Psoriasis


Psoriasis is a chronic skin disease characterized by dry, scaly and inflamed elevated areas (papules and plaques) of various sizes. It affects up to 2% of all people in the United States.  Psoriasis often follows a pattern of relapse and remission.  It can vary from a few small patches to an almost complete covering of the skin.  Naturopathic physicians observe that incomplete protein digestion, poor liver function, bowel toxemia and increased blood endotoxin levels in the development of psoriasis (Murray and Pizzorno, 1991).  Due to similarities with eczema and seborrhea, natural medicine treatments are similar, but with slight variations.

TAM doctors have a clear understanding of psoriasis causation, postulating that there is a slow-acting poison trapped in the inner layers of the skin (dusivisa kustha), and that the causative factors are arteriole over-exudation and failure of venous drainage due to venous stasis (Bajracharya, 1988). TCM doctors attribute it to blood stasis, dryness or heat and damp.

The process of psoriasis is revealed in the dynamic interaction between the top layer of the skin (epidermis) and the dermal layer it contacts.  Blood vessels embedded in in the underlying dermal layer transport in blood cells that communicate with keratinocytes (cells) in the surface epidermis. Under ordinary circumstances, healthy blood would support healthy skin. In psoriasis, microscopic examination of the lesions shows dilated tortured vessels (Robbins, 1999), and the lesions contain elevated levels of mast cells and histamine (Krogstad et. al., 1997). The presence of these inflammatory toxins and exudates apparently alters the skin cells, and, as a result, they divide rapidly, causing the thick scaly lesions to form. The Ayurvedic literature also notes that insect bites can be triggers for psoriasis.

Upon closer examination, we find that the lesion formation is indirect in nature, caused by epidermal cell stimulation driven primarily by altered immune cells.  Researchers at Loyola University were able to induce full-fledged psoriasis in normal skin by injecting it with T-lymphocytes from psoriasis patients (Nickoloff and Wrone-Smith, 1999). In other words, altered (sick) immune cells signal the epidermal cells to multiply.  This may also explain why sunlight temporarily helps psoriasis, because UV light can alter the abnormal epidermal cells back toward normal (Gutierrez-Steil et al., 1998), but as long as the immune cells remain sick, the psoriasis will return in the absence of UV stimulation. This research seems to suport the Ayurvedic explanation that toxins trapped in the dermis are causative and must be cleaned out. Such toxins could cause the immune cell changes and inflammation noted by researchers. In any case, I have personally seen Ayurvedic treatments given in Nepal reduce severe psoriatic lesions in less than 2 months. I have achieved similar results in my clinic.

Utilizing the beneficial effects of sunlight, modern allopathic treatment uses UV light along with chemicals called psoralens (called PUVA treatment).  These chemicals can be found in herbs like bishop’s weed (Ammi visnaga) and vakuchi seeds (Psoralea corylifolia), herbs used historically by both TCM and TAM doctors for psoriasis.  In one Chinese study, intramuscular injections of a psoralea extract resulted in a 24% cure rate (reported by Bensky and Gamble, 1986).  Dr. Duke points out that ancient Egyptians and Indians rubbed their skin with plants containing psoralens and then sat in the sunlight to treat psoriasis (Duke, 1997).

Addition of the herb katuki (Picrorhiza kurroa) was reported to strengthen the activity and speed the effects of allopathic psoralens and sunlight treatment (Bedi KL et al.  1989).  Taking advantage of this, I have been able to duplicate this by mixing katuki and psoralea into a powder (4:1 concentrate) and give two grams twice per day to patients with both psoriasis and vitiligo, a skin disease characterized by spreading patches of discoloration.  This treatment must be combined with at least 20 minutes of daily exposure to sunlight or UV radiation.  Several times I have seen dramatic results within a few weeks. This is the first step in treatment, and it must be followed by blood cleansing to prevent recurrence. A professional herbalist should administer this treatament, as using too much of these herbs can induce photo-sensitization.

• Many of our long-term patients have benefited from detoxification, fasting, food allergy control and improvement of liver function with herbs like milk thistle seeds, burdock root, dandelion root and turmeric root.

• In 1974, an Indian Central Drug Research Institute screening of Indian medicinal plants identified a plant chemical called forskolin found in Coleus forskohlii. Coleus extract (available in pills standardized for forskolin content) has the ability to help with activation of the cell-regulating chemical cAMP in psoriasis patients (Ammon & Muller 1985). This is a very strong plant, and should be prescribed by a qualified practitioner.

• Ayurvedic doctors use blood-cleaning formulas, along with the standard formula called Kaishore Guggul.  Its main ingredients are guggul gum, guduchi stem, triphala and black pepper.

• In cases of increased inflammation, with itching and angry red patches, I recommend sarsaparilla, honeysuckle flower, boswellia gum, raw rehmannia root, neem leaf, red peony root and salvia root.

• In cases with signs of blood stasis, thick scales that do not subside, and mild itching, I recommend red peony root, salvia root, carthamus flower and turmeric root.  Topical application of diluted teatree oil can also be helpful.

• In cases of increased dryness, the lesions appear browner in color, with fur, itching and scaling.  I recommend raw rehmannia root, white peony root, dang gui root, tribulus fruit (bai ji li fruit or T. terrestris), astragalus root and licorice root.