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Psoriasis is a quite common condition and occurs in about 1-3% of the population. It affects men and women equally and is more common in temperate climates.
The term psoriasis is actually used to describe a number of conditions such as plaque, guttate, pustular, erythrodermic and light-sensitive psoriasis as well as psoriasis that appears in a number of body areas such as the palms and soles, the scalp, nails, elbows, knees, in skin folds and between the buttocks.
 

The areas affected generally start as deep red and scaly areas that merge, forming round or oval plaques. The scaly areas are silvery-white and when scratched or rubbed off can bleed—this is called the “Auspitz sign”. These plaques may or may not itch. The scales can get very dense, especially on the scalp. The most common areas for psoriasis are the elbows, knees, scalp, between the buttocks, and on the nails.

The cause (s) of psoriasis is/are not known, but it does run in families and there is both an inflammation and an immune aspect of psoriasis that is important to understand when talking about treatment. Another common aspect of psoriasis is the overgrowth of skin cells—psoriasis skin cells may have a rate of growth that is a thousand times faster than normal skin cells! Psoriasis can develop after a trauma to the skin such as sunburn, surgery or scratching and can be made worse with drugs such as lithium, steroids and beta-blockers (used in cardiovascular disease). People with psoriasis often suffer not only from the condition, but from emotional and psychological problems because of the way psoriasis makes them look and feel about themselves.

There are a number of lifestyle approaches that can be helpful for psoriasis. Thermal baths in water of high salt content followed by twice daily sun exposure of about 3 hours a day resulted in some very marked improvements in 73-88% of patients with psoriasis. The best results were obtained in spas and clinics using a very high salt content, similar to that found at the Dead Sea in Israel. The UVA content used was also higher in these Dead Sea studies. The high salt content seems to be very important in the successful treatment—it doesn’t necessarily have to be salt from the Dead Sea—but,  the bath DOES have to be about 33% salt as opposed to normal sea water which is about 3% salt.

Diet, as always, is very important for any condition.  In naturopathic medicine, skin is considered to be an organ of excretion—any toxins that you take in may be excreted through the skin—and may cause problems.  There is some evidence that removing gluten and dairy products can improve some people’s symptoms.  There is no specific diet that has been tested for psoriasis patients, but a healthy, whole foods diet with a minimum of processed foods or beverages is advisable.  You may, if you suspect specific food sensitivities, try an elimination diet to see if that helps your psoriasis—or helps you feel better overall!

Supplements to Help Treat Psoriasis

There are a number of supplements that have been used to treat psoriasis—though, what works for one person sometimes doesn’t work for another, so you may have to try a few different things.  As always, make sure you are working with a knowledgeable health professional who understands supplements and herbs.  For example, people with psoriasis should avoid St John’s wort because St John’s wort can make you light (and sun) sensitive. Some of these supplements have been useful as topical (on the skin surface) or taken as capsules or tablets.

  • Fish oil high in omega-3 fatty acids are potent anti-inflammatory agents. A number of studies have shown that people with psoriasis can benefit from taking up to 5.4 g of EPA and 3.6 g of DHA. Side effects were mild—mostly the fishy taste.  Fish oil has also been applied directly to the skin with an improvement of symptoms and appearance.
  • Neem oil comes from the neem tree (Azadirachta indica), which is an evergreen tree found primarily in India. The active ingredient in the bark is nimbidin, which has sugar-lowering, wound healing and anti-cell growth effects. Nimbidin is a more potent inhibitor of prostaglandin synthesis, and therefore a better anti-inflammatory agent than acetylsalicylic acid (aspirin).  The neem oil was taken orally.
  • Aloe vera has pain and itch-relieving, anti-allergic, wound-healing, and anti-inflammatory properties and has been used topically to treat the plaques of psoriasis.
  • Minerals such as zinc and selenium have been reported to be low in patients with psoriasis  and adding these minerals as supplements has shown some positive results.
  • Vitamin D has been studied and showed some slight improvements—but they were not considered significant.
  • Various herbs such as Oregon grape (barberry, Mahonia aquifolium), yarrow (Achilleae millefolium), garlic (Allium sativum), calendula (Calendula officinalis),  dandelion (Taraxacum), stinging nettles (Urtica urens/dioica) and common gypsyweed (Veronica officinalis) have been used topically with some success.

Sources & Links

  • 1. Knudsen E.A., Worm A.M.: Psoriasis treatment at the Dead Sea. Ugeskr Laeger 158. 6440-6443.1996
  • 2. Harari M., Shani J.: Demographic evaluation of successful antipsoriatic climatotherapy at the Dead Sea (Israel) DMZ Clinic. Int J Dermatol 36. 304-308.1997
  • 3. Gupta A.K., Ellis C.N., Tellner D.C., Anderson T.F., Voorhees J.J.: Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis. Br J Dermatol 120. 801-807.1989
  • 4. Escobar S.O., Achenbach R., Iannantuono R., Torem V.: Topical fish oil in psoriasis–a controlled and blind study. Clin Exp Dermatol 17. 159-162.1992
  • 5. Pandey S.S., Jha A.K., Kaur V.: Aqueous extract of neem leaves in treatment of psoriasis vulgaris. Indian J Dermatol Venereol Leprol 60. 63-67.1994
  • 6. Syed T.A., Ahmad S.A., Holt A.H., Ahmad S.A., Ahmad S.H., Afzal M.: Management of psoriasis with aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health 1. 505-509.1996.
  • 7. Paulsen E., Korsholm L., Brandrup F.: A double-blind, placebo-controlled study of a commercial aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol 19. 326-331.2005
  • 8. Smith N, Weymann A, Tausk FA, Gelfand JM., Complementary and alternative medicine for psoriasis: a qualitative review of the clinical trial literature. J Am Acad Dermatol - 01-NOV-2009, 61(5): 841-56
  • 9. Serwin A.B., Mysliwiec H., Hukalowicz K., Porebski P., Borawska M., Chodynicka B.: Soluble tumor necrosis factor-ɑ receptor type I during selenium supplementation in psoriasis patients. Nutrition 19. 847-850.2003
  • 10. Siddiqui M.A., Al-Kwawajah M.M.: Vitamin D3 and psoriasis: a randomized double-blind placebo-controlled study. J Dermatol Treat 1. 243-245.1990
  • Photo by shutterstock.com

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