"There are genetic contributions to psoriasis and it takes a long time to change a person's internal environment."
(MICHAEL TRAUB)
Q: How effective are alternative therapies for psoriasis versus conventional treatments?
A: Conventional medicines can be quite effective in terms of taking down the inflammation quickly, but they are not effective in achieving a long-term cure. Natural medicines sometimes don’t work as fast, but when they are combined with dietary and lifestyle changes, they can take a person who has moderate to severe psoriasis and get them to the point where they just have mild psoriasis or are psoriasis-free.
Q: What natural remedies have proven to be effective in treating psoriasis?
A: Fish oil works, as does an anti-inflammatory diet. Vitamin D has anti-inflammatory properties, and while it doesn't have a rapid effect with psoriasis, it is helpful long-term.
Q: Are there natural remedies that definitely don't work, even though people seem to think they will help?
A: A lot of people think that essential fatty acids are helpful for a variety of skin conditions. In the case of psoriasis, fish oil has been proven effective. Some people will want to use other types of oils like flaxseed oil or primrose oil. As far as I know, those have not shown any effectiveness. People need to understand that if they are going to supplement essential fatty acids, they should use fish oil and not cod liver oil or flaxseed oil.
Many natural remedies are recommended for psoriasis, but they have no proven effectiveness. Things like vitamin E—I haven't seen any evidence of its effectiveness, but a lot of people think of it as a natural medicine that is helpful for skin problems. Zinc is something that I haven't seen work. Psoriasis is an inflammatory disease and there are a lot of anti-inflammatory herbs and supplements, but that doesn't necessarily mean they are going to be helpful for psoriasis.
Q: Your research has shown that eating an anti-inflammatory diet helps alleviate psoriasis. But emphasizing whole grains, fruits, and vegetables is good advice for everyone, right?
A: Inflammation underlies a lot of health problems—from cancer to diabetes to migraines and arthritis. So it's basically a good diet for anybody. You might call it a whole-foods diet. But when you have an inflammatory condition, it's especially important to avoid fatty meats and fried foods, which promote inflammation. If you're eating them once a month, that's probably OK. But once a week is not.
Q: Should you stay away from processed foods and refined carbohydrates as well?
A: Yes. Carbohydrates and processed foods are usually full of sugar, and sugar certainly promotes inflammation in the body.
Q: You have also researched the effectiveness of spices in treating psoriasis. Which ones are the best?
A: Curcumin has probably been the most studied. It is the active ingredient in turmeric, which you find in curries. But any food that has a proven anti-inflammatory effect like garlic, onions, rosemary, ginger—those are all good for keeping outbreaks away.
Q: If you're not getting good fats through your diet, will supplements make up for that and help curb your psoriasis?
A: Yes. As long as you don't have too many inflammatory fats in the diet, the supplements can compensate.
Q: How can you tell the difference between a supplement that will work for psoriasis and a scam?
A: You have to look at the evidence, that these things have been tested in humans and proven to be effective. One of the problems we have with natural products is that regulation is only beginning to come around. There's still a huge problem with things being marketed and claims being made that are fraudulent or unsubstantiated.
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A: I would recommend that people buy supplements from health-food stores or naturopathic physicians or other integrated physicians that have them in their office so that the patient gets a higher quality product. I tell my patients they can purchase them through me or I'll give them the names of certain brands that they can look for in the natural-food store or online.
I think psoriasis is a tough condition to treat, and you really have to find a doctor who has more expertise than yourself, although some patients do become quite knowledgeable.
Q: What about topical treatments? What should you be looking for at your local drugstore or health store?
A: There's a cream made from an herb called Berberis aquifolium that is marketed under the name Psoriaflora, and it's been proven to be effective. That's available in most health-food stores. Aloe vera creams also work. Those are the two most common things you're going to find available. They're not very expensive, probably $10 to $15 for a tube or jar.
Overall it's really important to moisturize the skin, and the types of moisturizers and emollients you choose are important. If you're treating psoriasis, you're putting a lot of this stuff on your skin, so you want to use products that are free of harmful ingredients like parabens and other things that have been shown to pose health risks.
There is a new class of moisturizers that have a compound in them called ceramides, which help increase the water content of the skin and relieve dryness. Those have really shown effectiveness for psoriasis and I always recommend them. Some of them are over-the-counter and some are prescription.
Q: Are there any controversial natural topical treatments that you should avoid?
A: Most of them aren't available in health-food stores. But there might be some things online you should avoid. There is something called Skin-Cap that turned out to have a steroid in it, even though it was marketed as a nonprescription product.
You have to be extra careful online. You may think you're getting a deal, but you need to look at these products with a discerning eye.
Q: A lot of psoriatics have found relief through treatments at the Dead Sea and other types of climatotherapy. How does this work?
A: Ultraviolet light helps most people with psoriasis, so just being outdoors in the sun is definitely beneficial. Bathing in certain types of mineral baths or salt water can also be beneficial, but I'm not sure it's really been demonstrated how much of the effect is from the mineral or salt bath, compared to being outdoors. It's hard to separate the two unless you are bathing indoors in a dark room.
These types of treatments can be pretty expensive—but you can do it for free if you go to the ocean and expose yourself to the sunlight. Of course, in certain places, the sun is going to be more intense, depending how close you are to the equator. But whenever you expose your skin to the sun, you are taking the risk of causing skin to undergo mutations from the ultraviolet lights that may predispose you to skin cancer and aging, and it's something that people need to do judiciously and cautiously. The main thing is to not get overexposed and to not be in the sun to the point where your skin gets red. As long as you're careful, it can be done daily.
Q: Have meditation and acupuncture been proven to relieve psoriasis?
A: Meditation has; there was a 1998 study where they took a group of people and had them meditate while they were undergoing artificial ultraviolet light treatments. Their skin cleared four times faster than people who were not meditating but were getting the light treatments. Meditation and stress reduction are a very important part of natural treatment for psoriasis.
I really haven't studied the literature on acupuncture. I know that there is some evidence of the effectiveness of a Chinese herbal formula for psoriasis, but I'm not really sure how well psoriasis has responded to acupuncture treatment.
Q: Is artificial light as effective as natural UV light?
A: Both can be beneficial. Artificial light is a lot more controllable, but you can get overexposed doing that too. Usually the lights are intense and it's a shorter duration of time that you spend having the exposure, so it can be easier to control.
Q: What is the best piece of advice you have for patients looking for alternative treatments for psoriasis?
A: Work with a naturopathic physician who has knowledge of the condition and experience with it. If not a naturopathic doctor, definitely another integrative physician who can incorporate natural approaches into the treatment plan.
This is a condition that takes patience to get under long-lasting control without using some of the stronger medications from conventional medicine. You can’t look for a quick cure for it. There are genetic contributions to psoriasis and it takes a long time to change a person's internal environment so these genes don't get expressed so much. I think it's a condition that does respond well to natural medicine. With the combination of a knowledgeable physician and patience, you can achieve really good results.
