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A Promising New Therapy for Itch
By
Dr. Charles B. Goldberg, MS, MD |
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Summary:
Discussion of an anti-itch therapy that mimics the anti-itch mechanism
of UVB light.
Itch is a particularly distressing symptom for millions of patients
suffering from skin ailments. Severe, chronic itch can significantly
reduce the quality of life and scratching can cause skin damage and lead
to infection. Limited advancements have been made in the past several
decades in the treatment of itch, so patients are faced with the choice
of continuing to suffer, using palliative OTC products that offer only
minor relief or and other expensive prescription treatments, such as
steroid creams that can damage skin and become less effective over time.
A promising new treatment for itch has come to my attention. DermaVive
Inc, an Oregon company located near my practice has introduced a unique
product, DermaVive Natural Itch Relief Cream. The product contains 0.1%
Menthol, an FDA approved itch ingredient plus HPD3, High Potency Vitamin
D3. The founder of the company, Marilyn Strube, discovered the anti-itch
property of HPD3 while suffering from a severe case of chickenpox. She
used her background as a medical research biologist to determine the
mechanism 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 vitamin
D3 is formed in skin during exposure to sunlight, but since vitamin D3
formulations usually fail to relieve itch, vitamin D3 was not
implicated. Strube's research determined that to achieve an
anti-pruritic (itch) effect in a topical treatment, a relatively high
concentration of vitamin D3 is required, along with a formulation that
promotes sufficient absorption.
The company believes that HPD3 relieves itch in the same way that
ultraviolet light therapy does. Ultraviolet light therapy and HPD3 most
likely work by reducing elevated phosphate levels in itchy skin. The
following is an excerpt from the company website detailing the
pathophysiology involved.
"Vitamin D is formed in skin during exposure to sunlight. The sun's
energy, specifically ultraviolet (UV) light, causes vitamin D to be
formed 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 itch
contained abnormally high concentrations of phosphate ions. After
treatment with ultraviolet light, the concentration of phosphate ions
was reduced to normal levels in 8 of 9 patients, along with a
corresponding reduction in itch. Molecules made partially of phosphate
ions, such as magnesium phosphate, are usually dissolved in the fluid
inside the skin cells. The study authors believed that at abnormally
high concentrations, these molecules precipitate, resulting in
irritation of nerve endings manifested as itch. If the phosphate is
reduced, the molecules dissolve back into solution with a resulting
decrease in itch. Because vitamin D is a principal and potent regulator
of phosphate metabolism (1) and because it is formed in the skin during
exposure to ultraviolet light, the authors speculated that vitamin D may
have 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 been
proven 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 is
the most direct, effective and natural method of reversing the
mechanisms that lead to itch."
The company is working to gather efficacy data in preparation for a
clinical trial. I agreed to give product samples to 30-40 clinic
patients. I asked patients to test the product. Those I asked
ppatients were asked to evaluate the product and fill out a
questionnaire. Over 90% of the patients surveyed experienced similar or
better 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 Itch
Relief Cream, I wish to pass the information on to others who may
benefit from it. I have agreed to act as an independent medical advisor
to the company, but otherwise have no affiliations with DermaVive Inc.
Product information and ordering are available at the company website at
www.dermavive.com.
References:
1. Cross H., Peterlik M. Effects of vitamin D and insulin on phosphate
transport in the differentiating chick small intestine. Calcium and
Phosphate Transport. 1981. Pp. 293-296.
2. Blackley J., et. Al. Uremic pruritus: skin divalent ion content and
response to ultraviolet phototherapy. Am J Kidney Dis, Vol V, No 5, May
1985.
3. Martindale: The Extra Pharmacopoeia 30th ed. 1993
4. Campos F., Flores H., Underwood B. Effect of an infection on vitamin
D status of children as measured by the relative dose response (RDR). Am
J Clin Nutr 1987:46:91-4.
5. Krawitt E., Grundman M., Mawer E. Absorption, hydroxylation, and
excretion of vitamin D3 in primary biliary cirrhosis. Lancet, 1977,
1246-1249.
6. MacLaughlin J. and Holick M. Aging decreases the capacity of human
skin to produce vitamin D3. J. Clin. Invest. Vol. 76 Oct. 1985. 1536-38.
Author's Bio
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