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Ask
the Herbalist
Andrew Gaeddert, BA, AHG
How Do You Treat Psoriasis?
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.
Andrew Gaeddert, BA, AHG
8001 Capwell Drive
Oakland, CA 94621
Tel: 510-639-0280
Fax: 510-639-9140
