Inflammatory lesions and interleukin-1β levels in patients with moderate to severe acne vulgaris were reduced significantly with topical vitamin D, according to a recent study. 

In the double-blind, randomized controlled trial, published in Clinical, Cosmetic and Investigational Dermatology, researchers evaluated the efficacy of topical vitamin D in reducing inflammatory lesions in patients with acne vulgaris (AV). Sixty-four participants with moderate to severe AV were randomized into two groups: one receiving topical vitamin D (cholecalciferol 50 mcg) and the other placebo. Both groups also received topical adapalene 0.1% as standard therapy. The intervention spanned 8 weeks, during which interleukin (IL)-1β levels in acne lesions and the number of inflammatory AV lesions were assessed. Inflammatory acne vulgaris lesions were evaluated at the start of the study (week 0) and then tracked at weeks 1, 2, 4, 6, and 8. 

Cytokine levels in acne lesions were measured using Luminex Polystyrene Screening Assays to detect and quantify IL-1β. Acne severity was evaluated by a dermatologist following Lehmann’s Grading System, which is based on standards from the Global Alliance, the Indonesian Acne Expert Meeting, and the Indonesian Association of Dermatology and Venereology Specialists. This grading system classifies acne vulgaris into mild, moderate, and severe categories, considering the type and number of lesions, with attention to both inflammatory and noninflammatory types. Mild AV includes < 20 comedones, < 15 inflammatory lesions, or a total count of < 30 lesions; moderate AV consists of 20 to 100 comedones, 15 to 50 inflammatory lesions, or a total lesion count between 30 to 125; and severe AV is characterized by > 100 comedones, > 50 inflammatory lesions, a total lesion count exceeding 125, or more than 5 nodules. 

The results of the study demonstrated a significant correlation between decreased IL-1β levels in acne lesions and a reduction in the severity of inflammatory AV lesions (P = .028). The vitamin D-treated group exhibited a greater reduction in inflammatory lesions compared with the placebo group (P = .045). The reduction in inflammatory lesions with topical vitamin D was observed in combination with standard therapy using adapalene. 

Adverse events were reported by 43.75% of the participants in both the vitamin D and placebo groups; however, there were no statistically significant differences in the type or frequency of side effects between the groups, and none of these events were considered serious. The most common adverse effects included skin irritation, a burning sensation, and itching following the administration of the medication.

The researchers concluded that topical vitamin D was associated with a reduction in proinflammatory cytokine levels and the severity of inflammatory acne lesions.  

Additional studies are required to investigate the use of oral and topical vitamin D together, or topical vitamin D alone, to gain a clearer understanding of its mechanism of action in reducing acne severity. 

Full disclosures can be found in the published study.