What are the key factors influencing psoriasis. How does diet impact psoriasis severity. What are effective natural treatments for managing psoriasis symptoms. How can lifestyle changes improve psoriasis outcomes. What is the connection between psoriasis and other health conditions.

Understanding Psoriasis: A Chronic Inflammatory Skin Condition

Psoriasis is a persistent inflammatory skin disorder characterized by thick, raised, bright red and pink plaques covered with silvery scales. Affecting between 1% and 8.5% of adults worldwide, its prevalence increases with distance from the equator. In the United States, approximately 2% of the population is affected by this condition.

The most common form, plaque psoriasis, typically involves the scalp, elbows, knees, and back. While psoriasis can occur at any age, it is less common in children. The onset of psoriasis tends to peak in the fourth decade of life and again between the ages of 50 and 69.

What causes psoriasis?

Psoriasis is generally considered an immune system disorder that leads to the production of proinflammatory cytokines and abnormal maturation of the outer layer of skin cells. While genetics play a significant role in the development of psoriasis, behavioral and environmental factors clearly influence the course of the disease.

• Infections
• Stress
• Trauma
• Certain medications

These factors can initiate or worsen flares in people with a genetic predisposition to developing psoriasis. Smoking is clearly implicated in the onset and severity of psoriasis, with the incidence decreasing after successful smoking cessation. Higher body mass index and increased alcohol intake have also been linked to psoriasis.

The Impact of Medications on Psoriasis

Certain medications are known to exacerbate psoriasis symptoms. These include:

• Lithium
• Beta-blockers
• Antimalarials
• Interferon
• Rapid tapers of systemic corticosteroids

It’s crucial for individuals with psoriasis to be aware of these potential triggers and discuss any new medications with their healthcare provider.

Psoriasis and Associated Health Conditions

Psoriasis is not just a skin condition; it has been associated with several comorbidities that can significantly impact overall health and quality of life. These include:

1. Psoriatic arthritis
2. Cardiovascular disease
3. Depression
4. Diabetes
5. Metabolic syndrome
6. Nonmelanoma skin cancer

Given these associations, it is essential for healthcare providers to screen for these conditions in patients with psoriasis and address them when present. A comprehensive approach to psoriasis management should consider not only skin symptoms but also potential systemic effects.

Holistic Approaches to Psoriasis Treatment

While conventional treatments for psoriasis often focus on topical medications and systemic therapies, holistic approaches can play a significant role in managing symptoms and improving overall well-being. These approaches consider the whole person, addressing not only the skin manifestations but also lifestyle factors that may influence the condition.

Gentle Skin Care Practices

Proper skin care is fundamental in managing psoriasis symptoms and preventing flares. Here are some key recommendations:

• Use lukewarm water for bathing
• Choose non-detergent-based cleansers or glycerin-based soaps
• Avoid abrasive cleansing devices
• Apply thick moisturizing creams or ointments, especially while the skin is still damp
• Consider natural oils such as avocado, coconut, almond, or olive
• Try colloidal oatmeal in the form of an emollient or bath powder to soothe itching and irritation

These gentle skin care practices can help minimize itching and limit trauma-induced flares, keeping psoriatic skin soft and less vulnerable to irritation.

The Role of Diet in Psoriasis Management

Dietary choices can have a significant impact on psoriasis symptoms and overall health. While research in this area is ongoing, several dietary approaches have shown promise in managing psoriasis:

Anti-Inflammatory Diet

An anti-inflammatory or Mediterranean-style diet has been found to enhance many aspects of health, especially in the setting of inflammatory diseases like psoriasis. While dietary studies in psoriasis are limited, some indicate that an anti-inflammatory diet contributes to less severe disease. This approach not only may help with psoriasis symptoms but also can address comorbidities associated with the condition.

Weight Loss Diets

For overweight and obese patients with psoriasis, diets that promote weight loss (e.g., low-calorie diets) have been found to be beneficial. It’s crucial to ensure that any weight loss diet provides adequate nutritional intake. Consulting with a dietician can be helpful in developing a balanced and effective meal plan.

Gluten-Free Diet

Some patients with psoriasis have experienced improvement on a gluten-free diet. This may be particularly relevant for individuals with elevated markers for celiac disease. However, it’s important to note that not all psoriasis patients will benefit from a gluten-free diet, and such dietary changes should be made under the guidance of a healthcare professional.

Lifestyle Modifications for Psoriasis Management

Beyond diet and skin care, several lifestyle modifications can help manage psoriasis symptoms and improve overall health:

Stress Management

Given that stress is a known trigger for psoriasis flares, implementing stress reduction techniques can be beneficial. These may include:

• Meditation
• Deep breathing exercises
• Yoga
• Regular physical activity
• Adequate sleep

Smoking Cessation

As smoking is clearly linked to the onset and severity of psoriasis, quitting smoking can lead to significant improvements in symptoms. Support from healthcare providers, nicotine replacement therapy, and behavioral counseling can aid in successful smoking cessation.

Alcohol Moderation

Reducing alcohol intake may help improve psoriasis symptoms. For those who choose to drink, moderation is key. Guidelines typically recommend no more than one drink per day for women and two for men.

