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Acupuncture Today
June, 2004, Vol. 05, Issue 06
 
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How Do You Treat Psoriasis?

By Andrew Gaeddert, BA, AHG


This article was excerpted from Mr. Gaeddert's book, Healing Skin Disorders, published by North Atlantic Books.


Psoriasis is characterized by elevated, red and inflamed patches, which are often covered by silvery scales.

The patches are usually asymptomatic, except during flare-ups when itching and a burning sensation may be present. Psoriasis can be found anywhere on the body, though typically the knees, elbows and scalp are affected. The fingernails can show yellowing, with stippling and pitting of the nail bed. With psoriatic arthritis, there may be joint pain and stiffness. A skin biopsy may be performed to confirm a visual diagnosis. Medical attention should be sought immediately if psoriasis develops over a large portion of the body.

The biomedical cause of psoriasis appears to be an autoimmune phenomenon. Also, persons with psoriasis often have a family history for the disease. Flare-ups of psoriasis can be triggered by emotional stress, skin damage, cold weather, physical illness, or other factors. Medications such as lithium, quinidine, and those that treat high blood pressure and inflammation are also known to exacerbate psoriasis.

Biomedical treatment of psoriasis involves topical agents when the affected areas are limited to less than 20 percent of body surface. Such agents used include emollients, keratolytics, corticosteroids and coal tar, among others. Systemic and more aggressive treatment is used for psoriasis that covers more than 20 percent of the body surface. Such treatment involves phototherapy and medications like retinoids (acitretin), antimetabolites (methotrexate) and calcineurin inhibitors (cyclosporin). Sidee-ffects are often associated with long-term administration of all medications, whether topical or systemic. For example, corticosteroids often become ineffective and may exacerbate psoriasis by masking symptoms.

Psoriasis can be a debilitating disease physically and emotionally because of the unsightly blemishes. Therefore, complementary therapies such as acupuncture, meditation and yoga may be helpful. An elimination diet may cut to the root of the problem, since there appears to be anecdotal evidence that diet and nutrition are causal factors for psoriasis flare-ups.

Self-Treatments

  • Oatmeal baths: Use to soothe psoriatic areas (follow label directions).
  • Black currant oil (3,000 milligrams daily).
  • Pine tar soap (follow label directions).
  • Zinc and other antioxidant supplements with multi-mineral ingredients (follow label directions).
  • Smilax (sarsaparilla) (1/2 to 1 teaspoon three times a day; reduce dosage if diarrhea occurs).
  • Flaxseed oil (1 to 3 tablespoons daily) taken with vitamin E (400 to 800 IU daily), or fish oil concentrate (3 to 10 grams daily).

