Psoriasis

Psoriasis

I first developed something a dermatologist diagnosed as lichen planus, a type of psoriasis, about 20 years ago. Rather symmetrical patches of itchy scales began appearing on both of my legs. Then similar small patches appeared on both arms.

Although my doctor was quick to come up with a diagnosis, he had no idea what had caused what he said was psoriasis or how to cure it. He gave me salves, steroids and vitamins, but nothing seemed to work. I would have tried sunlight, a standard treatment for psoriasis, and a natural one, but it was winter, and there just wasn't much sun. I nearly scratched my skin to the bone.

Then a funny thing happened. When I left the intemperate climate of Maryland for the tropical climate of Ecuador, my "psoriasis" cleared up. Now I'm convinced that the doctor was wrong. I don't think I had psoriasis, just dry skin. We heat our house with oil-fired, hot-water radiators. They produce a dry heat that apparently parched my skin to the point where my symptoms appeared. Every year, a week or two after the first frost, when we start heating the house, my skin acts up by getting dry, itchy and flaky. For me, the best treatment is a trip to the humid tropics, one of many reasons that I love the Amazon. But my skin condition has certainly piqued my interest in psoriasis.

It also leads to the first lesson here: Doctors don't know all that much about treating psoriasis, and sometimes they're wrong when they diagnose it. It makes good sense to investigate gentle herbal approaches before submitting yourself to harsher medical treatments that don't always do the trick anyway.

Skin That Misbehaves

Psoriasis causes red, scaly patches of varying sizes, usually on the scalp and lower back and over the elbows, knees and knuckles. On the toenails and fingernails, it causes pitting and brownish discoloration, and sometimes it causes the nail to lift and crack.

Typically, the rash first appears in teenagers and young adults. It may continue throughout the person's life, increasing and decreasing in severity, often for no apparent reason. Psoriasis leaves no scars and usually itches only when it appears in body creases. In severe cases, it may cause scales, cracks and blisters on the palms of the hands and the soles of the feet. Psoriasis may also cause a rash on the genitals, profuse shedding of dead skin flakes and even (although rarely) arthritis involving the spine and large joints.

Psoriasis afflicts an estimated 2 to 4 percent of Americans, with whites accounting for the overwhelming majority of cases. The condition is a medical mystery. It's not caused by an infection or allergic reaction, nor does it appear to be caused by stress, foods or vitamin or mineral deficiencies. It may be an autoimmune condition, meaning that the immune system attacks the body. It's not contagious.

We also know that psoriasis isn't hereditary, yet for some unknown reason it sometimes shows up in several family members. Illnesses, scrapes and bruises and emotional upsets can make it worse.

Psoriasis somehow interferes with the normal growth and replacement cycle of skin cells. Normally, the body replaces skin cells every 28 days or so. Psoriasis speeds up this process to five to ten times the normal rate, which causes the buildup of scaly patches.

As I've mentioned, sunlight often helps get rid of the patches. Many of us now avoid sunbathing because we know that sun exposure contributes to rising rates of malignant melanoma skin cancer. For people with psoriasis, however, the benefits of sunlight could outweigh the risks. When the weather or the season doesn't allow sunbathing, sunlamps are an alternative.

For mild cases, doctors may recommend over-the-counter 0.5 percent hydrocortisone creams, and stronger prescriptions are also available. The newest treatment for psoriasis, PUVA, involves a combination of exposure to UVA, one type of ultraviolet light, and taking compounds known as psoralens. Psoralens are found in plants and also show up in certain pharmaceuticals. Because PUVA has potentially serious side effects, it should be administered only by a psoriasis specialist.

Green Pharmacy for Psoriasis

Fortunately, there are also a number of herbs that can sometimes provide significant relief.

Bishop's weed (Ammi visnaga). The "new" PUVA treatment is actually thousands of years old. The ancient Egyptians and Indians rubbed red, scaly skin patches (presumably psoriasis) with plants containing psoralens and then had people sit in the sun.

Bishop's weed contains a good deal of one of these psoralens (methoxy-
psoralen), so its reputation as a psoriasis treatment makes sense. The latest studies have shed light on why psoralen treatment works. These compounds inhibit cell division, slowing down the fast-dividing skin cells that cause psoriasis patches. If you have access to the fresh herb, you might want to give this ancient treatment a try. Do be cautious, however; if this treatment seems to irritate your skin, discontinue use. (High doses of psoralens can be carcinogenic.)

Red pepper (Capsicum, various species). Thanks to an article in Prevention magazine, I have also found one herbal treatment that seems to help both dry skin and psoriasis--hot pepper, specifically one of the many creams
containing 0.025 percent capsaicin. Capsaicin is the compound that makes hot -peppers hot. Capsaicin creams such as Zostrix and Capzasin-P are sold as pain relievers, and they work.

In one study, 98 people with psoriasis used a capsaicin cream, while 99 others treated their skin patches with an inactive cream (a placebo). The
capsaicin group successfully reduced both scaling and redness, although the hot-pepper cream caused some burning, stinging and itching.

If you use a capsaicin cream, be sure to wash your hands thoroughly
afterward so that you won't get it in your eyes. And, of course, if you ultimately get further irritation rather than relief from the cream, don't use it again.

Angelica (Angelica archangelica) and other herbs containing psoralens. Many plants contain psoralens. To get a natural version of a commonly prescribed treatment for psoriasis, take any herb or herbs containing psoralens, then spend a little time in the sunlight, which of course supplies ultraviolet light. Food plants that contain psoralens include some of my favorites, such as angelica, carrots, celery, citrus fruits, figs, fennel and parsnips.

