Psoriasis is an inflammatory autoimmune skin disease. Psoriasis sufferers have an increased frequency of a variety of cardiovascular risk factors including diabetes, obesity, high blood pressure, elevated blood cholesterol levels, and smoking. In particular, psoriasis is associated with key components of the metabolic syndrome -- a clustering of heart risk factors -- and that this association is stronger in cases of severe psoriasis. For women with psoriasis, high levels of estrogen during pregnancy seem to improve their skin condition. Non-blistering skin diseases, such as alopecia areata, vitiligo and psoriasis are increasingly believed to be directly mediated by the activities of autoreactive T cells.

Natural Treatment for Psoriasis
I am not aware at this time of a natural psoriasis cure. You may consider increasing your fish intake along with fresh vegetables and reducing simple carbohydratess, trans fats, and junk foods. See suggestions for a healthy diet. Patients with psoriasis have high blood triglyceride and cholesterol levels. Basically, psoriasis is an inflammatory disorder and you would do best consuming an anti-inflammatory diet. Smoking cigarettes raises the risk for psoriasis.

Avoid smoking. Smoking increases the risk for psoriasis.
Reduce weight or eat less. Excess body fat triggers an overproduction of certain inflammatory substances in the body, which leads to a higher psoriasis risk. Those who are overweight are more likely to have psoriasis, and there is a possibility that eating less can reduce symptoms of psoriasis. If you wish help with losing weight, consider Diet-Rx, a powerful herbal appetite suppressant.
Avoiding gluten may help some individuals
Fish oils could be helpful. Psoriasis is an inflammatory process in the skin and omega-3 fatty acids in fish oils, such as EPA and DHA, reduce inflammation. You can find Fish-Oils here.
Chondroitin sulfate may be helpful. See the study below.
Inositol supplements could be helpful in psoriasis patients who are taking lithium medication
Topical Vitamin D could be helpful
Turmeric or curcumin may be helpful, we have had an email from someone who found turmeric supplements helpful in reducing his psoriasis condition.
Folate supplementation may be helpful in patients with psoriasis who are being treated with methotrexate.



Subscribe to a FREE Supplement Research Update newsletter. Twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, including psoriasis and diet, and their practical interpretation by Ray Sahelian, M.D.

Psoriasis and Diet
The significance of diet and associated factors in psoriasis.
Hautarzt. 2006 Nov;57(11):999-1004. Wolters M. Abteilung Ernahrungsphysiologie und Humanernahrung, Institut fur Lebensmittelwissenschaft, Zentrum Angewandte Chemie, Universitat Hannover, Wunstorfer Strasse 14, 30453 , Hannover
Both the general diet and single food components have been suggested to play a role in etiology and pathogenesis of psoriasis. Fasting periods, vegetarian diets, and diets rich in omega-3 polyunsaturated fatty acids from fish oil have all been associated with improvement in some studies. The most likely explanation is the reduced amounts of arachidonic acid and the increased eicosapentaenoic acid intake resulting in a modulated eicosanoid profile. However, only one of four controlled studies showed a benefit of omega-3 fatty acids compared to placebo. Some psoriasis patients are gluten-sensitive and may benefit from a gluten free diet. The active form of vitamin D exhibits anti-proliferative and immunoregulatory effects and has been shown to be useful in the treatment of psoriasis.

Diet and Psoriasis
Psoriasis is considered as a T-cell-mediated inflammatory skin disease with hyperproliferation and poor differentiation of epidermal keratinocytes. While susceptibility to psoriasis is inherited, the disease is influenced by environmental factors such as infections and stress. Diet has been suggested to play a role in the etiology and pathogenesis of psoriasis. Fasting periods, low-energy diets and vegetarian diets improved psoriasis symptoms in some studies, and diets rich in n-3 polyunsaturated fatty acids from fish oil also show beneficial effects. All these diets modify the polyunsaturated fatty acid metabolism and influence the eicosanoid profile, so that inflammatory processes are suppressed. Some patients with psoriasis show an elevated sensitivity to gluten. In patients with IgA and/or IgG antigliadin antibodies the symptoms have been shown to improve on a gluten-free diet. The active form of vitamin D, 1,25-dihydroxyvitamin D(3), exhibits antiproliferative and immunoregulatory effects via the vitamin D receptor, and thus is successfully used in the topical treatment of psoriasis. In this review, dietary factors which play a role in psoriasis are assessed and their potential benefit is evaluated. Furthermore, the risk of drug-nutrient interactions in psoriasis therapy is discussed. British Journal of Dermatology. 2005 Oct;153(4):706-14.

