Management of Psoriasis: A Natural Way
December 15th, 2009 | Published in Sexual Health
Psoriasis is one of the oldest disease recognized since ancient times, and the derivation of the term ‘‘psoriasis’’ is cloaked in ancient history. The relationship between modern psoriasis and biblical ‘‘lepra’’ has often been disputed. Psoriasis, as recognized today, is a chronic skin disease with significant morbidity that affects around 2% of the Caucasian population. The disability of hospital- treated patients with psoriasis has been shown to be similar to that of patients with angina and approaches that of patients with other cardiac problems. In addition to the soreness and irritation of the skin experienced by many, the psychosocial effects are more profound.
Many advances have been made in our understanding of the biology of psoriasis over the past 20 years. It takes 27 days for skin to replace itself with new mature skin cells. But the regions of skin affected by psoriasis the skin replace itself within 3-4 days with plenty of immature skin cells forming thick psoriatic patches.
Research showed that it is an autoimmune disease involving a type of white blood cell called T cell. Normally, T cells help to protect the body against infection and disease. T cells help to create scabs over wounds. In the case of psoriasis, T cells are put into action and become so active that they trigger other immune responses, which lead to inflammation and to rapid turnover of skin cells. Most recently, the natural or innate immune system has been found to be highly implicated. Non-specific natural responses of the skin immune system, and virtually every subsystem of that, are found activated in psoriasis. Epidermal cells up on the surface of the skin, forming itchy patches or plaques. The first outbreak of psoriasis is sometimes triggered by emotional or mental stress or physical skin injury, but heredity is a major factor as well. In about one-third of the cases, there is a family history of psoriasis.
Use of complementary and alternative medicine is common among people with psoriasis. A number of herbal and alternative medicine/ Formulations and therapies are used for management of psoriasis which is listed below.
Medicinal plants
Neem
The neem tree (Azadirachta indica) is an evergreen tree found mostly in India. The active ingredient in the bark is nimbidin, which has hypoglycemic, antiulcer, and antitumor effects. It is a more potent inhibitor of prostaglandin synthesis than acetylsalicylic acid, hence inhibiting anti inflammatory responses.
Aloe
Aloe vera is also used in management of psoriasis due to its analgesic, antiallergic, antipruritic, wound-healing, and anti-inflammatory properties.
Oregon grape
Mahonia aquifolium (barberry or Oregon grape) is an evergreen shrub. The active compound is berberine, which is an isoquinoline alkaloid that has anti-inflammatory, antineoplastic, and antibacterial properties. There have been several studies showing efficacy of this compound in patients with psoriasis.
Oleum oil
Researcher has studied a combination of extracts from several medicinal plants called Oleum horwathiensis,. The active extracts are of Achilleae herba (yarrow), Allium sativum (garlic), Calendulae flos (calendula), Taraxaci radix (dandelion root), Urtica folium (stinging nettle), and Veronica officinalis (common gypsyweed). It was dissolved in soft paraffin and showing good relief against psoriasis.
Animal drugs
Fish oil
Most of cold water fish such as mackerel, sardine, salmon, pilchard, kipper, and herring are having rich amount of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These molecules compete with arachidonic acid as substrates for cyclo-oxygenase and lipoxygenase, which thereby reduces downstream proinflammatory molecules in psoriatic plaques.
Vitamin D There have been case reports showing efficacy of vitamin-D metabolites for psoriasis. Also, patients receiving vitamin D for osteoporosis have showed improvements in their psoriasis.
Inorganic compounds
Inositol. Lithium has been shown to worsen psoriasis. Inositol depletion explains, in part, the mechanism of action of lithium in bipolar disease. That said, inositol supplementation has been shown to decrease side effects of lithium (ie, polyuria) without decreasing its efficacy.
Zinc
Zinc deficiency has been associated with the presence of psoriasis form plaques. Neutrophil zinc levels have been found to be reduced in patients with psoriasis compared with patients with atopic dermatitis. Zinc supplements (Zinc sulfate 220 mg; 45 mg elemental zinc) are generally used to manage zinc deficiency in psoriasis.
Selenium.
Selenium has been shown to be decreased in patients with psoriasis. Due to its antioxidants and immunomodualtory actions it is used in relieving psoriatic patients.
Formulations
Nimbatiktum
Nimbatiktam is an ayurveda formulation isolated from the neem seed oil of Azadirachta indica. It is available in powder form and used orally to treat psoriasis.
Lajjalu Keram
It is also an ayurveda formulation containing Coconut oil (1 Part), Fresh Lajjalu Plant Juice (4 Part). It is available as oil and used topically. It smoothens the affected area and keeps the psoriatic wound moist.
‘777’ OIL
‘777’ oil is a siddha formulation used topically in managing poriasis. It contains oil soluble contents of Vetpalai elai (Wrightia tinctoria), obtained with equal quantity of coconut oil.
Vitamin B12/avocado oil.
There have been case reports of efficacy with parenteral vitamin B12 in patients with psoriasis. It is used topically for 12 weeks with calcipotriol or a combination of vitamin B12 and avocado oil.
Other Therapies
Climatotherapy
Climatotherapy and balneotherapy applies to the practice of traveling to the Dead Sea (DS) and sunbathing and/or bathing in the sea. It is thought that the combination of the high Salinity of the sea and the UV conditions (mostly UVA at this latitude) can improve psoriasis.
Acupuncture/Chinese medicine
A study by extracting 150 to 200 mL of venous blood from 128 allocated patient; treating it with magnetism, radiofrequency light radiation, and inputting ion-oxygen; and then reinjecting 8 mL into specific points dictated by the patients’ particular psoriatic subtype showed a significant benefit in the active treatment group.
A prospective, subject-blinded, placebo controlled study of standardized acupuncture in 56 patients showed the efficacy of acupuncture in plaque psoriasis. Patients in the treatment group received deep intramuscular insertion of needles according to traditional Chinese medicine at 20 named points on the ear and all needles were then electro stimulated. In the placebo group, needles were inserted into the subcutaneous tissue 1 cm outside classic points, and one ear acupuncture needle was placed at a medial position on the ear. All needles in placebo were attached to the stimulator but no electric tension was initiated.
Based on the above mentioned remedy, the most promising modalities seem to be: fish oil, and climatotherapy. These 2 modalities have the largest number of studies (however conflicting), many of these studies are both interesting to patients and dermatologists, and some of them are very well designed. Also, with regard to fish oil, these modalities are investigated for treatment or attenuation of psoriatic comorbidities such as cardiovascular disease and depression.
MD Tanwir Athar is a Senior Research Fellow in Hamdard University New Delhi, India with over 4 years experience of standardization and animal activity of herbal drugs/Formulation.he specializes in various analytical Techniques like HPTLC, HPLC and column chromatography for standardzitaion and isolation of herbal drugs. Article Source: