When I was a kid, there used to be a magazine advertisement that began “Do you suffer the heartbreak of psoriasis?” I couldn’t understand the connection between a skin rash and a broken heart until I began actually treating people with this skin condition. Psoriasis, which affects about 6 million Americans, is indeed a frustrating disorder, for both patient and doctor. Although the exact cause is unknown, we do know that new skin cells reproduce and accumulate faster than they can be sloughed off. The condition can range in severity from a few small patches to large and unsightly thick plaques that appear just about anywhere on the body.
Conventional medicine, though it still regards psoriasis as incurable, provides much more help against the condition than it did in those “heartbreak” days. These treatments, which include steroid and vitamin D creams, immunosuppressive drugs, and PUVA (psoralen ointment with ultriviolet light therapy), are not without some risks, especially with long-term use.
The suggestions which have proven successful for us at WholeHealth Chicago can either be used by themselves or can be combined with any conventional treatments.
What is Psoriasis?
Psoriasis is a chronic skin condition whose main characteristic is raised red patches typically covered with silver or whitish skin flakes. This noncontagious disease usually strikes between the ages of 10 and 30, though people of any age can get it. The most common sites for psoriasis are the scalp, elbows, lower back, buttocks, and knees. Psoriasis can also affect the toenails and fingernails, leaving them yellowed and pitted. Psoriasis is not itchy or painful in most cases; for most the 6 million Americans who suffer from it, it’s more of a cosmetic problem. For about 15% of sufferers, the rash is so widespread and uncomfortable that performing daily activities becomes difficult. For a small minority, about 5%, psoriasis is accompanied by joint pain and swelling.
- Raised, red areas of skin covered with white flakes
- Yellowed, pitted or loose toenails or fingernails
- Blisters or cracked skin which can be painful in the worst cases
- Joint pain, swelling, and stiffness (psoriatic arthritis)
What Causes Psoriasis?
Psoriasis occurs when skin cells reproduce more quickly than usual. Normally, skin cells are created in the lower layers of the skin and take about 28 days to rise through to the surface, where they eventually are shed. For people with psoriasis, this life cycle of the skin cell lasts only eight days. New cells accumulate so quickly that they don’t have time to mature and cannot slough off. The skin then becomes red and inflamed, and overlapping patches of white, scaly skin develop.
Scientists have yet to explain why the skin cells’ life cycle speeds up and causes psoriasis. They do believe that the predisposition is genetic, since one in three sufferers have family members with the condition. They also know that psoriasis has a number of triggers, including behavioral factors such as alcohol and stress; environmental factors such as too much sun, cold temperatures and dry air; skin injury, sunburn, obesity, throat infection, and certain medications. Though many people believe that some foods cause psoriasis, this has never been proved.
Treatment and Prevention
Though medical doctors have no way to prevent psoriasis, psychologists may have some ideas. One study found that people who repressed their anger were more likely to develop psoriasis before age 40. Anger and stress may exacerbate the disease in people who already have it.
Researchers have also found that smokers are more likely to have the condition. Smokers with a 20-cigarette-a-day habit or more had twice the psoriasis risk of nonsmokers, with the risk for female smokers higher than for male smokers. As many as one in four cases of psoriasis may be smoking-related, according to researchers.
Nutrition experts have preventive approaches. Italian researchers found that people whose diets were high in carrots, tomatoes and fresh fruits–all of which contain ample antioxidants–were less likely to have psoriasis.
Conventional treatment for psoriasis depends on the type, location, and the severity of the condition. For local plaques of psoriasis, most dermatologists will begin with cortisone creams, although these tend to lose their effectiveness over time. Other topical treatments may include the old but reliable coal tar, anthralin, and a newer form of vitamin D (calcipotriene).
For more widespread disease, ultraviolet light therapy is combined with oral or topically applied psoralens (PUVA therapy), but long-term use has been associated with an increased risk of skin cancer. For severe and stubborn psoriasis, dermatologists may then resort to suppressing the immune system with methotrexate, an anticancer drug also used for rheumatoid arthritis, or a very high potency form of vitamin A called etretinate.
How Supplements Can Help
Taken daily, the supplements listed below may relieve psoriasis flare-ups. They may be used together. Results are usually apparent after about one month.
Omega-3 fatty acids, found in fish oil, are anti-inflammatories that work by blocking arachidonic acid, a natural body chemical that causes inflammation. People with psoriasis often have low levels of omega-3 fatty acids in their system. Take fish oil three times a day or flaxseed oil in the morning.
Grape seed extract is an antioxidant that blocks damage to many types of cells, including skin cells. Borage oil also has antioxidant benefits that help protect skin cells.
Vitamin A in high doses has been used by dermatologists for over 60 years for skin conditions associated with thickening of the uppermost layer (hyperkeratinization).