Psoriasis and chondroitin
Q. I read with great interest your page on chondroitin supplements. In 2005 a small study was published on:
Clinical And Histopathological Improvement Of Psoriasis With Oral Chondroitin Sulfate: A Serendipitous Finding.
Although small scale it showed extremely promising results on all but one (10 out of 11) cases of psoriasis. However psoriasis seems responsive to placebos quite regularly, yet n this case the trial was originally about osteoarthritus of the knee so arguably the placebo affect should not have affected outcome regarding psoriasis coverage. My question to add to your page is have you since seen any medical studies regarding the role of chondroitin sulfate and psoriasis treatment? And do you have any knowledge, direct or otherwise on whether this chondroitin treatment works with psoriasis.
   A. I have not seen any chondroitin psoriasis studies since the one in 2005, but it does look quite encouraging, 10 out of 11 people were helped. If a person has psoriasis, it is certainly worth a try.

Clinical and histopathological improvement of psoriasis with oral chondroitin sulfate: a serendipitous finding.
Dermatol Online J. 2005 Mar 1;11(1):31. Clinical Research Unit, Scientific Medical Department, Bioibérica, S.A., Barcelona, Spain.
We describe the clinical and histopathological results of plaque psoriasis in eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy treated with chondroitin sulfate. Patients received 800 mg per day of chondroitin sulfate for 2 months. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. The confirmation of these serendipitous findings in controlled prospective studies could represent an important advance in the therapeutic armamentarium for patients with psoriasis given the excellent safety profile of chondroitin sulfate.

Smoking, Obesity, and Psoriasis
Smoking appears to play a role in the risk of developing psoriasis and in the severity of the skin disease. Dr. Gerald G. Krueger, from the University of Utah School of Medicine in Salt Lake City, and colleagues compared the prevalence of smoking and obesity in 557 psoriasis patients with that seen in the three population databases. Thirty-seven percent of psoriasis patients were smokers, whereas the percentage in the other groups was significantly lower, ranging from 13 percent to 25 percent. Similarly, obesity was noted in 34 percent of psoriasis patients compared with 18 percent of subjects in the general Utah population. Further analysis of changes in body image perception over time suggested that, unlike smoking, obesity was a consequence rather than a cause of psoriasis.

Smoking and the risk of psoriasis in women: Nurses' Health Study II.
Am J Med. 2007 Nov;120(11):953-9. Setty AR, Curhan G, Choi HK. Department of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass, USA.
We prospectively examined over a 14-year time period (1991-2005) the relation between smoking status, duration, intensity, cessation, and exposure to secondhand smoke, and incident psoriasis in 78,532 women from the Nurses Health Study II. In this prospective analysis, current and past smoking, and cumulative measures of smoking were associated with the incidence of psoriasis. The risk of incident psoriasis among former smokers decreases nearly to that of never smokers 20 years after cessation.

Types of Psoriasis
Guttate psoriasis
Pustular psoriasis
Psoriasis of the liver
Psoriasis arthritis

Traditional Psoriasis treatment - Psoriasis medication
Topical psoriasis treatment includes tar, topical corticosteroids, topical calcipotriene, topical tazarotene, anthralin, and corticosteroid tape (Cordran tape). Systemic therapy incluves UVB phototherapy, psoralen, acitretin, methotrexate, and cyclosporine.
   A long list of treatments has been available for patients with psoriasis. Topical therapies such as corticosteroids, vitamin D analogues, and retinoids are used for localized disease. Phototherapy including broadband ultraviolet B (UVB), narrowband UVB, PUVA, and climatotherapy are effective for more extensive disease. Systemic therapies such as methotrexate, retinoids, and cyclosporine are for patients with refractory or extensive cutaneous disease.

Topical ointments and creams, including salicylic acid and topical steroids.
Lotions, bath solutions and other nonprescription topical preparations to help soothe symptoms and reduce scaliness.
Light therapy, including UVB and lasers.
Prescription oral medications are reserved for people with moderate-to-severe cases. Treatment with methotrexate or ciclosporin for chronic plaque psoriasis brings satisfactory disease control. Ciclosporin appears to be more effective than methotrexate in the short-term.

Psoriasis treatment side effects
Patients with moderate or severe psoriasis frequently require systemic treatment and these medications may be associated with side effects. Little is known about the frequency of these side effects when systemic agents are used in true clinical practice. Methotrexate is the most prescribed psoriasis medication. Oral retinoids casue the highest psoriasis treatment side effects, although most are minor side effects. Cyclosporine has the highest significant side effects.

Psoriasis and Heart Attack
Psoriasis may be an independent risk factor for heart attack, particularly in young individuals with severe psoriasis. Psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors. Psoriasis is a "T-helper cell disease" and heart attack has been linked to such diseases, Dr. Joel M. Gelfand, from the University of Pennsylvania in Philadelphia, and colleagues explain in the Journal of the American Medical Association.

Psoriasis Research Update
Medical nutrition therapy as a potential complementary treatment for psoriasis--five case reports.
Altern Med Rev. 2004 Sep;9(3):297-307.
Brown AC, Hairfield M, Richards DG, McMillin DL, Mein EA, Nelson CD.
Department of Human Nutrition, Food and Animal Sciences,University of Hawaii at Manoa, 1955 East West Road, Rm 216, Honolulu, HI 
This research evaluated five case studies of patients with psoriasis following a dietary regimen. There is no cure for psoriasis and the multiple treatments currently available only attempt to reduce the severity of symptoms. Treatments range from topical applications, systemic therapies, and phototherapy; while some are effective, many are associated with significant adverse effects. There is a need for effective, affordable therapies with fewer side effects that address the causes of the disorder. Evaluation consisted of a study group of five patients diagnosed with chronic plaque psoriasis (two men and three women, average age 52 years; range 40-68 years) attending a 10-day, live-in program during which a physician assessed psoriasis symptoms and bowel permeability. Subjects were then instructed on continuing the therapy protocol at home for six months. The dietary protocol, based on Edgar Cayce readings, included a diet of fresh fruits and vegetables, small amounts of protein from fish and fowl, fiber supplements, olive oil, and avoidance of red meat, processed foods, and refined carbohydrates. Saffron tea and Slippery elm bark  water were consumed daily. The five psoriasis cases, ranging from mild to severe at the study onset, improved on all measured outcomes over a six-month period.

The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial.
Br J Dermatol. 2004 May;150(5):966-9.
Lithium carbonate is the most widely used long-term treatment for bipolar affective disorders, but its ability to trigger and exacerbate psoriasis can become a major problem in patients for whom lithium is the only treatment option. Inositol depletion underlies the action of lithium in bipolar affective disorders and there are good theoretical reasons why the use of inositol supplements might be expected to help this group of patients. OBJECTIVES: To determine whether inositol supplements improve the psoriasis of patients on lithium therapy. METHODS: Fifteen patients with psoriasis, who were taking lithium, took part in a randomized, double-blind, placebo-controlled, crossover clinical trial comparing the effect of inositol supplements with those of a placebo (lactose). Changes in the severity of their psoriasis were measured by Psoriasis Area and Severity Index scores recorded before and after the different courses of treatment. The effect of inositol supplements on the psoriasis of 11 patients who were not taking lithium was evaluated in the same way. RESULTS: The inositol supplements had a significantly beneficial effect on the psoriasis of patients taking lithium. No such effect was detected on the psoriasis of patients not on lithium. CONCLUSIONS: The use of inositol supplements is worth considering for patients with intractable psoriasis who need to continue to take lithium for bipolar affective disorders.

Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study.
Complement Ther Med. 2003 Dec;11(4):226-34.
Al-Waili NS.
Dubai Specialized Medical Center and Medical Research Laboratories, Islamic Establishment for Education, Dubai, United Arab Emirates.
To investigate the effects of honey, olive oil and beeswax mixture on patients with atopic dermatitis (AD) or psoriasis vulgaris (PV). Twenty-one patients with dermatitis and 18 patients with psoriasis were entered for patient-blinded, partially controlled study; 11 patients with dermatitis used topical betamethasone esters and 10 patients with psoriasis used clobetasol propionate. Honey mixture contained honey, beeswax and olive oil (1:1:1). Mixtures A, B, and C contained honey mixture with the corticosteroids ointment in a ratio of 1:1, 2:1, and 3:1 respectively. Patients with dermatitis were subjected to controlled bilateral half-body comparison to evaluate the efficacy of honey mixture against Vaseline, or mixture A against Vaseline-betamethasone esters mixture (1:1) in patients using topical corticosteroid treatment. In patients with psoriasis, the effect of honey mixture was compared with paraffin in an individual right/left-sites comparison, or mixture A against paraffin-clobetasol propionate mixture (1:1) in patients using corticosteroid topical therapy. In dermatitis, body lesions on right or left half-body were assessed for erythema, scaling, lichenification, excoriation, indurations, oozing and itching on a 0-4 points scale. In psoriasis, lesions of selected site were assessed for redness, scaling, thickening and itching, on a 0-4 points scale. In honey mixture group, 8/10 patients with dermatitis showed significant improvement after 2 weeks, and 5/11 patients pretreated with betamethasone esters showed no deterioration upon 75% reduction of corticosteroid doses with use of mixture C. In psoriasis, 5/8 patients showed a significant response to honey mixture. In patients using clobetasol propionate, 5/10 patients showed no deterioration upon 75% reduction of corticosteroid doses with use of mixture C. Honey mixture appears useful in the management of dermatitis and psoriasis vulgaris.

Orally administered Polypodium leucotomos extract decreases psoralen-UVA-induced phototoxicity, pigmentation, and damage of human skin.
J Am Acad Dermatol. 2004 Jan;50(1):41-9.
Middelkamp-Hup MA, Pathak MA, Parrado C, Garcia-Caballero T, Rius-Diaz F, Fitzpatrick TB, Gonzalez S.
Wellman Laboratories of Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
The use of psoralen-UVA (PUVA) in patients of skin phototype I to II is limited by side effects of acute phototoxicity and possible long-term carcinogenesis. We sought to assess oral Polypodium leucotomos extract in decreasing PUVA-induced phototoxicity of human skin on a clinical and histologic level. A total of 10 healthy patients with skin phototypes II to III were exposed to PUVA alone (using 0.6 mg/kg oral 8-methoxypsoralen) and to PUVA with 7.5 mg/kg of oral PL. Clinically, phototoxicity was always lower in PL-treated skin after 48 to 72 hours, and pigmentation was also reduced 4 months later. Histologically, PL-treated skin showed a significant numeric reduction of sunburn cells, preservation of Langerhans cells, decrease of tryptase-positive mast cell infiltration, and decrease of vasodilation. No differences were found in Ki-67+ proliferating cells. CONCLUSIONS: PL is an effective chemophotoprotector against PUVA-induced skin phototoxicity and leads to substantial benefits of skin protection against damaging effects of PUVA as evidenced by histology.

Clinical study on effect of zhuhuang granule no. 2 in treating psoriasis with liver-qi stagnancy
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001 Apr;21(4):269-71.
To observe the efficacy of Zhuhuang Granule No. 2 (ZHG2) in treating psoriasis with Liver-Qi stagnancy. Sixty-seven patients were randomly divided into two groups, the 33 patients in the control group were treated with composite indigo capsule and the 34 in the treated group treated with ZHG2, and the clinical effect, changes of main symptoms and local skin lesion after treatment were evaluated. Meanwhile, the plasma levels of substance P (SP) and vasoactive intestinal peptide (VIP) in 15 patients and 13 healthy subjects were measured using radioimmunoassay (RIA). The total effective rate in the treated group and the control group was 97% and 78% respectively with significant difference. ZHG2 showed a significant effect in reducing plasma level of SP and VIP in patients of psoriasis with Liver-Qi stagnancy. The effect of ZHG2 in treating psoriasis patients with Liver-Qi stagnancy is satisfactory, and worth further studying.