Professional Treatments

  • A skin formula, consisting of barbat skullcap (ban zhi lian); oldenlandia (bai hua she cao); gentiana (long dan cao); rehmannia root (sheng di huang); viola (zi hua di ding); siler (fang feng); lonicera (jin yin hua); lysimachia (jin qian cao); coptis root (huang lian); tang kuei (dang gui); bupleurum (chai hu); carthamus [safflower] (hong hua); senna leaf (fan xie ye); and rhubarb (da huang), taken at the rate of 2 to 3 tablets, three to four times daily.
    For heat signs, add 1 to 2 tablets of a heat formula, consisting of isatis extract (da qing ye and ban lan gen); oldenlandia (bai hua she she cao); lonicera (jin yin hua); prunella (xia ku cao); andrographis (chuan xin lian); laminaria (kun bu); viola; cordyceps (dong chong xia cao); and licorice (gan cao), three times a day.
    For dryness, add 2 to 3 tablets of a marrow formula made from citrus peel (chen pi [ju pi]); ligusticum (chuan xiong); red jujube dates (da zao); salvia root (dan shen); tang kuei; codonopsis (dang shen); gelatin (e jiao); lycium fruit (gou qi zi); sprouted oryza (gu ya); polygonum (he shou wu); astragalus root (huang qi); milettia (ji xue teng); lotus seed (lian zi); fresh rehmannia (sheng di huang); and cooked rehmannia (shu di huang) four times a day.
  • Three tablets of a mobility formula comprised of red peony (chi shao); tang kuei; ligusticum (chuan xiong); rehmannia; persica (tao ren); atractylodes (bai zhu); poria (fu ling); citrus; siler; vitex (man jing zi); gentiana; achyranthes (niu xi); chiang huo (qiang huo); clematis (wei ling xian); ginger (gan jiang); angelica (bai zhi); and licorice, taken three to four times per day, and used for swollen joints.
  • Zaocys tablets, made from zaocys (wu shao she); agkistrodon (bai hua she); cnidium fruit (she chuang zi); tribulus (bai ji li); cicada (chan tui); red peony; tang kuei; schizonepeta (jing jie); siler; dictamnus (bai xian pi); rehmannia; and licorice, taken at a dosage of 3 tablets, three to four times daily, for psoriatic arthritis.
  • A dragon's blood formula, made from dragon's blood (xue jie); tienchi root (san qi); catechu (er cha); corydalis (yan hu suo); carthamus (hong hua); myrrh (mo yao); frankincense (ru xiang); borneol (bing pian); alcohol; and glycerine, can be applied undiluted directly to affected areas one to three times daily. If the skin is too sensitive to use the formula undiluted, then dilute in a ratio of one part formula to three parts safflower or avocado oil, and apply to affected areas one to three times daily.
  • A dictamnus formula, consisting of dictamnus; siler; red peony; tribulus; moutan (mu dan pi); lophatherum (dan zhu ye); cooked rehmannia; arctium (niu bang zi); sophora (ku shen); phellodendron (huang bai); atractylodes (cang zhu); talc (hua shi); and licorice, taken at a dosage of 3 tablets, three to four times daily. Use for cases with more scaling and itching, and less redness and heat signs. If heat signs are more prominent, use the skin formula as above.

Case Studies

Case # 1

Steve, a 58-year-old professional, had psoriasis for over 20 years. His main symptoms were dry, reddish-purple lesions on his legs, arms, hands and body. The lesions were itchy whenever they flared up. He was about 20 pounds overweight, and he drank alcohol regularly. Traditional Chinese medicine diagnosis revealed that his pulse was wiry and irregular, and his tongue was purple. We suggested that Steve drink more water, consider going on a digestive clearing program, and try limiting his consumption of wheat-containing foods. We also recommended that he incorporate more fatty fish into his diet. He was asked to take the skin formula (2 tablets, three times a day), the mobility formula (3 tablets, three times a day), and a supplement high in EPA and DHA (3 capsules daily with meals) to control the inflammatory response.

After three weeks Steve reported that the lesions were less itchy and red. However, he felt agitated from following the digestive clearing diet and not having alcohol for one week. We noticed that he'd smoked a cigarette in the parking lot while waiting for his appointment. When we inquired, he said that for several months he had been trying to cut down to a few cigarettes per day, but that not drinking alcohol increased his cigarette cravings. His pulse was more wiry, and his tongue was dry and purple. We suggested he continue the herbs at the same dosage and increase the EPA/DHA to 6 capsules daily with meals. We also referred him to an acupuncturist to help ease the cigarette cravings and treat the neck pain he was also experiencing.

Steve returned in three weeks showing considerable improvement. The skin lesions started to shrink; they were mostly pink instead of reddish-purple, and less itchy. His pulse was less wiry than his previous visits, but his tongue was unchanged. The acupuncture treatments had helped him cut down to one cigarette a day, and had reduced his neck pain. He had abandoned the digestive clearing diet after two weeks, but had noticed a correlation between alcohol and wheat consumption and the itching. Although Steve was willing to eliminate bread from his diet, he did not want to eliminate alcohol entirely. We recommended that he continue on the skin formula (2 tablets, four times a day) and mobility formula (3 tablets, four times a day), and EPA/DHA (6 capsules per day).

