB, Kirby J, Ingram JR, Tran T, Pansar I, Ciaravino V, et al. Burden of hidradenitis suppurativa: a systematic literature review of patient reported outcomes. Dermatol and Ther. 2024;14(1):83-98. DOI: https://doi.org/10.1007/s13555-023-01085-w

Alavi A, Anand N, Yamanaka-Takaichi M, Piguet V, Simmers J, Machado M, et al. Evaluating the hidradenitis odor and drainage scale (HODS): A new validated potential instrument to assess odor and drainage in hidradenitis suppurativa—A cross-sectional study. JAAD Int. 2023;10:75-6. DOI: https://doi.org/10.1016/j.jdin.2022.11.003

Agarwal P, Lunge SB, Shetty NS, Karagaiah P, Daveluy S, Ortega-Loayza AG, et al. Itch in hidradenitis suppurativa/acne inversa: a systematic review. J Clin Med. 2022;11(13):3813. DOI: https://doi.org/10.3390/jcm11133813

Molina-Leyva A, Cuenca-Barrales C. Pruritus and malodour in patients with hidradenitis suppurativa: impact on quality of life and clinical features associated with symptom severity. Dermatol. 2020;236(1):59-65. DOI: https://doi.org/10.1159/000502139

Cuenca-Barrales C, Montero-Vilchez T, Krajewski PK, Szepietowski JC, Matusiak L, Arias-Santiago S, et al. Sexual dysfunction and quality of life in patients with hidradenitis suppurativa and their partners. Int J Env Res and Public Health. 2022;20(1):389. DOI: https://doi.org/10.3390/ijerph20010389

Poveda I, Vilarrasa E, Martorell A, García-Martínez FJ, Segura JM, Hispán P, et al. Serum zinc levels in hidradenitis suppurativa: A case–control study. American J Clin Dermatol. 2018;19:771-7. DOI: https://doi.org/10.1007/s40257-018-0374-5

Brocard A, Knol AC, Khammari A, Dréno B. Hidradenitis Suppurativa and Zinc: A New Therapeutic ApproachA Pilot Study. Dermatol. 2007;214(4):325-7. DOI: https://doi.org/10.1159/000100883

Hessam S, Sand M, Meier NM, Gambichler T, Scholl L, Bechara FG. Combination of oral zinc gluconate and topical triclosan: an anti-inflammatory treatment modality for initial hidradenitis suppurativa. J of Dermatol Sci. 2016;84(2):197-202. DOI: https://doi.org/10.1016/j.jdermsci.2016.08.010

Seetan K, Eldos B, Saraireh M, Omari R, Rubbai Y, Jayyusi A, et al. Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study. PLoS One. 2022;17(3):265672. DOI: https://doi.org/10.1371/journal.pone.0265672

Sánchez-Díaz M, Salvador-Rodríguez L, Montero-Vílchez T, Martínez-López A, Arias-Santiago S, Molina-Leyva A. Cumulative inflammation and HbA1c levels correlate with increased intima-media thickness in patients with severe hidradenitis suppurativa. J of Clin Med. 2021;10(22):5222. DOI: https://doi.org/10.3390/jcm10225222

Guillet A, Brocard A, Bach Ngohou K, Graveline N, Leloup AG, Ali D, et al. Verneuil's disease, innate immunity and vitamin D: a pilot study. J European Acad of Dermatol Ven. 2015 Jul;29(7):1347-53. DOI: https://doi.org/10.1111/jdv.12857

Pullar JM, Carr AC, Vissers M. The roles of vitamin C in skin health. Nutrients. 2017;9(8):866. DOI: https://doi.org/10.3390/nu9080866

Wang K, Jiang H, Li W, Qiang M, Dong T, Li H. Role of vitamin C in skin diseases. Frontiers in physiology. 2018;9:378515. DOI: https://doi.org/10.3389/fphys.2018.00819

Keen MA, Hassan I. Vitamin E in dermatology. Indian Dermatol J. 2016;7(4):311-5. DOI: https://doi.org/10.4103/2229-5178.185494

Pincemail J, Meziane S. On the potential role of the antioxidant couple vitamin E/selenium taken by the oral route in skin and hair health. Antioxidants. 2022;11(11):2270. DOI: https://doi.org/10.3390/antiox11112270

Liu X, Yang G, Luo M, Lan Q, Shi X, Deng H, et al. Serum vitamin E levels and chronic inflammatory skin diseases: A systematic review and meta-analysis. PLoS One. 2021;16(12):261259. DOI: https://doi.org/10.1371/journal.pone.0261259

Ammar M, Heni S, Tira MS, Khalij Y, Hamdouni H, Amor D, et al. Variability in response to vitamin D supplementation according to vitamin D metabolism related gene polymorphisms in healthy adults. Euro J Clin Nutr. 2023;77(2):189-94. DOI: https://doi.org/10.1038/s41430-022-01218-y

Asif A, Farooq N. Vitamin D Toxicity. In StatPearls. StatPearls Publishing. 2024.

Schoofs H, Schmit J, Rink L. Zinc toxicity: understanding the limits. Molecules. 2024;29(13):3130. DOI: https://doi.org/10.3390/molecules29133130

Abdullah M, Jamil RT, Attia FN. Vitamin C (ascorbic acid). StatPearls Publishing. 2023.

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Published

2025-02-24

How to Cite

Herrick, G., Kakarla, S., Frasier, K., Mukarram, M., Rodriguez, E., Dragovic, M., Vinagolu-Baur, J., & Welp, H. (2025). Evaluating the impact of high-dose vitamin D3, vitamin C, vitamin E, and zinc supplementation on inflammatory cytokines, lesion severity, and symptom management in hidradenitis suppurativa. International Journal of Research in Dermatology, 11(2), 199–207. https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20250443

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Review Articles