Natural treatments for psoriasis

  • DEFINITION: Treatment of a skin condition that leads to an intensely itchy rash with clearly defined borders and scales.
  • PRINCIPAL PROPOSED NATURAL TREATMENT: Oregon grape
  • OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, aloe vera cream, balneotherapy (spa therapy), capsaicin cream, cetylated fatty acids, fish oil, folate (to reduce side effects of methotrexate), fumaric acid, hypnotherapy, seal oil, vitamin A, vitamin D

Introduction

Many Americans have psoriasis, a skin condition that leads to an intensely itchy rash with clearly defined borders and scales that resemble silvery mica. The fingernails are also frequently involved, showing pitting or thickening.

Medical treatment for psoriasis includes applications of topical steroids and peeling agents that expose the underlying skin for the steroid to contact. Ultraviolet light can also be used. It is sometimes combined with coal tar applications or medications called psoralens. Synthetic relatives of vitamins A and D are also used.

Principal Proposed Natural Treatments

Oregon grape. Evidence from two double-blind, placebo-controlled trials and one comparative trial suggests that cream made from the herb Oregon grape (Mahonia) may help reduce symptoms of psoriasis, although it does not seem to be as effective as standard medications. In a double-blind study, two hundred people were given either a cream containing 10 percent Oregon grape extract or a placebo twice a day for three months. The results indicate that those using Oregon grape experienced greater benefits than those in the placebo group, and the difference was statistically significant. The treatment was well tolerated, although it caused a rash or a burning sensation in a few people.

Benefits were also seen in a double-blind, placebo-controlled study of eighty-two people with psoriasis. However, the study design had a significant flaw: The treatment salve was darker in color than the placebo, possibly allowing participants to guess which was which.

Another study found that dithranol, a conventional drug used to treat psoriasis symptoms, was more effective than Oregon grape. The authors failed to state whether this study was double-blind. Forty-nine participants applied one treatment to their left side and the other to their right for four weeks. Skin biopsies were then analyzed and compared with samples taken at the beginning of the study. The physicians evaluating changes in skin tissue were unaware of what treatments had been used on the samples. Greater improvements were seen in the dithranol group.

A large open study in which 443 participants with psoriasis used Oregon grape topically for twelve weeks found the herb to be helpful for 73.7 percent of the group. Without a placebo group, it is not possible to know whether Oregon grape was truly responsible for the improvement seen, but the trial does help to establish the herb’s safety and tolerability. Laboratory research suggests Oregon grape has some effects at the cellular level that might be helpful in psoriasis, such as slowing the rate of abnormal cell growth and reducing inflammation.

Other Proposed Natural Treatments

Aloe vera. Aloe vera cream may be helpful for psoriasis, according to a double-blind study performed in Pakistan that enrolled sixty men and women with mild to moderate symptoms of psoriasis. Participants were treated with either topical aloe vera extract (0.5 percent) or a placebo cream, applied three times daily for four weeks. Aloe treatment produced significantly better results than placebo, and these results were said to endure for almost one year after treatment was stopped. The study authors also reported a high level of complete “cure,” but what exactly they meant by this was not reported clearly. A follow-up study of forty people that attempted to replicate these results failed to find aloe more effective than the placebo.

Capsaicin. Capsaicin is the “hot” in cayenne pepper. Creams made from capsaicin are used to treat a number of pain-related conditions. Some evidence indicates that capsaicin cream may also be helpful for psoriasis. A double-blind, placebo-controlled trial of almost two hundred people found that the use of topical capsaicin can improve itching and the overall severity of psoriasis. Benefits were also seen in a smaller double-blind trial.

Fish oil. The evidence regarding fish oil’s effectiveness for psoriasis remains incomplete and contradictory. An eight-week double-blind study followed twenty-eight people with chronic psoriasis. One-half received ten capsules of fish oil daily, and one-half received a placebo. By the end of the study, researchers saw significant improvement in itching, redness, and scaling but not in the size of the psoriasis patches. However, another double-blind study followed 145 people with moderate to severe psoriasis for four months and found no benefit compared with placebo.

Other natural treatments. Based on preliminary evidence, shark cartilage and cetylated fatty acids have also been proposed for the treatment of psoriasis. Beta-carotene, barberry, burdock, chromium, cleavers, Coleus forskohlii, goldenseal, topical licorice cream, milk thistle, red clover, selenium, taurine, vitamin E, yellow dock, and zinc are also sometimes mentioned as possible treatments for psoriasis. However, there is no meaningful evidence that they work.

A somewhat toxic natural substance called fumaric acid is sometimes recommended for psoriasis. Vitamin A or special forms of vitamin D taken at high levels may improve symptoms, but these are dangerous treatments that should be used only under the supervision of a physician.

People using the drug methotrexate for psoriasis frequently develop nausea, mouth sores, and other side effects. Evidence indicates that taking folate supplements may help.

Seal oil has shown some promise for the treatment of psoriatic arthritis (a type of joint pain and inflammation that can occur in association with psoriasis). Another study found that hypnosis may improve psoriasis symptoms. Balneotherapy (spa therapy) might also have value. Although case reports suggest that acupuncture might be useful for psoriasis, a controlled trial failed to find acupuncture more effective than fake acupuncture. Another small study suggested that the Chinese herbal decoction Qinzhu Liangxue may be helpful in selected persons with psoriasis, though this finding is highly preliminary.

Other recommendations include oatmeal baths, Epsom salt baths, salicylic acid cleansers, cortisone, and hydrocortisone. Every person is likely to react differently to treatments.

Herbs and Supplements to Use with Caution

Various herbs and supplements may interact adversely with drugs used to treat psoriasis, so persons considering the use of herbs and supplements should first consult a physician.

Bibliography

Bernstein, S., et al. "Treatment of Mild to Moderate Psoriasis with Relieva, a Mahonia aquifolium Extract." American Journal of Therapeutics, vol. 13, no. 2, 2006, pp. 121-126.

Berry, Jennifer. “12 Home Remedies for Treating Psoriasis.” Medical News Today, 30 Nov. 2023, www.medicalnewstoday.com/articles/314525. Accessed 20 Nov. 2024.

"14 Natural and Home Remedies for Psoriasis." Cleveland Clinic, 17 June 2024, health.clevelandclinic.org/home-remedies-for-psoriasis. Accessed 20 Nov. 2024.

Gambichler, T., N. S. Tomi, and A. Kreuter. "Controlled Clinical Trials on Balneophototherapy in Psoriasis." British Journal of Dermatology, vol. 154, no. 4, 2006, pp. 802-803.

"Integrative Approaches to Care." National Psoriasis Foundation, 2020, www.psoriasis.org/integrative-approaches-to-care. Accessed 20 Nov. 2024.

“Psoriasis - Diagnosis and Treatment.” Mayo Clinic, 17 May 2024, www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845. Accessed 20 Nov. 2024.

Szpadel, Krzysztof, et al. "Promising Strategies in Plant-Derived Treatments of Psoriasis-Update of In Vitro, In Vivo, and Clinical Trials Studies." Molecules, vol. 27, no. 3, 2022, p. 591, doi.org/10.3390/molecules27030591. Accessed 20 Nov. 2024.

Watson, Kathryn. “Herbs for Psoriasis.” Healthline, 31 May 2024, www.healthline.com/health/psoriasis/herbs-for-psoriasis. Accessed 20 Nov. 2024.