Natural Remedies and Supplements for Psoriasis

While more research is needed, some natural remedies and supplements have shown potential in managing psoriasis symptoms:

Omega-3 Fatty Acids

Found in fatty fish, flaxseeds, and fish oil supplements, omega-3 fatty acids have anti-inflammatory properties that may help reduce psoriasis symptoms. However, it’s important to consult with a healthcare provider before starting any new supplement regimen.

Aloe Vera

Topical application of aloe vera gel may help soothe psoriasis plaques and reduce inflammation. Look for products containing at least 0.5% aloe vera.

Turmeric

This spice contains curcumin, which has anti-inflammatory properties. While more research is needed, some studies suggest that oral or topical turmeric may help manage psoriasis symptoms.

Vitamin D

Adequate vitamin D levels are important for overall skin health. While sunlight exposure can help the body produce vitamin D, it’s important to balance this with the risk of skin damage. Vitamin D supplements may be beneficial for some individuals with psoriasis, but should be taken under medical supervision.

The Importance of a Comprehensive Approach to Psoriasis Care

Managing psoriasis effectively requires a multifaceted approach that addresses not only the skin symptoms but also the potential underlying factors and associated health conditions. This comprehensive strategy may include:

• Regular dermatological check-ups
• Screening for associated comorbidities
• Customized treatment plans that may combine conventional therapies with holistic approaches
• Patient education about triggers and self-management strategies
• Psychological support to address the emotional impact of living with a chronic skin condition

By taking a holistic view of psoriasis care, individuals can work towards not only managing their skin symptoms but also improving their overall health and quality of life.

Emerging Research and Future Directions in Psoriasis Treatment

The field of psoriasis research is continually evolving, with new insights into the disease mechanism and potential treatments emerging regularly. Some areas of ongoing research include:

Targeted Biologics

New biologic medications that target specific components of the immune system involved in psoriasis are being developed and refined. These treatments offer the potential for more effective management with fewer side effects.

Microbiome Studies

Research into the role of the skin and gut microbiome in psoriasis is ongoing. Understanding how the microbiome influences inflammation and immune function may lead to new treatment strategies.

Personalized Medicine

Advances in genetic testing and biomarker identification may allow for more personalized treatment approaches, tailoring therapies to individual patients based on their specific genetic and immune profiles.

Combination Therapies

Exploring the effectiveness of combining different treatment modalities, such as biologics with phototherapy or topical treatments, may lead to more comprehensive and effective management strategies.

As research progresses, individuals with psoriasis can look forward to potentially more effective and personalized treatment options in the future. However, it’s important to remember that managing psoriasis is an ongoing process, and working closely with healthcare providers to develop and adjust treatment plans remains crucial.

Psoriasis – Whole Health Library

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Background

Psoriasis is a chronic inflammatory skin disease that is characterized by thick, raised, bright red and pink plaques with a silvery scale. The most common form is plaque psoriasis, which typically involves the scalp, elbows, knees, and back. It is estimated to affect between 1% and 8.5% of adults worldwide and becomes more common with increased distance from the equator. In the United Sates, it affects about 2% of the population. Psoriasis is much less commonly seen in children. The onset of psoriasis peaks in the fourth decade and again between the ages of 50 and 69.

Psoriasis is generally regarded as a disorder of the immune system that leads to the production of proinflammatory cytokines and overproduction and abnormal maturation of the outer layer of skin cells. While genetics plays a big role in the development of psoriasis, behavioral and environmental factors clearly influence the course of the disease. Infections, stress, trauma, and certain medications are known to initiate or worsen flares in people who have a genetic predisposition to developing psoriasis. Additionally, smoking is clearly implicated in the onset and severity of psoriasis, with the incidence of psoriasis decreasing after successful smoking cessation. Psoriasis has been linked with higher body mass index and increased alcohol intake as well. Finally, some medications are known to worsen psoriasis. These include lithium, beta-blockers, antimalarials, interferon, and rapid tapers of systemic corticosteroids.

Psoriasis is associated with several comorbidities including arthritis (psoriatic arthritis), cardiovascular disease, depression, diabetes, and metabolic syndrome, and nonmelanoma skin cancer.[1] It is important to screen for these and address them when present.

Treatment

Skin Care

Gentle skin care can help minimize itching and limit trauma-induced flares. Bathing in lukewarm water using non-detergent-based cleansers such as soapless cleansers or glycerin-based soaps is an important first step. Abrasive cleansing devices should be avoided because these can be traumatic to the skin and actually worsen psoriasis. Finally, applying thick moisturizing creams or ointmentsespecially while the skin is still dampwill help keep psoriatic skin soft and less vulnerable to itching and trauma. Natural oils such as avocado, coconut, almond, or olive can be very helpful. Colloidal oatmeal in the form of an emollient or bath powder (such as Aveeno) can also help soothe itching and irritation from psoriasis.