After two months, all of Steve's symptoms were improving, so we adjusted his herbal protocol to 2 tablets, four times a day of the skin formula. The mobility formula was stopped, and the marrow formula (2 tablets, four times a day) was added to build his blood. The EPA/DHA dosage remained the same. He continued taking the herbs for six months with total resolution of the psoriasis.

Discussion: Steve's tongue and lesions were purplish, indicating blood stasis, while his overweight and the presence of a lingering condition, i.e., the psoriasis, indicated dampness. The skin formula was used to clear the liver. In the biomedical model, alcohol is toxic to the liver, and in the Chinese model, alcohol is too warming to both the liver and the body in general. Although Steve was reluctant to eliminate alcohol totally, he was able to reduce his consumption to 1 to 2 drinks on the weekends only. This helped keep the psoriasis under control. The mobility formula was used to increase blood circulation and drain dampness, and the marrow formula was selected to help tonify the blood in order to relieve itching. A six-month course of treatment is not unusual for stubborn cases of psoriasis.

Case # 2

Steve, a 50-year-old landscaper, complained of psoriasis characterized by red, itchy lesions on the arms, legs, scalp and nails. The skin on his face, arms and hands was particularly rough, probably due to his working almost exclusively outdoors in a very windy climate. His diet consisted mainly of fast foods, fried foods and soda. He also drank alcohol regularly. He had tried various medications, but was reluctant to use the methotrexate recommended by his doctor. Traditional Chinese medicine diagnosis revealed that his pulse was slightly slow, and his tongue was pale and dry.

Since Steve's diet was so poor, we suggested he reduce or eliminate his consumption of fast foods and fried foods. He was also urged him to eliminate soda and alcohol, and drink at least 64 ounces of water daily. We recommended he take 1 part of the dragon's blood formula diluted in 3 parts of safflower oil to be applied twice daily to his arms, legs and scalp. He was also asked to use the skin formula (2 tablets, four times a day) and the marrow formula (2 tablets four times a day). One month later, Steve reported that the itching had decreased by 50 percent and that the lesions had shrunk in size by 75 percent. Visually his skin looked less red, though his pulse and tongue were unchanged. We reduced the skin formula to 1 tablet four times a day, and increased the marrow formula to 3 tablets four times a day. After three months on this protocol, the lesions were gone and Steve reported that his itching had improved by 90 percent. He continued to take the marrow formula (3 tablets, three to four times daily) for another six months, and used the topical formula as needed. He also reported that his diet was much healthier; he was eating more vegetables and fruits, and drinking plenty of water.

Case #3: Psoriatic Arthritis

Grace, a 56-year-old manager, had a 12-year history of psoriasis. In addition, for several years she had been struggling with arthritis and temperomandibular joint (TMJ) syndrome. The psoriasis was present on her knuckles, elbows, knees, toes, and head. The lesions were purple, thick, and scaly, and itched during flare-ups. Her hands were especially affected by both the arthritis and psoriasis. She had tried numerous topical and internal pharmaceutical treatments, including methoxtrexate injections. Traditional Chinese medicine diagnosis revealed her pulse was wiry and her tongue was reddish-purple.

We recommended Quercenol, an antioxidant formula, and fish oil capsules (2 capsules, three times a day with meals), along with the mobility formula (3 tablets, three times a day between meals) and the skin formula (1 tablet, three times a day between meals). We also suggested she eat cold-water fish such as salmon, mackerel and tuna, which contain high levels of omega-3 oils and help reduce inflammation. After three weeks, Grace noticed a slight decrease in the joint pain, swelling and itching, though her pulse and tongue were unchanged. We recommended she continue with the protocol, but increase the dosage of the skin formula (to 3 tablets three times a day) and apply the dragon's blood formula topically to the skin lesions (three times daily).

After one month, Grace noticed a major improvement in symptoms. She reported a 50 percent reduction in pain, and substantial improvement in the lesions and itching. Grace remained on the protocol for several months, with almost complete elimination of her symptoms. Subsequently she elected to stop the herbs, but continued taking the antioxidant formula and fish oil capsules, and ate fatty fish several times per week.


Click here for previous articles by Andrew Gaeddert, BA, AHG.

 

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