When we consider the adverse side effects of conventional modern topical psoriasis treatments that still are not able to cure psoriasis, it is encouraging to look at the natural alternative treatments that have shown themselves to be effective against psoriasis – proven by science and withstood the test of time as traditional medicine.
The only warning needed with these treatments is that ‘gentle’ usually also means ‘slow’. If you see no sign of spotlessness in the first few weeks, please persist and keep faith. Conventional medicine has its place in immediate short-term responses to psoriasis outbreaks and may be used as an adjunct, whilst its long- term use is known to cause harmful side effects.
These plant-based ointment or lotion treatments target the hyper proliferation of keratinocytes and it is useful to understand this process before I explain the benefit of the plants. Psoriasis is caused by an over active immune response because incorrect signals from cytokines are triggering a much faster than usual production of keratinocytes – our skin cells. New skin cells are pushed to the skin’s surface in 3 to 4 days instead of the usual 28 to 30 days in healthy skin. The psoriasis lesions are red because of inflammation from our dysfunctional and overactive immune response and because they have not properly developed as skin tissue before racing to the surface.
By finding a plant-based treatment that is right for you, you will achieve a long term sustainable solution to treat your psoriasis. Here are the favourites:
White willow (Salix alba) The bark of the white willow contains salicylic acid, one of the strongest ingredients prescribed for on the skin by conventional medicine. The white willow bark can exfoliate psoriasis plaques because of its keratolytic substance [1] [2].
Araroba tree (Andira araroba) One of the most effective skin treatments for psoriasis is cignolin (anthralin), which today is produced synthetically. It was originally derived from chrysarobin, a component of the bark of the araroba tree, which grows in the rain forests of the Amazon. Cignolin slows down the release of inflammation producing cytokines and the proliferation of keratinocytes. In a study on 106 psoriasis patients, cignolin proved to be superior to calcipotriol [3].
Bishop’s weed (Ammi majus) Psoralens originally isolated from the bishop’s weed with the main active ingredient 8-methoxypsoralen (8-MOP) inhibit keratinocyte proliferation in combination with UVA irradiation (PUVA) and are an effective therapy for psoriasis. Numerous clinical studies demonstrated the anti-psoriatic effects of 8-MOP in combination with UVA irradiation in the form of systemic use, but also as a bath additive or in the form of cream [4] [5] [6].
Mahonia (Mahonia aquifolium) The use of mahonia for the treatment of psoriasis originally derives from homeopathy, where it has been used for decades as a 10% tincture in cream form. Only in recent times was a large study performed. In a randomised, vehicle-controlled, double-blind study on 200 psoriasis patients a 10% mahonia cream was effective and well-tolerated [7].
Indigo naturalis (Baphicacanthus cusia) In traditional Chinese medicine indigo naturalis is a common remedy. It is a blue powder that is produced by crushing, fermenting and adding calcium to the plant Baphicacanthus cusia. The main active agent is the alkaloid indirubin. In a randomized, placebo controlled clinical study 42 patients with chronic plaque-type psoriasis were treated for 12 weeks with an ointment containing indigo. With the indigo ointment 81% of patients had improvement of signs and symptoms as opposed to only 26% of patients with placebo. As a side effect pruritus occurred in 4 patients [8].
References
White willow [1] Waller JM, Dreher F, Behnam S, Ford C, Lee C, Tiet T, Weinstein GD, Maibach HI. Keratolytic properties of benzoyl peroxide and retinoic acid resemble salicylic acid in man. Skin Pharmacol Physiol 2006; 19: 283–9
White willow [2] Augustin M, Hoch Y. Phytotherapie bei Hautkrankheiten. Grundlagen-Praxis-Studien. Elsevier GmbH, München, 2004.
Araroba tree [3] van de Kerkhof PC, van der Valk PG, Swinkels OQ, Kucharekova M, de Rie MA, de Vries HJ, Damstra R, Oranje AP, de Waard-van der Spek FB, van Neer P, Lijnen RL, Kunkeler AC, van Hees C, Haertlein NG, Hol CW. A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: a randomized controlled trial of supervised treatment of psoriasis vulgaris in a day-care setting. Br J Dermatol 2006; 155: 800–7.
Bishop’s weed [4] Markham T, Rogers S, Collins P. Narrowband UV-B (TL-01) phototherapy vs oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis. Arch Dermatol 2003; 139: 325–8.
Bishop’s weed [5] Vongthongsri R, Konschitzky R, Seeber A, Treitl C, Honigsmann H, Tanew A. Randomized, double-blind comparison of 1 mg/L versus 5 mg/L methoxsalen bath-PUVA therapy for chronic plaque-type psoriasis. J Am Acad Dermatol. 2006; 55: 627–31.
Bishop’s weed [6] Abramovits W, Boguniewicz M. A multicenter, randomized, vehicle-controlled clinical study to examine the efficacy and safety of MAS063DP (Atopiclair) in the management of mild to moderate atopic dermatitis in adults. J Drugs Dermatol 2006; 5: 236–44.
Mahonia [7] Bernstein S, Donsky H, Gulliver W, Hamilton D, Nobel S, Norman R. Treatment of mild to moderate psoriasis with Relieva, a Mahonia aquifolium extract – a double-blind, placebo-controlled study. Am J Ther 2006; 13: 121–6.
Indigo naturalis [8] Lin YK, Chang CJ, Chang YC, Wong WR, Chang SC, Pang JH. Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer blind, vehicle-controlled trial using indigo naturalis. Arch Dermatol 2008; 144: 14