Zinc speeds healing when taken daily. People taking zinc for longer than a month should also take copper, because zinc prevents the efficient absorption of copper.
Milk thistle can be very useful for improving normal liver function, which is often beneficial for people with psoriasis. This herb also reduces leukotriene production in the white blood cells, which in turns helps slow the overactive reproductive cycle of psoriatic skin. Some nutritionally oriented physicians suggest combining milk thistle with the amino acid NAC (N-acetylcysteine), which has been shown to protect the liver during exposure to certain toxic chemicals.
Individualized homeopathic medicines prescribed by a health-care provider skilled in their use may be an effective way to decrease the severity of psoriasis flare-ups.
Cayenne pepper cream (capsaicin) is used by both conventional and alternative practitioners. Applied directly to lesions, it causes the body to block production of the inflammation-causing chemicals found within the psoriatic plaques. Because capsaicin can be highly irritating, it should probably be used only under a dermatologist’s supervision.
Expose psoriatic areas to the sun. Between 15 and 30 minutes of sun on the skin each day may help heal psoriasis. Results begin to show after three to six weeks. Protect areas that don’t have psoriasis against sunburn by using a strong sunscreen.
Try to minimize your exposure to chemicals in the home, including pesticides, solvents, oil-based paints and cleaning solutions.
Drink plenty of pure water. And try to avoid chlorine in water; be sure to shower after swimming in a chlorinated pool.
In winter, turn on the humidifier. Moist air may prevent lesions.
Use a moisturizer on lesions–and the rest of the body as well–to prevent dryness and itching. Aloe vera gel works well for many people.
Take a bath containing oatmeal, coal tar, or oils you find soothing. Keeping your skin well hydrated is a very important part of the treatment of psoriasis. A 15-minute soak in warm water is recommended.
Try an application of fumaric acid cream. It’s sold in health food stores, and it relieves pain and itching and reduces the size of psoriasis lesions. Apply three times daily during acute attacks.
Include fatty fish in your diet often. Among those that contain protective and healing oils are mackerel, sardines, tuna, salmon, and herring. For those who don’t like fish, fish oil capsules sold in the health food store are an alternative.
When to Call a Doctor
- If psoriasis does not improve with home treatments.
- If new areas of psoriasis form or if existing areas enlarge significantly.
- If the psoriasis spreads widely, whether or not it is accompanied by fatigue, fever, or joint pain.
From David Edelberg, M.D. at WholeHealth Chicago: The long-term use of conventional drugs for psoriasis has certain risks that you can discuss with your doctor. Since you’re dealing with a chronic condition and you’re using treatments that are decidedly imperfect, it’s reasonable to try the supplements we recommend at WholeHealth Chicago just to see if you can reduce the size of your lesions or prevent new flare-ups.
Be sure to start with a daily high-potency multiple vitamin and a potent antioxidant combination. All multivitamins contain vitamins A and D to help get your psoriasis program off to a good start, and we recommend including additional vitamin A as well. Multivitamins also contain B complex vitamins, which are especially important for healthy skin growth and repair. The antioxidant combination is important because low levels of antioxidants frequently are present among psoriasis patients.
All of the supplements in our list can combined with each other, and you can safely use them even if you’re already taking conventional medications. You’ll probably need to be on all the supplements for several months before you begin to see improvement.
How to Take the Supplements
Vitamin A is very important for maintaining healthy skin. When low levels of A were noted among psoriasis patients, nutritionally oriented doctors began routinely recommending extra amounts of this vitamin. High doses of vitamin A, however, are associated with birth defects, so if you are pregnant or considering pregnancy never take more than 5,000 IU a day.
Taking zinc helps promote the healing of irritated skin. (And interestingly, many people with psoriasis frequently have low levels of this essential mineral.) When you take zinc for longer than a month, add copper, since using zinc long term interferes with your body’s absorption of copper.
Psoriasis is an inflammation of the skin. The omega-3 essential fatty acids in fish oils and the omega-6 fatty acids in either evening primrose oil or borage oilcan provide real anti-inflammatory benefits. Grape seed extract and N-acetylcysteine (NAC) act as powerful antioxidants that may prevent further damage to skin cells.
Nutritionally oriented and naturopathic physicians believe that psoriasis can be aggravated by an accumulation of toxins in the body. They describe this condition as “sluggish liver.” The herb milk thistle helps your liver process and excrete these toxins. Interestingly, silymarin, the active component of milk thistle, has been shown to reduce the type of inflammation that contributes to psoriasis.
Applying cayenne pepper cream (capsaicin) to lesions can reduce the itching of psoriasis. Because the cream can burn or irritate, it’s best to let your dermatologist know you plan to use it. Be careful not to put cayenne cream on skin that is raw or open.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders, click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD