Psoriasis is a complex condition with no available cure through conventional care. Many individuals are dissatisfied with treatment options presented to them by their dermatologist, are unwilling to risk the potential side effects, or their condition is unchanged or worsens over the course of treatment. Many seek a safer, more natural treatment for psoriasis which can address the root cause of their symptoms.
This article presents a comprehensive summary of treatment options for plaque psoriasis.
Psoriasis is a common immune-mediated inflammatory skin condition affecting 1-4.5% of the population. Plaque psoriasis is most prevalent, but other subtypes include guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis.
Initially plaque psoriasis manifests with very small red spots which then grow and may become slightly raised. Silvery scales may form on the red spots and if the condition progresses, they will multiply and coalesce to form larger “plaques”. This may occur on the scalp, the extensor surfaces of the elbows and knees, the sacrum, the buttocks, genitals, behind or in the ears, and on the fingernails and toenails. It may be itchy or painful, scaly or weepy.
Emotionally, the appearance of psoriasis can be distressing. It can lead to shame, guilt, feelings of isolation, and personality changes.
What causes psoriasis, according to conventional medicine?
The psoriasis disease process is clear but the cause is not well-established.
Psoriasis lesions form due to a hyperproliferation of keratinocytes, an untamed inflammatory process which causes a build-up of tissue on the surface of the skin. This dysregulation is thought to be the result of an autoimmune process. Common suspected triggers include genetic factors, infection, trauma, and certain drugs.
In a minority of cases, psoriatic arthritis develops alongside psoriasis, causing systemic joint stiffness and pain.
How does conventional medicine treat psoriasis?
Most conventional treatments for psoriasis work by controlling the immune system.
- Topical steroid creams are the cornerstone and first-line treatment for psoriasis. They suppress the immune response by preventing the release of inflammatory chemicals locally. They are recommended for short-term, intermittent use, and in clinical studies they are well-tolerated when used correctly. Topical steroid creams do not resolve systemic immune dysfunction, but can be effective in mild to moderate cases when the immune system is able to rapidly stabilize itself. There are several common side effects with appropriate use, they are not always effective, and if overused, they can cause permanent damage to the skin.
- Phototherapy is able to slow the proliferation of keratinocytes; UVB has been shown to induce immunosuppression. It is relatively safe but has severe common side effects, and it increases the risk of skin cancer. Like topical steroid creams, phototherapy can be effective when the immune system is able to stabilize during the course of treatment. Otherwise, the systemic immune dysfunction is unchanged and psoriasis will return.
- Internal medications such as Methotrexate and Cyclosporine suppress the immune system. Methotrexate inhibits DNA synthesis and repair and general cellular replication. Cyclosporine inhibits the production and release of interleukin II, and inhibits interkeukin-II activation by immune cells.These medications are moderately effective in cases of moderate to severe psoriasis, but both present the risk of vast side effects and require careful monitoring of blood levels.
- Biologics are a relatively new class of drug derived from non-synthesized organic material. They are administered by routine injection, and each drug functions differently to control particular elements of immune response. Most control protein production as a way of reducing systemic inflammatory activity. They are appropriate for moderate to severe cases of psoriasis and psoriatic arthritis, with the risk of vast side effects.
What causes psoriasis, according to traditional Chinese medicine (TCM)?
Common psoriasis triggers include prolonged emotional stress, a period of illness or allergic reaction, a fatty or rich diet, or a depleted physical state. Just like conventional medicine, TCM recognizes a matrix of factors which cause disease. Our diet, lifestyle, and environmental and genetic factors all affect our health, and TCM considers the interplay of these factors in each individual’s pattern diagnosis.
A TCM dermatology practitioner will determine your individual pattern after closely examining your skin, and considering your health history, lifestyle, and emotional patterns.
How does holistic TCM dermatology treat psoriasis?
In China, where many hospitals offer conventional care alongside TCM, TCM is the favored treatment for psoriasis. This holistic approach includes acupuncture, herbal medicine, and nutrition and lifestyle prescriptions.
- Acupuncture. Through the application of hair-thin, sterile, single-use needles, acupuncture catalyzes the body’s own healing process. The complete mechanism of action of acupuncture is unknown but research demonstrates its wide-ranging effects on the inflammatory process, immune system, microcirculation, and regulation of hormones.
- Herbal medicine. Just like the food we eat and the pharmaceuticals and supplements we take, herbal therapy affects change in the body from the inside out. By incorporating herbal therapy into your treatment plan, you may experience improvements more quickly than with acupuncture alone. In chronic or severe cases, herbal therapy may be essential to a successful treatment plan, and in some cases, it may be effective on its own.
- Nutrition and lifestyle prescriptions. Chinese medicine is a wealth of resources on balanced behavior and consumption, and this dialogue is an important part of treatment. Supplementation with Omega-3, vitamin D, or prescriptive diet changes may be helpful.
Based on your unique pattern diagnosis, a TCM dermatology practitioner will recommend a treatment plan outlining goals, tools, and the expected timeline of care. No two treatment plans are alike because no two individuals with psoriasis are alike.
The length of time required for psoriasis to heal will vary depending on the severity of the condition. It may resolve after 1-4 weekly acupuncture treatments, or in the case of a longstanding chronic condition, it may require 6 months to one year of treatment with acupuncture and herbal medicine.
Psoriasis is one of the most difficult to treat skin diseases. If no improvement is seen within an expected time frame, it may be appropriate to look more closely at nutrition and lifestyle factors, or refer to another medical professional.
If you think you are suffering with psoriasis, seek a diagnosis from a dermatologist. To learn more about how holistic TCM dermatology can support you, schedule a free consultation by calling (971) 341-9546, or book online.
Betsy Gordon Acupuncture in Portland, OR specializes in holistic TCM dermatology and the treatment of digestive, allergic, and autoimmune conditions. She supports individuals across Oregon with stubborn, complex conditions. If you are located outside of Oregon, find a TCM dermatologist near you.