Food & Drink

Healthy dietary choices are important for overall health. Anti-inflammatory or Mediterranean-style dietary approaches have been found to enhance many aspects of healthespecially in the setting of inflammatory diseases. Psoriasis is an inflammatory condition and will likely improve when dietary choices better align with foods that inhibit rather than promote inflammation. Dietary studies in psoriasis are limited, but there are a few that indicate an anti-inflammatory diet contributes to less-severe disease. [2] Additionally, a plant based, anti-inflammatory approach to diet will help with the comorbidities associated with psoriasis. More information about these dietary approaches can be found in the Whole Health tool Choosing a Diet.

Diets that promote weight loss (e. g., low-calorie diets) have been found to be beneficial in overweight and obese patients with psoriasis.[3] It is important to make sure that the specific diet followed ensures adequate nutritional intake. Involving the aid of a dietician may be helpful.

Additionally, some patients with psoriasis have experienced improvement on a gluten-free diet.[4] Elevated markers for celiac disease (tissue transglutaminase antibodies and endomysial antibodies) have been found in some patients with psoriasis as well, and in these patients, disease severity appears to correlate with circulating levels of these markers.[5][6] Asking about family history of gluten sensitivity and about gastrointestinal symptoms of flatulence, diarrhea, and iron deficiency anemia may suggest sensitivity to gluten. Testing for these markers may help identify those patients who are most likely to benefit from a gluten-free diet. Find more information about how to eliminate gluten refer to the Whole Health tool Elimination Diets.

Supplements

Note: Please refer to the Passport to Whole Health, Chapter 15 on Dietary Supplements for more information about how to determine whether or not a specific supplement is appropriate for a given individual. Supplements are not regulated with the same degree of oversight as medications, and it is important that clinicians keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.

Omega-3 Fatty Acids

Omega-3 fatty acids have been shown to decrease the production of inflammatory compounds. Studies looking at the effects of increased intake of fish high in omega-3 fatty acids and at the effects of omega-3 fatty acid supplementation on psoriasis have found benefit.[7][8][9] However, the data is not entirely supportive. A recent meta-analysis concluded that fish oil supplementation does not result in significant improvement in psoriasis. [10] Another review looked at 12 articles and found the evidence to be inconclusive.[11] It appears that the ratio of omega-3 to omega-6 fatty acids is important and dietary differences of the subjects could explain why the results are inconclusive.

Ideally, omega-3 fatty acids should come from foods such as fatty fish (salmon, mackerel, and sardines), flaxseeds, and walnuts. When that is not possible, supplements can be helpful. Fish oil has also been shown to minimize the side effects of systemic therapies for psoriasis.

• Dose: 640-3,500 mg EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) daily[12][13]

Curcumin

Curcumin is the active component of turmeric. It has been shown to inhibit proinflammatory pathways important in psoriasis.[14] Studies evaluating clinical use have been limited, but the spice is very safe. Clinical studies have found it safe at doses up to 8-12 gm/day with the only side effects being reversible gastrointestinal problems (nausea and diarrhea). [15]

• Dose: 1,500 mg up to three times a day[16]

Vitamins and Minerals

Vitamin D

One study found that vitamin D levels were decreased in patients with psoriasis when compared to age-matched controls, and it appears that the level of vitamin D deficiency correlates with disease severity.[17] For patients who are deficient in vitamin D, supplementation can be helpful, but it is not recommended for people with psoriasis who are not found to be deficient.[18] Given the role vitamin D plays in other chronic inflammatory diseases such as cardiac disease, autoimmune diseases, and diabetes, checking a patients vitamin D level and/or conservative supplementation may be helpful.

• Dose[19]:
  • 600 IU/day for supplemental uses
  • 1,000 IU/day for treatment of vitamin D deficiency
  • 4,000 IU/day is the current suggested upper limit*

*More recent research suggests that doses up to 10,000 IU/day are safe and that the upper limit should be set at this level. [20] Above 10,000 IU/day a person should be in the care of a physician and monitored for signs of vitamin D toxicity, which includes of hypercalcemia (headache, nausea, vomiting, abdominal pain, increased urination, and thirst).

Zinc

Zinc is a cofactor in many reactions important in maintaining skin health and immune function and has been shown to have anti-inflammatory properties. Most clinical studies looking at zinc supplementation for treatment of psoriasis have not shown benefit. However, there are case reports of zinc therapy resulting in improvement of psoriasis, and some clinicians who have used zinc supplements for patients with psoriasis feel strongly that it can be beneficial for some patients.

It is likely that the formulation of zinc is important, and it appears that effervescent preparations of zinc, zinc picolonate, and methionine-bound zinc are more bioactive than other formulations such as zinc gluconate.

• Dose:
  • 30-50 mg elemental zinc a day[21]*
  • 220 mg zinc sulfate (50-90 milligrams elemental zinc depending on the preparation) 1-3 times a day[22]

*At doses higher than 30 mg a day, zinc can induce a copper deficiency; 2 mg of copper should be added for every additional 30 mg of elemental zinc.

Food sources: oysters, beef, poultry (dark meat), pork, beans, nuts

Selenium Topical Botanicals

Aloe Vera

Aloe vera is a succulent plant whose thick leaves contain an inner pulpy mucilaginous gel. The compounds in aloe vera have been found to have anti-inflammatory and anti-itch properties, as well as pain reduction and wound healing effects. Various preparations have been found effective in the treatment of psoriasis.

