Features - Psoriasis and Western Herbs by Claire Choudhury

Treating Psoriasis with Western Herbs
Psoriasis is a distressing and generally stubborn condition marked by a greatly increased turnover of cells in the epidermis of the skin from causes as yet not fully understood. The normal life-cycle of an epidermal cell is 28 days, from cell replication to desquamation (or shedding). In Psoriasis, however, the whole cycle can be as short as four days, leading to a chaotic build up cellular matter and the tell-tale reddened plaques and silvery scaling.

As a medical herbalist, I am often approached by potential patients with Psoriasis; probably because herbal treatment is recognised as a particularly effective treatment for chronic and acute skin conditions, and Psoriasis is certainly no exception. However, it is important to realise that there are no magic formulae, no 'Psoriasis herbs' as such. Herbalists don't actually treat the Psoriasis - they treat the person who has the Psoriasis, and by encouraging the body's natural resources for healing, the Psoriasis often improves. As hippocrates put it so beautifully nearly 2,400 years ago: "It is better to know what kind of a person has a disease, than to know what kind of disease a person has."

Each patient comes with their own unique health history, lifestyle and disease state, and it is a herbalist's job to work out which herbs will be particularly suited to that unique set of circumstances. Psoriasis itself comes in a number of forms including the classical plaque Psoriasis, Guttate Psoriasis (which often follows a throat infection), Arthropathic Psoriasis (involving the joints), Exfoliative Psoriasis (covering much of the body) and Acute Pustular Psoriasis (which can be life-threatening). Herbal treatment is likely to vary considerably depending on the type of Psoriasis someone has, as well as the type of person they are.

Some general rules do apply, however, and are worth investigating - whether or not you decide to see a herbalist for personalised treatment.

One therapeutic approach is to help ensure the body is excreting toxins effectively through the gut and bladder. This is important for most skin conditions, and especially so if they involve the joints as well. This means taking herbs which work on the liver, the gut and the kidneys. Treatment may also include herbs that work on the nervous system and the adrenal glands as - for many people - Psoriasis appears to be stress-related. Herbs to help modulate the immune system can be helpful as Psoriasis is considered to be an auto-immune condition, whilst herbs that help reduce abnormal cell turnover (anti-mitotics) can be used directly on the skin and/or internally. If infection is involved (for example in Guttate Psoriasis) then anti-microbial herbs can be very effective. Last but not least, the aim is to ensure the Psoriasis patient's overall mental and physical health is as good as possible, thus reducing any internal stresses on the body.

Topical treatment
In my experience, applying creams, oils or lotions to the skin can be helpful but never gets to the root of the problem. Evening Primrose Oil, Aloe Vera Gel or Vitamin E Oil will help keep the skin from drying out, as will a mix of Marigold, Chickweed and Chamomile cream. If you add a few drops of Myrrh and Tee Tree Essential Oil to a carrier cream or oil that can help reduce flaking, and Comfrey Root Cream applied directly to the lesions will help normalise cell replication. Oat meal added to your bath is both soothing and healing. Many people find exposure to sunlight also helps reduce symptoms, though the usual precautions against excessive sun exposure still need to be taken.

Diet
Diet can be a crucial factor. Eating the wrong foods will often bring on flare ups, whilst eating more of the right foods can help improve symptoms and gain extensive periods of remission.

Foods best avoided are those which increase the acidity of the body, such as red meat, animal fats in general (including dairy products), sugars (including refined carbohydrates such as cakes and white bread) and alcohol. Many of these also put additional demands on the liver, which is the body's primary detoxing organ.

Essential fatty acids can play an important role in improving symptoms. A daily intake of cold-pressed sunflower oil or evening primrose oil can be very helpful in providing Omega 6 essential fatty acid. It is also important to have a daily intake of Omega 3 essential fatty acids which can be found in oily fish such as herring, mackerel, salmon and sardines (vegetarians can get their supply from unrefined linseed/flaxseed oil). Supplements which can be helpful include Vitamin E (check first with your doctor if you are on 'blood thinning medication), Vitamins A, C, B (as a complex) and zinc. People on a modern diet are often deficient in zinc, which is a mineral that assists healing, reduces inflammation and helps promote healthy cell replication. Nuts, seeds, seafood and whole grains are rich in zinc.

