Thursday, January 23, 2014


Psoriasis is the most common autoimmune disorder in the U.S.  It affects about 2 percent of the population and 30% of those affected by this condition report having relatives with psoriasis.  Psoriasis is most often seen in those between the ages of 15-30 and those in their 50s and 60s.  There are numerous forms of psoriasis including plaque psoriasis, guttate psoriasis, pustular psoriasis, psoriatic arthritis, and in severe cases erythrodermic psoriasis.  Of these various forms, plaque psoriasis accounts for about 90% of the cases seen.

Plaque psoriasis can develop into a variety of different patterns.  The most common distribution seen are lesions on the extensor aspects of the limbs, especially the elbows and knees.  Some develop psoriasis in isolated regions such as the scalp where it typically stops just outside the hairline or in and around the ears.  Others will develop it more widespread over the abdomen, lumbar region and sacrum, and nails.  Less commonly the lesions can be seen in the genital region, intertriginous regions, palms and soles. 

No matter the location, psoriasis can be safely and effectively treated with internal Chinese herbal treatments.  The treatments are very unique in comparison to other treatments that may be used to address this autoimmune disorder.  This is evident in that no one person's herbal treatment is alike.  The unique presentation of the person and their skin is truly taken into account and guides the practitioner to construct a specific formula to address the pattern of inflammation that is occurring.  Being an autoimmune condition, the patient must be willing to stick with the treatment and not begin treatment with the expectation of being free of psoriasis after a month or two of treatment.  Sometimes miraculous changes occur with herbal treatments where the skin clears significantly after a month of treatment but this is by no means the norm.  These treatments require persistence and patience on the end of the patient.  In my experience, this often pays off and the patients are pleased with the results.

An interesting aspect to these treatments is that they regulate and rebalance the inflammatory response in the body.  Once the skin has remained stable on treatment, discontinuing treatment doesn't typically lead to a flare but instead what is observed is that the skin remains stable while off herbs.  This isn't an observation that is isolated to psoriasis patients but is something that is seen when treating other forms of inflammation including eczema with Chinese herbs.  The inflammatory process is being brought back to a normal state through the use of herbs thereby allowing patients to discontinue treatment while their skin remains stable.

When looking at mainstream approaches to treating psoriasis, what is often seen is the use of internal and external steroids, and/or immunosuppressants (i.e. azathioprine), or biologics (i.e. Enbrel).  This new class of biologics have a long list of side effects and risks that make the treatment a last resort for a lot of people.  Being such a new medication, we are just not aware of all the long term repercussions associated with their use.  When we look at immunosuppressants we run into a similar situation, numerous risks and side effects from the use of the medication.  With azathioprine, there is an increased risk of cancer, bone marrow suppression, and risk of secondary infection associated with its use.  The use of steroids is often the first treatment utilized when treating psoriasis with a mainstream medical treatment approach.  They can be effective to reduce the inflammation and reduce the plaques of psoriasis while they are actively being applied.  However, once these suppressive steroids are stopped, the inflammation that has been suppressed leaps back to life.  This often leads to a stronger flare of the skin and a worsening of the symptoms than prior to the use of the steroids.  This is an all too often scenario that is seen clinically, but is unfortunately the most common treatment that the mainstream medical community offers those with this debilitating immune disorder.  It should also be made clear that steroids cannot be used indefinitely.  Typically, patients develop tolerance to the steroids and so over time the potency must be increased to achieve a similar response.  But not only this, if steroids are continued to be used internally for more than three weeks, there is risk that the adrenal glands will shrink, the bones will become weaker, the patient can develop hypertension, fluid retention, cataracts, and a weakened immune system.  These are just a few of the side effects that can be seen with long term steroid use.  Long term external steroid use will atrophy or thin and weaken the skin leaving the skin unable to heal from injury or from the active psoriasis.  

With all the side effects associated with the various pharmaceuticals used in the treatment of psoriasis it is no wonder that many are seeking out alternative treatments.  Chinese medicine has been used for thousands of years to address this chronic skin condition known as song pi xuan (pine skin dermatosis) or psoriasis and has done it in a safe and effective manner.  In practice I've seen so many patients come in after struggling with the rebound flares of steroid use, where they've become frustrated with the treatment approaches that have been offered.  Many of these patients respond quite well to treatment and are able to manage their skin without the use of steroids but solely through the use of herbal medicine.  This not only relieves them of their psoriasis but allows their skin to heal from the inside out and leaves the skin stronger and healthier.  From my experience and the experience of other Chinese herbal dermatology specialists, this treatment approach is far more desirable in its results.        

No comments:

Post a Comment