Development of contact dermatitis is possible but appears to be rare.

• Dose:
  • Aloe vera gel applied two to multiple times a day[23]
  • 0.5% extract in cream applied three times a day[24]
  • Cream containing 70% aloe mucilage applied twice a day[25]

Indigo Naturalis Extract

Indigo naturalis extract has been shown to decrease markers of cell proliferation and inflammation seen in psoriasis. An 8-week, side-by-side trial where 14 people with chronic plaque psoriasis applied either 5% indigo or vehicle placebo to contralateral sides of the body were evaluated with both objective measures of psoriasis severity as well as with biopsies. Ki-67 (a marker for skin cell proliferation) and CD3 (an inflammatory marker seen in psoriasis) were both decreased.[26]

• Dose: 3%-7% ointment, cream, or oil applied 1-2 times a day

Glycerrhetinic Acid

Glycyrrhetinic acid is a component from licorice root that has inhibitory activity on the enzyme 11-beta-hydroxysteroid dehydrogenase which is responsible for inactivating cortisol. It has been shown to potentiate the action of hydrocortisone in the skin. [27] Glycyrrhetinic acid has also been shown to have anti-inflammatory properties as well [28]. One review looked at 11 randomized controlled trials in which topical glycyrrhetinic acid was used along with conventional therapy for psoriasis. The glycyrrhetinic acid enhanced the response, with a greater number of people experiencing significant improvement. Adverse reactions were the same with and without the addition of glycyrrhetinic acid. [29]

• Dose: 2% glycyrrhetinic acid cream or ointment once to twice a day

Mahonia Aquafolium

Also known as Oregon grape, Mahonia aquafolium contains berberine, which has anti-inflammatory and antimicrobial activities. It is a compound that can be helpful in treatment of psoriasis. It has been shown to decrease 5 lipoxygenase activity, reduce levels of inflammatory cytokines, and decrease expression of keratins 6 and 16, which are overexpressed in psoriatic plaques. Berberine also appears to decrease keratinocyte proliferation.[30] Topical treatment with M. aquafolium appears to surpass treatment with calcipotriene, and it is safe. Potential side effects reported include itching, burning, and rash.

• Dose: 10% Mahonia aquafolium cream or ointment once or twice a day.

Capsaicin

Itching is caused by a compound called substance P, which has been found to be higher in skin affected by psoriasis. Capsaicin is a compound extracted from the red pepper that causes depletion of substance P. It has been shown to decrease the sensation of itch in psoriasis.

It can cause a burning sensation that usually only lasts a few days with continued use.

• Dose:
  • 0.025% cream applied 4 times per day[31]
  • 0.075% cream is also available

Topical Over-the-Counter Medications

Keratolytics

Keratolytics are compounds that break down the outer layers of the skin. This class of compounds includes salicylic acid (2%-10%), urea (20%-40%) and alpha-hydroxy acids (glycolic and lactic acids). They can help to decrease the thickness of psoriatic plaques, which can lead to increased comfort, decreased itching as well as better absorption of other topical medications.

• Dose: Compounds with 2%-10% salicylic acid, 20%-40% urea, or alpha-hydroxy acids applied once to several times a day as long as they do not cause irritation

Tar

Tar-based products are either derived from coal or from wood (pine, birch).

A precise mechanism of action is difficult to determine because of the large number of compounds present in tar-based products. Possible mechanisms of action include anti-inflammatory properties, anti-itch properties, and the ability to slow down the increased rates of cell turnover seen in psoriasis. Side effects are infrequent and potentially include local irritation or allergic reactions, folliculitis or acne-like eruptions, and increased photosensitivity. Prolonged use of high concentrations in sun-exposed areas may result in an increased risk of skin cancer. If the formulation is too strong or irritating, it can worsen psoriasis.

• Dose: 1%-5% crude tar or 10%-20% tar extract (LCD)[32]

Other Therapies to Consider

Lifestyle Choices

Regular exercise and good sleep are important for all aspects of overall health. One large population-based study found a decreased risk of psoriasis in people who engage in vigorous physical exercise for at least 3-4 hours per week,[33] and other studies have found improvement in psoriasis with exercise. Other health problems should be considered when starting a new exercise program, but it is reasonable for most otherwise healthy people with psoriasis to consider adding or increasing regular vigorous exercise in their daily lives.

Ultraviolet (UV) exposure can also help minimize psoriatic flares and phototherapy is often used in the clinical setting for treatment of psoriasis. Spending time engaged in outdoor activities may help improve psoriasis by UV exposure as well as by increasing physical activity levels. Overall risks for developing skin cancer including skin type, family history, and past sun exposure should be taken into account when determining how long a person with psoriasis should be in the sun without UV protection.

Mind-Body

Stress plays a strong role in psoriatic flares.[34] There are a wide range of mind-body approaches that can be beneficial for people who have psoriasis.[35] Mindful awareness meditation has been shown to help alleviate symptoms of psoriasis in some people. Medical hypnotherapists help guide people into a deeply relaxed trance state. They make suggestions with specific intentions regarding the alleviation of suffering and promotion of healing. Hypnosis has been shown to improve psoriasis in patients who are highly hypnotizable. Biofeedback uses technology to help patients learn to relax by learning to control their autonomic nervous system, and can be particularly helpful to people who have lower hypnotic abilities.[36] Cognitive Behavioral Therapy (CBT) has been found beneficialespecially in patients with moderate to severe psoriasis.[37]

The relationship between practitioner and patient is extremely important for any mind-body therapy, and it is crucial to find a practitioner that one can work with comfortably.

Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is a health system that has been around for over 2,500 years. It is based on the premise that qi is a vital energy that maintains health and balance in the body. Two opposing but complementary forcesyin and yangsupport health when they are in harmony and are responsible for disease when they are out of balance. There are several techniques used in the scope of TCM with acupuncture and herbal medicine being the most common in the United States. As a system, the techniques are best used in combination by skilled practitioners. Acupuncture alone or with TCM herbs has shown effective for treating psoriasis.[38] Other acupoint-related therapies including acupressure (needleless pressure applied at an acupuncture point) and cat gut embedding (catgut is embedded under the skin at acupuncture points providing stimulation for 5-7 days before it is absorbed) have also shown benefit in psoriasis.[39]

When looking for a TCM practitioner, one should inquire about certification and education. Any practitioner should at minimum have state licensure. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) has strict certification requirements, and members are required to recertify every 4 years. Refer to the NCCAOM website for a directory of certified practitioners. For more information, refer to Whole Systems of Medicine, Chapter 18 in the Passport to Whole Health.

Homeopathy

Homeopathy is a medical system that uses highly diluted substances to treat disease with the intention of triggering the bodys innate ability to heal. Remedy selection takes into consideration the patients symptoms, personality traits, physical and psychological states, and life history. Although research is limited, homeopathy has been shown effective at treating psoriasis.[40] Because worsening of a condition is possible with homeopathic treatment, it is important to work with a well-trained and qualified homeopathic practitioner. One should look for a practitioner who is certified by at least one of the following organizations: Council for Homeopathic Certification (CHC), North American Society of Homeopaths (NASH), American Board of Homeotherapeutics (ABHt), or Homeopathic Academy of Naturopathic Physicians (HANP). For more details, refer to Whole Systems of Medicine, Chapter 18 of the Passport to Whole Health.

Prevention Outline: Psoriasis

• Maintain a balanced lifestyle including regular exercise and adequate sleep
• Eat a high-quality anti-inflammatory or Mediterranean-style diet
• Eat foods high in omega-3 fatty acids (salmon, nuts, flax) or take a supplement
• Consider a trial of a gluten-free dietespecially if you have GI symptoms.
• Maintain a healthy body weight
• Find ways to better manage stress
• Avoid alcohol overuse
• Avoid tobacco
• Avoid or minimize medications known to exacerbate psoriasis: lithium, beta-blockers, antimalarials, interferon, and rapid tapers of systemic corticosteroids
• Practice good skin hygiene and use emollients liberally to minimize itch.
• Consider topical aloe and indigo

Author(s)

Psoriasis was written by Apple Bodemer, MD (2014, updated 2020).

References

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6 Too-Good-To-Be-True Psoriasis Treatments

Effective medications exist to help manage psoriasis, but many people are still tempted to try alternative approaches. Beware of psoriasis scams that could hurt, not heal.

By Madeline R. Vann, MPHMedically Reviewed by Niya Jones, MD, MPH

Reviewed: January 7, 2015

Medically Reviewed

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If you’re hoping for a magic pill to keep your psoriasis under control, beware: Scammers are out to fool you.

Do your research and talk to your doctor to find out whether you’re considering bogus psoriasis treatments and would do better with a prescription psoriasis medication. “In general when I talk to patients about treatment, I tell them that over-the-counter remedies are not particularly effective,” explained dermatologist Junko Takeshita, MD, PhD, a clinical instructor in the dermatology department at the University of Pennsylvania in Philadelphia.

What’s more, miracle cures or supplements promoted by scam artists could be downright dangerous. “I think people are always looking for alternative treatments because the systemic medications can have adverse side effects,” Dr. Takeshita said, but she noted that even treatments called natural approaches could be psoriasis scams and may actually lead to more severe side effects than you might expect. Read on to know when to be leery.

Skin-Cap, Blue-Cap, and Psor-Val

Different names, same idea. Manufacturers of these products tried flying under the radar of agencies like the Food and Drug Administration (FDA), putting prescription-strength active ingredients in their products. Not really bogus psoriasis treatments, they can work — but they can also be extremely dangerous because of high levels of topical steroids. “At the right dose, these are used to help control flares of psoriasis,” explained Takeshita. “It’s not surprising it would be effective.” But ongoing use of strong topical steroids, especially without your doctor’s supervision, can lead to adverse effects such as thinning skin, skin infections, and other complications.

