Vitamin E, including its mixed tocotrienol forms, is sometimes used as a complementary approach to managing psoriasis due to its antioxidant and anti-inflammatory properties. The scientific evidence supporting its use is limited but present, which is why it receives a rating of 2 out of 5. Several small clinical studies and case reports have evaluated the effects of Vitamin E (mainly tocopherol, with fewer studies specifically on tocotrienols) in psoriasis patients. Some studies suggest that topical or oral Vitamin E supplementation may lead to mild improvements in skin lesions and reductions in oxidative stress markers, which are implicated in psoriasis pathogenesis. For example, a few trials have demonstrated that Vitamin E, alone or in combination with other antioxidants, can modestly reduce Psoriasis Area Severity Index (PASI) scores. However, these studies are generally small, of short duration, and sometimes lack rigorous controls.

There is a plausible biological rationale, as oxidative stress and inflammation are central to psoriasis, and Vitamin E compounds act as potent lipid-soluble antioxidants. Tocotrienols, a less common form of Vitamin E compared to tocopherols, have shown stronger antioxidant activity in some laboratory studies, but clinical trials in psoriasis specifically using tocotrienols are scarce. Thus, while preliminary evidence and mechanistic reasoning suggest potential benefit, robust clinical validation is lacking. Larger, well-controlled trials are needed to confirm efficacy and safety before Vitamin E (especially mixed tocotrienols) can be recommended as a standard adjunct therapy for psoriasis.