Do pH-balanced, vitamin D products really impact skin's health?

Key Points

Q: Are pH-balanced skincare products better?

A relatively new concept in U.S. skincare is the idea that slightly acidic skincare products are better than neutral products in maintaining the acid mantle of the skin. Keeping the skin at a slightly acidic pH can minimize bacterial colonization of the skin by normal organisms, such as Staphylococcus epidermidis, and pathogenic organisms, such as Staphylococcus aureus. To accomplish this, products are formulated at a pH of 4. Some skin diseases are thought be triggered or worsened by bacterial colonization, and slight acidification of the skin may be beneficial.

Q: Can vitamin D in moisturizers enhance the serum vitamin D level?

A: One of the oldest skin balms is A&D Ointment, which is still available today. It is used for the treatment and prevention of diaper dermatitis and to moisturize severely dry skin. It contains vitamins A and D, but the vitamin D was not added to increase serum vitamin D levels, and it does not affect vitamin D levels in the skin or body.

The basis for A&D Ointment is petrolatum. It is an ointment without water, thus only oil-soluble vitamins could be placed in the formulation. The only oil-soluble inexpensive vitamins available at the time of its introduction were vitamins A and D. In this formulation, the vitamins function as low-level humectants to increase the water-holding capacity of the skin under the occlusive petrolatum. Despite its outdated formulation, this ointment remains popular in the marketplace.

Q: How can the appearance of ridged nails be improved?

A: Ridged nails are commonly found in men and woman over the age of 40. They are cells of the nail matrix that are no longer producing optimal nail. Each cell of the nail matrix manufacturers one section of the nail and, with growth, this abnormal section makes a longitudinal band. There are no known treatments for restoring aging nail matrix cells to health, nor are there effective dietary supplements. This means that the only treatment for longitudinal ridging is cosmetic intervention.

Longitudinal ridges can be removed by filing the surface of the nail to smooth the ridge. Usually, three files of successively decreasing grit are used. A coarse file is used to remove the ridge, followed by a smoothing file followed by a shining file. These files can be purchased for about $3 and used for around six months until dull. This is a worthwhile investment for many patients. It is highly effective for improving nail appearance, but it must be repeated with new nail growth.

Zoe Diana Draelos, M.D., is a Dermatology Times editorial adviser and consulting professor of dermatology, Duke University School of Medicine, Durham, N.C. Questions may be submitted via e-mail to zdraelos@northstate.net
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