Miralex

Not to be confused with the fiber product Miralax, this is another topical treatment with high levels of steroids, specifically clobetasol. Miralex, which was made in Canada, was the subject of a class action lawsuit in 2002 after the Canadian government issued a warning that included the risk of plaque psoriasis turning into the pustular form after stopping Miralex. If you’re tempted to seek out stronger meds like this in another country, don’t: “They don’t provide the same level of regulation that we have here,” Takeshita warned.

Exorex

Exorex is a line of expensive gels and shampoos advertised as containing emulsified coal tar to treat psoriasis. But there’s no magic here — emulsifying coal tar usually just means processing it with emollients. The FDA allows coal tar to be marketed for psoriasis treatment, and coal tar treatments have long been used to manage plaques, but many common drugstore brands contain as much or more coal tar as Exorex. Prescription topical treatments might be more effective. So talk to your doctor about whether coal tar products are appropriate for you.

Zinc Supplements

Though zinc pyrithione is a common ingredient in topical psoriasis creams and may offer some relief for psoriasis plaques, a 1994 clinical trial found no benefits of taking zinc orally for psoriasis. Yet bogus psoriasis treatment centered on zinc supplements is still circulating. “I’m not aware of any studies showing that zinc is effective in treating psoriasis,” emphasized Takeshita. “It doesn’t make sense to me why zinc would help.” She said that you could feel better with a healthy, balanced diet and by losing weight if needed, but there’s no reason to spend money on zinc specifically.

Neem Oil

Found in a variety of cosmetics, neem oil is also used as a pesticide, made from the seeds of the neem tree. The oil is touted as a skin soother for psoriasis. “If a product is truly an oil and doesn’t have any other ingredients, it might not be treating the psoriasis as much as cosmetically making sure the skin doesn’t look as flaky,” said Takeshita. Also, beware that even herbal products, including neem oil, have the potential to irritate skin. Takeshita advised discontinuing the use of any item that makes your skin worse or less comfortable.

Nystatin

Small studies on oral nystatin for psoriasis done in the 1980s and ’90s might have been behind this bogus psoriasis treatment. Nystatin is an antifungal cream, but while psoriasis plaques itch and irritate, they aren’t caused by a fungus. People who have used this might have found some benefit if they were experiencing a co-occurring fungal infection, but it’s unlikely that you’d otherwise see a benefit from an antifungal treatment. Before you add another topical treatment to the mix, check with your doctor to make sure you really need it, and it won’t interact with other treatments you are using.

How to Tell If a Psoriasis Treatment Is a Scam

If you’re considering a product and concerned that it’s a scam, pick up the phone. Takeshita suggested talking to your doctor about possible new treatments. If you suspect you’ve been prey to a bogus psoriasis treatment, you can report it to the health care section of your state attorney general’s office for investigation. According to Joe Peters, a spokesman for the New Jersey Attorney General’s office, “the complaints surrounding these products usually include allegations of misrepresentations surrounding a so-called free trial offer, deceptive or useless return policies, unauthorized charges, refusal to accept returns or refund money, and issues with efficacy, such as the product not working as advertised. ”

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The use of zinc pyrithione in the treatment of skin diseases

Zinc preparations have been used for many centuries as an effective remedy to help fight various skin problems. Zinc pyrithione is one of the modern forms of this substance, discovered in the 30s of the XX century. Despite the relative “youth” of this component, it is sufficiently studied. Its pharmacological properties have been studied in various studies, which made it possible to include this component in the composition of medicines. And, mainly, preparations with activated zinc pyrithione have found application in cosmetology and dermatology.

What other forms of zinc exist?

If we consider zinc as a whole, then in cosmetology and dermatology it is used in the form of bioactive salts. The substance is relatively safe for the body, therefore, in the production of medicines, caring and decorative cosmetics for the skin, its use in high concentrations is allowed. Most often, for medicinal purposes, zinc salts are added to the composition of creams, shampoos, lotions in a concentration of 0.1 to 5%.

Among zinc compounds, several of the most relevant, actively used in the pharmaceutical and chemical industries, should be distinguished:

• Zinc oxide – provides care for aging skin, effectively soothes it, restores protective functions. It is often included in skin protection products from the sun, as it is considered a natural UV filter.
• Zinc sulfate – the main purpose of this substance is to protect the skin from inflammation and fight pathogenic microorganisms.
• Zinc pyrithione – used to treat various skin diseases, including seborrheic and atopic dermatitis, psoriasis, has a pronounced anti-inflammatory, antibacterial and antifungal properties.

Preparations based on activated zinc pyrithione have recently become especially in demand. The relevance of these funds is due to the fact that they help to deal with serious dermatological problems, being in some cases an alternative to external hormone-containing drugs for the treatment of skin diseases.

Activated zinc pyrithione – what is it?

Products containing this substance are often used in dermatology for the treatment of many skin diseases. This is because zinc pyrithione has the following properties:

• is active against many pathogenic microorganisms (streptococci, staphylococci), inhibits the growth and reproduction of fungi of the genus Malassezia spp. , which support inflammation in diseases such as atopic dermatitis, seborrhea;
• has an anti-inflammatory effect;
• has a keratoregulatory and sebum-regulating effect, which is especially important for seborrheic dermatitis;
• helps to eliminate itching.

