Psoriasis is a common chronic inflammatory condition of the skin. Most often it manifests as round, red scales, sometimes with silvery plaques, and typically occurs on the scalp, extensor surfaces of the elbows and knees, the sacrum, buttocks, and
nails. It can be itchy and painful and concerning for cosmetic reasons.
What’s going on with psoriasis?
The lesions themselves are due to inflammation of the dermal and epidermal tissue and the hyperproliferation of keratinocytes: the skin becomes inflamed and there is a buildup of tissue at the outer layers. Keratinocytes constitute 95% of the epidermis and their function is both structural and immune-related; they serve similar immune functions in the lining of the mouth and esophagus, the eyes, and the genitals. It’s through a deeper systemic immune dysregulation (autoimmunity) that these cells misbehave. Suspected triggers include genetic factors, infection, trauma, and certain drugs.
In about 5-30% of cases, psoriatic arthritis develops and causes joint stiffness and pain. Also, with any autoimmune condition, the more the merrier. Expressing one autoimmune pathology makes one more likely to express others. “Autoimmune soup.”
Conventional treatment options
Psoriasis is routinely diagnosed by clinical observation. Skin biopsies are rare but may be helpful if the presentation is atypical. Once psoriasis is diagnosed or suspected, treatment options include:
- Topical treatment such as Vitamin D3 analogs, Tazarotene, emollients, Salicylic acid, coal tar, and Anthralin. Some are known to reduce keratinocyte proliferation while others simply soften and nourish the skin. Most are recommended in conjunction with other treatment.
- Phototherapy, specifically, UV light therapy may induce immunosuppression, though the mechanism in treating psoriasis is unknown.
- Immunosuppressants such as Methotrexate and Cyclosporine. These are able to fully halt psoriasis, though they’re not always effective and they require monitoring of blood levels, kidney, and liver function.
- Other systemic treatments such as systemic retinoids and immunomodulatory agents (biologics). These also are capable of clearing psoriasis, though they can have lasting side effects and may not be effective.
Topical corticosteroids are a first-line treatment for mild to moderately severe psoriasis. If these aren’t effective, if psoriasis returns, or if you’re keen to avoid steroids at all costs, it’s worth looking to Chinese medicine.
Treatment of psoriasis with traditional Chinese medicine
In China, where many hospitals offer conventional care alongside traditional Chinese medicine (TCM), TCM is the favored treatment for psoriasis. Diagnostic methods overlap with conventional medicine, considering the location of the lesions, their color, and quality. However, TCM arrives at a diagnosis which indicates a corresponding approach with acupuncture and herbal medicine, and which enables complete holistic healing of psoriasis.
Acupuncture is very helpful here and might clear a new onset of lesions, but it’s unlikely acupuncture alone is enough to treat moderate to severe cases. Herbal medicine carries most of the weight in TCM’s treatment of psoriasis. At All and One Acupuncture we stock herbal ingredients with high integrity, ensuring purity and safety, and good agricultural practices. Herbal medicine is safe and effective when prescribed appropriately. Options for consumption include:
- Herbal decoctions are the cheapest and most effective form of treatment. Raw herb material is soaked, boiled, boiled again, then the strained liquid is consumed. Decoction prescriptions are entirely customizable for an individual ’s needs and are easily changed. This method is recommended for severe or deep-rooted cases.
- Granules, tinctures, and pills are considerably less effective and more expensive than herbal decoctions. However, granules and tinctures are customizable. Raw herbs are processed with potato starch, cellulose, lactose, for example, and scoops of the granules dissolve in hot water to make a tea. This is a good option for mild to moderate cases, during travel, or when decoctions aren’t a reasonable option.
- Tinctures are typically the most expensive option and are only sometimes customizable. Raw herbs infuse an alcohol base, which rests until it ready, and can then be taken internally or applied topically.
- Topicals (washes, compresses, pastes, ointments, creams) can be helpful in conjunction with an
above formof internal herbal medicine.
During our lengthy new patient intake we gather a complete health history and piece together the reasons for immune dysfunction. It’s important to consider common triggering lifestyle and environmental factors, which include alcohol consumption, smoking, high stress, and an abundance of oily foods and pungent, warm spices in the diet (curry, chili, pepper, coriander, onion, garlic.) These items all fuel the inflammatory fire. Exercise and relaxation are recommended, and a diet full of fresh food and mild spices. Ah yes. Chinese medicine is a wealth of resources on balanced behavior and consumption, and we view this dialogue as an important component of treatment.
Every new patient at All and One Acupuncture receives a written treatment plan detailing our focus and goals, our tools, and our expected timeline of care. A typical treatment course for psoriasis will vary depending on the severity of the condition. It may resolve after 1-4 weekly acupuncture treatments, or it may require 6 months to a year of treatment with herbs. Psoriasis is one of the most difficult to treat skin diseases.
If we don’t start to see improvement within an expected treatment course, we’ll dig deeper to look at lifestyle and environmental factors that might not have come up in treatment conversation, and/or make an appropriate referral.
If you think you’re suffering from psoriasis, seek a diagnosis from a dermatologist. And we can help! To learn more about how Chinese medicine can support you, make an appointment or schedule a free consultation by calling All and One Acupuncture at (503) 281-6909, or book online.
All and One Acupuncturist Betsy Gordon, LAc specializes in the treatment of digestive, autoimmune, and dermatological conditions. She studies with a renowned clinician of Chinese medical dermatology, Mazin Al-Khafaji, and is interested in educating and presenting all possible tools to her patients.