A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris.
J Eur Acad Dermatol Venereol. 2005 May;19(3):326-31.
The Aloe vera plant has been used for an array of ailments, including skin diseases. Recent experimental research have substantiated the presence of biologically active compounds in the gel, but there are few controlled, clinical trials to assess the efficacy. Objective To test the effect of a commercial, preserved, but otherwise untreated Aloe vera gel in psoriasis. Patients/methods Forty-one patients with stable plaque psoriasis were included in a randomized, double-blind, placebo-controlled right/left comparison. The study comprised a 2-week wash-out period followed by a 4-week treatment period with two daily applications and follow-up visits after 1 and 2 months. Results Data on 40 patients were analysed. The score sum of erythema, infiltration and desquamation decreased in 72% of the Aloe vera-treated sites compared with 82.5% of the placebo-treated areas from week 0 to week 4, which was statistically significant in favour of the placebo treatment. Fifty-five per cent of the patients reported local side-effects, mainly drying up of the skin on test areas. Conclusions The effect of this commercial Aloe vera gel on stable plaque psoriasis was modest and not better than placebo. However, the high response rate of placebo indicated a possible effect of this in its own right, which would make the Aloe vera gel treatment appear less effective.

A rare cause of complete heart block after transdermal botanical treatment for psoriasis.
Pacing Clin Electrophysiol. 2004 Dec;27(12):1686-8.
We report the case of a 59-year-old man with a new 3 degrees AV block with a history of psoriasis. After implantation of a definitive DDDR pacemaker, the patient reported a transdermal self-medication with an extract of Nerium oleander for the treatment of his psoriasis.

2 years personal experience in anapsos treatment of psoriasis in various clinical forms
Med Cutan Ibero Lat Am. 1983;11(1):65-72. Pineiro Alvarez B.
A personal experience on 495 patients affected by several forms of psoriasis and its answer to the treatment with anapsos (Polypodium Leucotomos Extract) is presented. The whitenings between 80% and 100% of the affected skin were achieved on 304 patients (61.41%); 46 patients whitened between 30% and 80% of their lesions, 15 obtained null results and only 11 had relapses. It is remarkable the high number of abandonments to treatment which came at 119 patients (24.04%) due to slowness of process and other reasons probably. The association with PUVA which shortens the treatment and gives other advantages is pointed out as positive. The average time of treatment was 6 months, and daily doses were from 80 mg. and 720 mg. depending on age, weight and treatment phase. Side effects appeared in two patients only: one with intense pruritus and the other one with gastric disturbances. In both cases, these side effects disappeared when the treatment was interrupted.

Psoriasis Questions
Q. Do you know of an herb or natural treatment for psoriatic arthritis?
   A. Not at this time.

Q. Can MSM be useful in psoriasis treatment?
   A. We have not seen research regarding the relationship of a MSM supplement and psoriasis.

Q. My husband has suffered with psoriasis for over 20 years. We have tried just about everything over the counter to give him some psoriasis relief and they have worked little if at all. Last year he tried giving himself shots of some type of anti-cancer drug which did clear him up but also resulted in him getting very ill at which time he discontinued using them. We are now considering buying a sauna suit to see if that helps and wanted to know if there are any supplements that have been studied for use in psoriasis patients with positive results. I should also add that his psoriasis covers about 80% of his body and that he has used cortisone on his face for many years with decent results if used daily.
   A. We can only provide general info on psoriasis and we will update this site as more info becomes available on natural treatment or natural supplements for psoriasis.