Zinc pyrithione exerts its action in the skin lesion, while practically does not penetrate into the bloodstream. Preparations based on it are used in the treatment of skin diseases both in adults, including the elderly, and in children older than one year.

Indications for the use of zinc pyrithione

Preparations containing activated zinc pyrithione are used as therapeutic agents for complex diseases such as:

• atopic dermatitis;
• eczema;
• neurodermatitis;
• seborrheic dermatitis;
• psoriasis.

Contraindications and Precautions

Activated zinc pyrithione preparations are generally very well tolerated by patients. The only exception in which these funds are not recommended for use is increased individual sensitivity to individual components in the composition.

In the first days of treatment with a cream or aerosol based on activated zinc pyrithione, a short-term burning sensation may occur at the site of application. This is absolutely normal and does not require discontinuation of the drug.

And yet, it must be remembered that preparations based on activated zinc pyrithione are medicinal, and therefore it is necessary to use them on the recommendation of a doctor.

Line of preparations Skin-cap with activated zinc pyrithione

Today it is not a problem to find preparations containing activated zinc pyrithione among pharmaceutical products. As the best option for the treatment of atopic and seborrheic dermatitis, psoriasis and other skin problems, doctors often recommend the Skin-Cap line of drugs. The tool is available in several forms, which makes the use as convenient as possible, allows you to include these drugs in the treatment regimen at any stage of the disease and for any form of dermatitis.

Shampoo Skin cap

Contains activated zinc pyrithione at a concentration of 1%. The main purpose of this drug is to prevent and treat:

• psoriasis of the scalp;
• atopic dermatitis localized on the scalp;
• seborrheic dermatitis;
• oily and dry seborrhea;
• dandruff and itching;

Shampoo for external use. Before applying the bottle with the drug should be shaken well several times. The product is used in small quantities, applied to wet hair and scalp, distributed with massaging movements, after which it is necessary to rinse the hair with clean water. Next, the shampoo is applied again, lathered thoroughly and left on the hair for 5 minutes. This is necessary in order for the active substances to have their effect. After this time, the product is washed off the hair and scalp with plenty of warm water.

In the treatment of these skin diseases shampoo is used 2-3 times a week. The duration of the course of treatment depends on the disease. For example, shampoo with activated zinc pyrithione for psoriasis is used for five weeks, for seborrheic dermatitis – for two weeks. During the period of remission of the disease and to prevent relapses, shampoo is used as a prophylactic agent at least 1-2 times a week.

Skin cap cream

This preparation contains activated zinc pyrithione at a concentration of 0.2%. It is intended for external use in adults and children over one year old. Used to heal:

• psoriasis;
• atopic dermatitis, neurodermatitis;
• seborrheic dermatitis;
• dry skin.

Apply the cream to the surface of the skin after thoroughly shaking the tube. It is necessary to cover the skin with a thin layer of the drug in the places of localization of skin lesions. Use the cream twice a day. Depending on the disease, the following duration of treatment is recommended:

• for atopic dermatitis – up to 3-4 weeks;
• with psoriasis – up to 4-6 weeks.

If necessary, you can repeat the course of treatment after 1-1.5 months after consulting a doctor.

The cream has a light texture, easy to apply without leaving a greasy film, ideal for the localization of rashes on the face and exposed skin. Auxiliary components in the composition of the cream have additional caring properties – moisturize and nourish the skin.

Aerosol Skin-cap

The concentration of zinc pyrithione activated in the preparation is 0.2%. The aerosol is used both for the treatment of the scalp (a special nozzle is attached), it is also suitable for the treatment of so-called “weeping” rashes, it is convenient for non-contact application, including in skin folds. Used externally in treatment:

• psoriasis;
• atopic dermatitis, neurodermatitis;
• eczema
• seborrheic dermatitis.

Shake vial several times before use. Spray the aerosol onto the inflammation site from a distance of about 15 cm, holding the bottle in an upright position. If it is necessary to treat the scalp, then for the convenience of applying the product, it is recommended to use a special nozzle that comes with the kit. With exacerbation of these skin diseases, the drug is sprayed 2-3 times a day, the duration of use, depending on the disease, is 1-1.5 months.

Zinc pyrithione activated in the treatment of atopic dermatitis

Atopic dermatitis is a chronic inflammatory skin disease that is characterized by age-related rashes and is accompanied by severe itching.

As a rule, atopic dermatitis proceeds in waves, that is, periods of exacerbation are replaced by relative calm and a decrease in the severity of symptoms.

