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Discussion of an anti-itch therapy that mimics the anti-itch mechanismof UVB light.
Itch is a particularly distressing symptom for millions of patientssuffering from skin ailments. Severe, chronic itch can significantlyreduce the quality of life and scratching can cause skin damage and leadto infection. Limited advancements have been made in the past severaldecades in the treatment of itch, so patients are faced with the choiceof continuing to suffer, using palliative OTC products that offer onlyminor relief or and other expensive prescription treatments, such assteroid creams that can damage skin and become less effective over time.
A promising new treatment for itch has come to my attention. DermaViveInc, an Oregon company located near my practice has introduced a uniqueproduct, DermaVive Natural Itch Relief Cream. The product contains 0.1%Menthol, an FDA approved itch ingredient plus HPD3, High Potency VitaminD3. The founder of the company, Marilyn Strube, discovered the anti-itchproperty of HPD3 while suffering from a severe case of chickenpox. Sheused her background as a medical research biologist to determine themechanism of action. In doing so, she unraveled a medical mystery.Ultraviolet B (UVB) light therapy is highly effective at relieving itch,but researchers failed to understand why. A rich quantity of vitaminD3 is formed in skin during exposure to sunlight, but since vitamin D3formulations usually fail to relieve itch, vitamin D3 was notimplicated. Strube's research determined that to achieve ananti-pruritic (itch) effect in a topical treatment, a relatively highconcentration of vitamin D3 is required, along with a formulation thatpromotes sufficient absorption.
The company believes that HPD3 relieves itch in the same way thatultraviolet light therapy does. Ultraviolet light therapy and HPD3 mostlikely work by reducing elevated phosphate levels in itchy skin. Thefollowing is an excerpt from the company website detailing thepathophysiology involved.
"Vitamin D is formed in skin during exposure to sunlight. The sun'senergy, specifically ultraviolet (UV) light, causes vitamin D to beformed from its precursor, 7-dehydrocholesterol (3).
A study reported in the American Journal of Kidney Disease (2)demonstrated that the skin cells of patients suffering with severe itchcontained abnormally high concentrations of phosphate ions. Aftertreatment with ultraviolet light, the concentration of phosphate ionswas reduced to normal levels in 8 of 9 patients, along with acorresponding reduction in itch. Molecules made partially of phosphateions, such as magnesium phosphate, are usually dissolved in the fluidinside the skin cells. The study authors believed that at abnormallyhigh concentrations, these molecules precipitate, resulting inirritation of nerve endings manifested as itch. If the phosphate isreduced, the molecules dissolve back into solution with a resultingdecrease in itch. Because vitamin D is a principal and potent regulatorof phosphate metabolism (1) and because it is formed in the skin duringexposure to ultraviolet light, the authors speculated that vitamin D mayhave a role in the action of UV light treatment for itch.
The depletion of vitamin D may occur in skin damaged by disease, burns,wounds, viral infections and aging. A number of conditions have beenproven to be associated with both severe itch and vitamin depletion.These conditions include kidney failure, liver cirrhosis, chickenpox,HIV infection and aging (4,5,6). Replenishing the vitamin D topically isthe most direct, effective and natural method of reversing themechanisms that lead to itch."
The company is working to gather efficacy data in preparation for aclinical trial. I agreed to give product samples to 30-40 clinicpatients. I asked patients to test the product. Those I askedppatients were asked to evaluate the product and fill out aquestionnaire. Over 90% of the patients surveyed experienced similar orbetter relief compared to conventional OTC or prescription products.Surveys from two other clinics have yielded similar results.
I'm so impressed with the anti-itch effects of DermaVive Natural ItchRelief Cream, I wish to pass the information on to others who maybenefit from it. I have agreed to act as an independent medical advisorto the company, but otherwise have no affiliations with DermaVive Inc.
Product information and ordering are available at the company website atwww.dermavive.com.
References:
1. Cross H., Peterlik M. Effects of vitamin D and insulin on phosphatetransport in the differentiating chick small intestine. Calcium andPhosphate Transport. 1981. Pp. 293-296.
2. Blackley J., et. Al. Uremic pruritus: skin divalent ion content andresponse to ultraviolet phototherapy. Am J Kidney Dis, Vol V, No 5, May1985.
3. Martindale: The Extra Pharmacopoeia 30th ed. 1993
4. Campos F., Flores H., Underwood B. Effect of an infection on vitaminD status of children as measured by the relative dose response (RDR). AmJ Clin Nutr 1987:46:91-4.
5. Krawitt E., Grundman M., Mawer E. Absorption, hydroxylation, andexcretion of vitamin D3 in primary biliary cirrhosis. Lancet, 1977,1246-1249.
6. MacLaughlin J. and Holick M. Aging decreases the capacity of humanskin to produce vitamin D3. J. Clin. Invest. Vol. 76 Oct. 1985. 1536-38.