Maintaining regular bowel movements is crucial, so eating a good supply (at least 6 portions) of organic fruit and vegetables is highly recommended. Constipation should be avoided at all costs, and can usually be successfully treated by increasing fluid intake to at least 1.5 litres a day, upping natural roughage in the diet, and taking linseeds or psyllium seeds with water on a daily basis if necessary. A good intake of water is important in all cases, as it helps those other vital organs of excretion - the kidneys - to function at their best. If bowels and kidneys are not working well, there is only one other major way of shifting toxins from the body - through the skin via the sweat glands. This clearly is not ideal for any skin condition.

Stress
The skin and nervous system are closely linked, both originating from the same embryonic tissue in the developing foetus. In many ways the skin can be seen as the mouthpiece, as it were, of the nervous system - 'speaking out' when things are getting difficult. Psoriatic lesions often flare at times of emotional upheaval, particularly if the sufferer tries to ignore or suppress uncomfortable feelings and emotions. It is often people who are good at managing in difficult circumstances, who in fact cope rather too well, whose Psoriasis flares when the pressure is on. Learning to understand how stress affects you, and finding appropriate ways to relax and unwind is therefore very important for many Psoriasis sufferers. Whether this is taking up yoga, Tai Chi or meditation, or simply walking the dog, jogging or a vigorous gym work out - whatever works for you is good!

Herbs
Medicinal herbs contain a wide variety of plant constituents that can be taken together to enhance the required medicinal action. Most herbs are veritable medicine cabinets offering several valuable actions for the price of one! Some herbs are anti-inflammatory, others help promote better bowel or kidney function, or work directly on cells to help prevent abnormal cell replication. Some herbs help promote a healthy immune system or assist the central nervous system and adrenal glands to cope with stressors such as anxiety, poor sleep or overwork. The liver is an extremely important organ, not only of digestion but in making and breaking down hormones and ridding the body of toxins. There are a whole range of herbs which have their primary effect on the liver.

Herbs are generally a safe form of treatment, but if you are pregnant, breast feeding, taking medication from the doctor or have a serious medical condition, you should always consult a medical herbalist (see contact details below) who can prescribe safely in such circumstances.

The herbs listed below are frequently useful in treating Psoriasis:

Sarsaparilla (Smilax ornate) - antiseptic and stimulates the body's natural steroid production via the adrenal glands
Yellow Dock (Rumex crispus) - promotes the flow of pile and helps move the bowels
Blue Flag (Iris versicolor) - anti-inflamatory, promotes bile flow
Red Clover ( Trifolium pratense) - detoxing, oestrogenic, antispasmodic
Thuja (Thuja occidentalis) - detoxing, nerve stimulant, diuretic, anti-mitotic (reduces abnormal cell replication)
Poke Root (Phytolaca decandra) anti-inflammatory, anti-rheumatic, lymphatic
Cleavers (Galium aperine) - detoxing, diuretic, lymphatic
Burdock (Arctium lappa) - detoxing, diuretic, traditional skin herb
Dandelion (Taraxacum officinalis) - promotes bile flow, diuretic
Skullcap (Scutellaria laterifolia) - calming support for the nervous system, traditional skin herb
Valarian (Valariana officinalis) - tranquilliser
Mountain Grape (Mahonia aquifolium) - detoxing, promotes bile flow, anti-catarrhal
Hops (Humulus lupulus) - sedating, oestrogenic
Liquorice (Glycyrrhiza glabra) - promotes the body's natural steroids, mild laxative
Comfrey root (symphytum officinalis) - applied directly to the skin, helps promote normal cell replication
Oats (Avena sativa) - anti-inflammatory and healing when applied to skin

Claire Choudhury is a member of the National Institute of Medical Herbalists (established in 1864) and runs a busy practice in South London and Surbiton.

To contact NIMH for details of a herbalist near you, please phone 01392 426022, or email info@nimh.org.uk or check the NIMH website at www.nimh.org.uk

The advice in this article is intended as a general overview for treating Psoriasis, and should not be considered as specific advice to any individual reader.