Here's a pleasant treatment to try: Pick a sunny afternoon and mix up some of my Psoriaphobic Citrus Juice: Simply toss a mixture of citrus fruits (with a bit of peel), a carrot and a celery stalk into your juicer. Or perhaps you'd rather cook up my Psoralen Soup by adding carrots, celery, parsnips and fennel to your favorite vegetable soup recipe. Remember to go out into the sunlight or get under a sunlamp immediately after eating it. But be very careful if you decide to try herbs that contain psoralens, as large doses of these compounds can be carcinogenic. And if you notice any irritation, stop using the therapy.

Avocado (Persea americana). Folk healers have long recommended rubbing mashed avocado on psoriasis patches. It's certainly cool and soothing. If I had psoriasis, I'd take a piece of the inner peel with a little green pulp adhering to it and rub it on my scaly patches.

Brazil nut (Bertholettia excelsa). These nuts contain an oil rich in vitamin E and selenium. In the Amazon, people use this oil to treat skin conditions, and some skin creams available in the United States contain vitamin E.

Curious about its effects, for a couple of weeks I applied the oil religiously every night before retiring. Like any emollient oil, it soothed and curbed the itching. Brazil nut oil can be purchased at health food stores and seems to be worth trying.

Camomile (Matricaria recutita). Camomile preparations are widely used in Europe to treat psoriasis, eczema and dry, flaky skin. Naturopathic physicians in this country maintain that applying this herb externally works better than commonly prescribed medications for treating psoriasis. Compounds known as flavonoids, which are found in camomile, have significant anti-inflammatory activity. You can buy commercial creams containing camomile at health food stores.

If you have hay fever, however, you should use camomile products cautiously. Camomile is a member of the ragweed family, and in some people, it might trigger allergic reactions. The first time you use it, watch your reaction. If it seems to help, you can continue to use it. But if it seems to make the itching worse, simply discontinue use.

Flax (Linum usitatissimum). Several plant oils are chemically
similar to fish oils, which have a reputation for helping to relieve psoriasis. Flaxseed oil, for one, contains the beneficial compounds eicosapentaenoic acid and alpha-linolenic acid. I've reviewed studies showing that 10 to 12 grams (five to six teaspoons) of these acids can help treat psoriasis. You won't want to sip this much flaxseed oil, but believing as I do that every little bit helps, I think that you might want to add some flaxseed oil to your salad dressings. (Flaxseed oil is very high in calories, however, so if you use this therapy, be sure to adjust the rest of your diet accordingly.)

Licorice (Glycyrrhiza glabra). Naturopaths consider external applications of licorice to be equal or superior to hydrocortisone cream for treating psoriasis. They note that the compound glycyrrhetenic acid (GA), which is found in licorice, works rather like hydrocortisone in treating psoriasis, eczema and allergic dermatitis. Other scientists have shown that hydrocortisone works considerably better when used in combination with GA.

If you'd like to give this herb a try, buy a licorice extract and apply it directly to the affected areas using a cotton ball or clean cloth.

Oat (Avena sativa). Oatmeal is a hallowed folk remedy for relief of itching. Some herbalists recommend using oatmeal-paste packs or oatmeal baths to treat psoriasis.

You can either scoop a few handfuls of oatmeal into a warm bath or put the oatmeal in a piece of cheesecloth and tie it up to prevent the sticky oatmeal from clogging the drain. This treatment relieved my granddaughter's itchy chicken pox, so I've seen first-hand how well it relieves itching.

Oregon grape (Mahonia aquifolium). All of the anti-psoriasis chemicals in Oregon grape, and there are several, are potent antioxidants. This means that they neutralize the highly reactive molecules known as free radicals that damage cells and play a role in inflammatory diseases like psoriasis. The same chemicals are also found in barberry, goldenseal, goldthread and yellowroot.

In one study, researchers showed that compounds in these herbs--Mahonia alkaloids--slowed the proliferation of certain skin cells. If I had a psoriasis flare-up, I'd plan to try the yellow barks of any of these plants. They can be taken as teas or tinctures or in capsules.

Purslane (Portulaca oleracea). Herb advocate Andrew Weil, M.D., professor at the University of Arizona College of Medicine in Tucson and author of Natural Health, Natural Medicine, recommends several nutrients for treating psoriasis, including vitamins A, C and E, plus the mineral selenium and alpha-linolenic acid. In my database, purslane is the best plant source of vitamins A, C and E. If you have access to fresh purslane, you can enjoy it steamed like spinach or use the young shoots in salads.

Fumitory (Fumaria, various species). This herb contains fumaric acid, a compound that seems to be useful for treating psoriasis. Brew a strong fumitory tea and apply it directly to the affected area with a cotton ball or clean cloth.

Lavender (Lavandula, various species). Aromatherapists suggest external application of lavender essential oil, followed by an almond oil cream. I'm not surprised, since aromatherapists use lavender for treating all manner of skin problems, including psoriasis. It's worth a try. But do not ingest the oil, as even a small amount can be toxic.

Milk thistle (Silybum marianum). Milk thistle has an active ingredient, silymarin, that's reportedly useful in relieving psoriasis. In fact, milk thistle seed contains at least eight anti-inflammatory compounds that may act on the skin. This herb is taken as a tea or tincture or in capsules.