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  Article: A Promising New Therapy for Itch - by Dr. Charles B. Goldberg, MS., MD.  
  A Promising New Therapy for Itch By Dr. Charles B. Goldberg, MS, MD 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 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 and what the company calls “High Potency Vitamin D3 (HPD3)”. 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.” I agreed to give product samples to 30-40 clinic patients to test the product. Those patients 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.  

Brief bio Currently operating Sellwood Medical Clinic, a family practice in Portland OR I am a member of: • AAFP, American Academy of Family Physician • AAAI, American Academy of Allergy & Immunology • NAS, New York Academy of Science • AAS, American Academy of Science • OAFP, Oregon Academy of Family Physicians • NASEB, National Academy of Sciences and Experimental Biology, Several research publications in the fields of Immunology and Dermatology (The Lancet, Science, Proceedings of the Society of Science and Experimental Biology, et al) and Family Practice (American Journal of Family Practice), and others. Two year evaluation speaker re:generic vs. brand name Rx’s, and other speaking engagements.


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