Psoriasis

“The Heartbreak of Psoriasis” is a phase the author John Updike, a sufferer of psoriasis himself, used to describe his experience with the condition. While psoriasis is a skin condition, it impacts people’s daily lives in social situations and has a significant emotional impact. In addition, psoriasis may cause itching, physical discomfort, and is often associated with arthritic joint pain.   Acupuncture and Traditional Chinese Medicine has been extensively used to treat psoriasis.

What Causes Psoriasis?

In both acupuncture theory and western medicine, psoriasis is more than skin deep. Psoriasis is caused by dysfunction and dysregulation of the immune system, leading to an auto immune reaction.  In acupuncture,  this dysfunction is described as imbalances which disrupt the body and keep it from healing. Once the imbalances are corrected, your body can work to heal itself and stay healthy.

Psoriasis causes auto-immune reactions which make skin cells overgrow, leading to the development of plaques and scales.  The environment also influences the development of the condition including drugs, trauma, infection, and stress.

What are Psoriasis symptoms?

Psoriasis Plaque

Psoriasis causes the formation of round and oval raised lesions. Often there is silvery white scale over these lesions. If removed it may bleed easily, which is called an Auspitz’s sign. Itching is common, and can be severe in certain cases, but it is very variable. In those with psoriasis, the lesion may appear at a site of physical trauma, which is called a Koebner phenomenon. Many people with psoriasis also suffer from chronic joint pain and arthritis.

Psoriasis tends to affect the outside of the arms and legs more than the inside. Common areas that are most effected from psoriasis are the back, elbows, scalp, groin area, fingernails, and toenails. Some medications and drugs may exacerbate the development of this condition.

There are many types of psoriasis, the most common type being chronic plaque psoriasis. This chronic form is the most common and the lesions may last for months, even years when they develop. This form reacts well to acupuncture and Chinese medicine treatment.

There are some acute inflammatory forms of psoriasis, which must be treated immediately by a physician or in the emergency department.

Psoriasis in Acupuncture and Chinese Medicine

In acupuncture and Chinese medicine, psoriasis is caused by imbalances in the body. For autoimmune conditions like psoriasis, the concept of imbalances really makes sense. The immune system is overactive and the body attacks itself.

The diagnosis of the specific imbalance is based upon your symptoms, such as itch, pain, or irritation, the appearance of the skin lesions. The most common imbalances, which cause psoriasis, are blood heat, dryness, and blood stagnation. Damp heat can also be a factor, particularly in pustular psoriasis.

Chinese medicine and acupuncture doctors have long said that removing these imbalances is like hitting the reset switch.  In this case, resetting the immune system.

The Most Common Acupuncture and Chinese Medicine Imbalances

Blood Heat- Blood heat is characterized by the acute onset of psoriasis with possible severe itching. The lesions are often bright red irregular patterns of plaque. The size and extent of the lesions suggest the amount of heat. The greater number and larger the lesions, the greater amount of heat. The bleeding upon scratching is easy to elicit (1).

Blood Dryness- Blood dryness occurs with chronic cases of psoriasis. Itching may or may not be present. The lesions can appear pale red or dull red in color. The scales may appear to be dryer with blood dryness.

Blood Stagnation- Blood stagnation also occurs when there is long term chronic psoriasis. It often is characterized by remission and relapses. The plaques are irregular, hard, and thick and may be purplish and dry in color. Bleeding may be difficult to elicit but itching is still present.

Damp heat occurs in pustular psoriasis. This is when there is a large amount of inflammation, swelling, fissures, and exudate. The lesions may be moist and swollen and there may be pus.

Psoriasis Treatment with Acupuncture and Chinese Medicine

Chinese herbal therapy works by correcting the specific imbalance causing underlying psoraisis. The prescription is tailored to your symptoms and imbalance specifically.

The treatment usually combines both acupuncture and Chinese herbal therapy. Acupuncture can help to reduce itch and, if there is pain associated with the condition, help to kill the pain. Acupuncture points such as LI 11 and LI 4 help to clear heat. GB 34 and GB 31 can help relieve the itching. Ear acupuncture and ear magnet therapy I find helps to relieve itching very quickly.

Ku Shen and Huang qin

In addition to acupuncture, Chinese herbal therapy is necessary for having substantial results with psoriasis. Chinese herbs are given in formulas, which may contain 10-15 herbs. They are most often cooked and drank as teas. The ingredients are chosen specifically for your condition. For example, if there is blood stagnation and blood dryness, the formula would focus on moving the blood stagnation and nourishing the dryness.

The Immunologic Effects of Herbs for Psoriasis

A review of herbs used for psoriasis explored the immunologic effects of commonly used herbs for psoriasis (2). Chinese herbs are complex natural products. Rather than being a single chemical, like most medications, they are combinations of naturally occurring substances. Formulas are even more complex because they can have 10 or more herbs.

sheng di huang and dan shen

Three of the most powerful and commonly used herbs for psoriasis are Sheng di huang (Rehmania glutinosa), Dan shen (Salvia miltiorriza), and Zi cao (lithospermum erythrohizon).

Sheng di huang is used to cool the blood and clear heat. It is effective for many types of psoriasis, including psoriasis from blood heat and blood dryness. In the laboratory, sheng di has shown to inhibit histamine release from mast cells and regulate the cytokines TNF-α and IL-1 in astrocytes.

Dan shen is good for blood stagnation and heat type psoriasis. Dan shen was shown to reduce edema, inhibit the secretion of IFN-γ and IL-12, and inhibited the degranulation of mast cells.

Zi cao very strongly cools the blood and is often used with psoriasis. This in combination with other herbs showed a complete suppression of IL-α and TNF-α, which are factors in psoriasis. These anti-inflammatory effects may have a beneficial effect for psoriasis.

Chinese Herbal Formulas

Some of the herbs may not directly correct the immune system, but rather work synergistically with other herbs in the formula to enhance their action, or in some cases, protect from side effects. You can see how complicated the situation is and why it is important to be well trained in Chinese herbal medicine.

Licorice root, or gan cao (Glycyrrhiza uralensis), is widely used in Chinese medicine for psoriasis by boosting qi and harmonizing the effects of other herbs. It has long been know for immunoregulatory abilities. Studies are now showing that it can also reduce possible toxicity and helped to repair damaged liver cells. This is the harmonizing effect Chinese medicine doctors have been talking about for centuries.

How long does acupuncture and Chinese medicine treatment take?

Overall, a treatment course for psoriasis is about 3-6 months. This time period can vary depending on the severity and symptoms you are experiencing.

I want to see psoriasis symptoms such as itching and pain to improve within the first month to 6 weeks of treatment. By the end of the second month, I would like to see a reduction in the amount of redness and size of the plaque, which will continue throughout the treatment course.

One of the phenomenal aspects of acupuncture and Chinese medicine treatment is that it can lead to long term reduction in psoriasis.  We describe this as correcting the imbalances in the body rather than masking the psoriasis symptoms.

References:

1. Treatment of psoriasis with traditional Chinese medicine. Lin Li. Hai Feng Publishing, 1990.

2. Tse, T. W. Use of common Chinese herbs in the treatment of psoriasis. Clinical and Experimental Dermatology. 28: 5. 469-475. 2003

Photos: The Wednesday Island of English Wikipedia

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