Nail psoriasis is difficult to have and to treat and often gets overlooked in medical research. Psoriatic fingernails are both highly visible and because of their weakness, are also vulnerable. I have a special place in my heart for those who have nail psoriasis.
While it’s easy to feel blue about psoriatic nails, blue may be the just the treatment you need! Indigo naturalis is a plant extract widely used in Traditional Chinese Medicine and referred to as Qing Dai. Indigo naturalis was used as a blue colorant for dyeing textiles in China for hundreds of years. Currently it is used as a natural blue dye for jeans and as a blue colourant for food, hair dye, toothpaste and creams. Traditional Chinese Medicine continues to use indigo naturalis medicinally to treat high fever, chronic myelogenous, eczema, child epilepsy, nose bleeding, mouth inflammation, sore throat, gum inflammation, tonsillitis, coughing, insect or snake bite, and psoriasis.
Comparison between Daivonex and Indigo naturalis
The results of a 2015 study by Lin et al compared indigo naturalis with a current topical medication, calcipotriol solution, marketed as Daivonex scalp solution,50μg/mL. For the study, the very blue indigo naturalis was mixed with olive oil to remove the blue component. The result was Lindioil, a purple-red product to treat skin and nail psoriasis without the blue staining.
The study demonstrated that indigo naturalis shares several therapeutic mechanisms with the calcipotriol solution, such as regulating the keratinocyte proliferation, restoring the epidermal barrier function, and reduction of inflammatory processes. Clinically, indigo naturalis, mixed with olive in its Lindioil state, is well tolerated and is a safe and effective alternative therapy for psoriatic nails.
In the study, the participants had equal nail psoriasis severity on each hand. The participants applied 1 to 2 drops (0.05 mL/drop) of Lindioil to the fingernails of one hand and calcipotriol to the other hand, twice daily for 24 weeks. In the first 4 weeks of the study the results of both hands were similar. It was after week 4 to week 24 that a significantly better improvement occurred in the fingernails treated with Lindioil.
The source of indigo naturalis
Indigo naturalis is also called indigo powder and Qing Dai in Chinese. One of its most common forms is in dried powder cultivated from fermented leaves.
Indigo Naturalis powder has a long history of use in traditional medicine in China. The indigo naturalis is extracted from the plant Baphicacanthus cusia. The leaves are harvested every August, and then dried in the sun for a whole year. The dried leaves are then fermented in lime water for 72 hours for extraction and this solution is then dried again to create the powder.
What can you do with this information?
This recent research of indigo naturalis suggests that it is a safe, inexpensive, and effective alternative topical treatment for skin and nail psoriasis with only two participants (6%) experiencing irritation when using indigo powder in the Lindioil form, compared to 10 (30%) participants with the use of calcipotriol.
My research of indigo powder suppliers has made me aware of the differences in integrity of the product. Whilst many products for sale include indigo naturalis as one of their ingredients, my personal preference is to use pure indigo powder where I can control the strength and avoid unknown irritants, making my own trials more authentic. Every research article I have read about indigo powder refers to topical treatment and so for me, it’s definitely going on the outside and not the inside!
References
Lin, Y., Chang, Y., Hui, R., See, L., Chang, C., Yang, C. and Huang, Y. (2015). A Chinese Herb, Indigo Naturalis, Extracted in Oil (Lindioil) Used Topically to Treat Psoriatic Nails. JAMA Dermatology, 151(6), p.673.
Chinwonbio.com. (2018). Natural Ingredients | Stachyose, Indigo naturalis. [online] Available at: http://www.chinwonbio.com [Accessed 30 Jul. 2018].