Q. Curcumin, as always, I enjoy your newsletters. Due to an unwillingness of Dermatologists in my area to treat the uninsured and underinsured, I have been volunteering my time each week to care for them. Many of these unfortunate patients have severe psoriasis, accompanied by its many physical and psychological effects. I wholeheartedly agree that smoking and stress worsen their condition. Some patients seem to smoke, in all ill-conceived effort to self-manage their stress. Nevertheless, most treatments in my armamentarium are too expensive, potentially toxic in the long-term, or both. Even those patients with some insurance rarely have their insurance plans approve the high-cost, but fairly effective treatments. Given that insurance appeals processes are often time-intensive yet futile, and the major pharmaceutical companies have cut their patient assistance programs, one can understandable why some previously well-intentioned doctors have withdrawn from delivering this care. Although I understand that expenditures on their smoking habits could pay for medications or supplements, not all of the patients smoke. I'm searching for low cost alternatives for these patients. Could you either lay out a more detailed or comprehensive dietary and behavioral management plan for my patients on your website, or perhaps provide me with references to review and distribute to them? As an antinflammatory, can be helpful for those who suffer psoriasis?
   A. We have not seen any good clinical studies with the use of curcumin for psoriasis treatment.

Q. I am a 70 year old male and have had psoriasis for over 40 years. The psoriasis has progresses to approximately 20 percent coverage. I began having minor arthritis symptoms in my shoulder and hands about 3 years ago. I began taking 2 grams of turmeric in capsule following one 10mg of Bioperine 3 times per day 5 months ago. My arthritis is practically non existent. I was taking 800 mg of Ibuprofen each morning to alleviate the pain. I take none now! My psoriasis has improved probably 70 percent with practically no scaling, a great reduction in redness and almost no itching.

Q. I have suffered with psoriasis for over 30 years now and am seeking help. I have ordered curcumin and would like your opinion as to how much I should take. I am tired of taking dangerous drugs that have caused me many other health problems and the light treatments have caused me squamous cell skin cancer. I have no idea if curcumin is my answer but I want to give it a try. Your opinion on the dose would be appreciated.
   A. We can't give such an answer since we have not seen studies with curcumin and psoriasis and each person has a different tolerance level to herbs. It's best to discuss with your doctor and start with one capsule a day for a week and then gradually increase the dosage over time if you can tolerate the one capsule.

Q. I am a medical doctor, and, as always, I enjoy your newsletters. Due to an unwillingness of Dermatologists in my area to treat the uninsured and underinsured, I have been volunteering my time each week to care for them. Many of these unfortunate patients have severe psoriasis, accompanied by its many physical and psychological effects. I wholeheartedly agree that smoking and stress worsen their condition. Some patients seem to smoke, in all ill-conceived effort to self-manage their stress. Nevertheless, most treatments in my armamentarium are too expensive, potentially toxic in the long-term, or both. Even those patients with some insurance rarely have their insurance plans approve the high-cost, but fairly effective treatments. Given that insurance appeals processes are often time-intensive yet futile, and the major pharmaceutical companies have cut their patient assistance programs, one can understandable why some previously well-intentioned doctors have withdrawn from delivering this care. Although I understand that expenditures on their smoking habits could pay for medications or supplements, not all of the patients smoke. I'm searching for low cost alternatives for these patients. Could you either lay out a more detailed or comprehensive dietary and behavioral management plan for my patients on your website, or perhaps provide me with references to review and distribute to them?
   A. It's great of you to spend your valuable time helping poor patients, that's commendable. Basically one needs to reduce the overall inflammation in the body with omega-3 fish oils and veggies, and decrease sugar, white flour, and omega-6 vegetable oils that are inflammatory. Research in this area is still early so I don't have a comprehensive plan yet but plan to develop it with time.

Q. Psoriasis antigen genetically was never found, so is it not clear what is going on and if it is an autoimmune disease?
   A. This is not an area that I have specialized in, but my understanding is that psoriasis is an autoimmune disease.

Q. Does stress make psoriasis symptoms worse?
   A. The issue of the relationship of stress and psoriasis severity has been debated with some thinking that stress does make the skin condition worse whereas other doctors don't think there is a relationship. It appears that the influence of stress on psoriasis is minimal and not significant.


Sarsaparilla has been historically used for psoriasis.