The role of oral vitamins and supplements in the management of atopic dermatitis: a systematic review

Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterized by disruption of epidermal barrier function and aberrant immune response to antigens. Current therapies focus on symptom management by restoring epidermal barrier function with emollients and reducing inflammation. Given the prevalence of "steroid phobia" and reported dissatisfaction with first-line therapies, oral vitamins and supplements have been proposed as promising complementary and alternative therapies. The purpose of this systematic review is to evaluate the evidence for various oral vitamins and supplements for the treatment of AD. A literature search was performed in February 2018 in MEDLINE, EMBASE, and Cochrane databases. Included studies were clinical trials and meta-analyses on the oral supplementation of vitamins and supplements for the treatment or prevention of AD. The search identified over 300 articles, of which 37 were included for review. Supplementation with vitamins E and D have the most robust evidence for AD symptom management. Probiotics may play a role in the prevention of infantile AD. Fatty acids such as docosahexaenoic acid, sea buckthorn oil, and hempseed oil also have preliminary evidence for use as supplements to decrease AD severity, but randomized controlled trials are needed. Vitamins and supplements may have a role in the management of AD, however, many of the studies reviewed are limited by small sample size. More studies are needed to better inform medical providers and patients about the role of these treatments in the management of AD.