External therapy is an integral part of the treatment of atopic dermatitis. For this purpose, patients with a severe exacerbation may be prescribed hormonal preparations based on corticosteroids to relieve acute inflammation. The second stage, as a rule, is prescribed more gentle drugs, for example, Skin-cap, as maintenance therapy. It is known that the skin microbiome of a patient with atopic dermatitis has its own characteristics – streptococci and fungi of the genus Malassezia, which abundantly colonize the skin, causing constant irritation and itching. That is why Skin-cap is especially indicated for atopic dermatitis – it not only helps to eliminate inflammation and reduce itching, but also has antibacterial and antifungal effects. Another difficulty in the treatment of atopic dermatitis is that the rashes differ in different periods – weeping rashes predominate in younger children, and peeling, dryness and thickening of the skin in the older age group. The Skin-cap line includes various forms for any type of rashes – it is convenient to apply the aerosol without contact on wet areas, while the cream is suitable for dry rashes. The drugs are approved for use from 1 year old, can be applied to any area of ​​the skin without restrictions.

Zinc pyrithione in the treatment of seborrheic dermatitis

Seborrheic dermatitis, or seborrhea, is a chronic disease that is inflammatory in nature and is accompanied by the formation of inflammation, peeling in places with a high accumulation of sebaceous glands. With seborrheic dermatitis, most often the foci of inflammation are located in the scalp, behind the auricles, in the chest area, as well as in large skin folds (in the groin, under the mammary glands). Inflammation in seborrheic dermatitis is maintained by the activation of fungi of the genus Malassezia on the skin.

Treatment of seborrheic dermatitis is prescribed complex, with mild and moderate course of the disease, preparations with zinc pyrithione activated must be prescribed. They help reduce inflammation, are active against fungi of the genus Malassezia, which allows you to achieve a stable remission. Since the foci of inflammation are usually localized in the area of ​​the scalp, it is recommended to use a special skin-cap therapeutic shampoo. It not only helps to reduce itching, inflammation, but also eliminates the problem of dandruff, without affecting the color and structure of the hair.

Zinc pyrithione in the treatment of psoriasis

Psoriasis occurs in about 2-3% of people inhabiting the planet. This disease is inflammatory in nature, accompanied by the formation of psoriatic plaques, peeling and itching. Preparations with activated zinc pyrithione help eliminate all these manifestations and alleviate the course of psoriasis. Since psoriasis is an incurable disease, a patient should always have a safe drug in their arsenal that can be used “on an ‘as needed’ basis to control the disease without the risk of serious side effects. One of these drugs is Skin-cap. It can be used as maintenance therapy for psoriasis on its own or after hormone therapy.

Psoriasis? 3 components of effective treatment

About psoriasis

The causes of psoriasis today remain unknown. However, a lot of evidence has accumulated in the literature that this disease is based on disorders at the genetic level. There is also an opinion that the virus genome can interfere with the human cell genome, i.e. this is a viral disease. It is widely believed that psoriasis is a skin disease of a multifactorial nature. The question of the hereditary nature of psoriasis remains debatable to this day, but psoriasis is often found in close relatives. The main changes occur in the epidermis, in which cells begin to divide uncontrollably, and their transformation into mature structures and, ultimately, into full-fledged scales, strongly deviates from the norm. This reduces the time of the cell cycle (the time from cell division to its transformation into a scale, which is exfoliated) from 28 to 4 days. At the same time, keratinization processes begin earlier than the cell is ready for this. As a result, genetically programmed keratinization is disrupted. It is essential to emphasize that in psoriasis in the epidermis, the content of macrophages, active participants in local immunity, almost doubles. Violations of the regulatory relationships between them and keratinocytes are associated with these cells. The most resistant to treatment are changes in the connective tissue of the skin, where signs of immune inflammation develop. Today, the disruption of relationships at the level of regulatory macromolecules between epithelial and immunocompetent cells in the development of psoriasis is of great importance. There are even new drugs that interfere with these processes at the level of regulatory molecules.

Because the causes of psoriasis are unclear, there is no single evidence-based approach to its treatment. Existing empirically found therapies sometimes contradict each other, but they help. So the regression of rashes in the absence of new ones can reach 75%. This keeps patients working and improves their quality of life.

With the help of modern methods of treatment, diseased skin can be brought into remission and further maintained at a socially acceptable level, when a person will not experience discomfort in communicating with other people from his cosmetic defects. It is possible to achieve remission – a state of significant and stable improvement – by medication and physiotherapy.

Today, psoriasis is treated with drugs aimed at reducing intoxication, as well as drugs that reduce sensitivity to various allergenic effects, although the role of allergies in the development of psoriasis remains unclear. A large place in the treatment of psoriasis is occupied by drugs for external use. These are hormonal (glucocorticosteroid) agents, preparations containing zinc, synthetic analogues of vitamins A and D, ointments, the action of which is aimed at exfoliating stratum corneum and resolving lesions. The Standard of Medical Care for Patients with Psoriasis, approved by order of the Ministry of Health and Social Development, includes Naftaderm ointments (by substance Naftalan oil), Radevit, Redecyl, Videstim (by substances retinol, tocopherol and ergocalciferol), as well as Berestin liquid (by substance birch tar) .

Phototherapy has a good effect, in its pure form and in combination with photosensitizers that increase the sensitivity of the skin to ultraviolet rays. For this reason, summer sun tan has a good effect on the course of the disease.

Pure tar is effective in treating psoriasis. The strength of the effect of tar on the lesions can be adjusted by the time of application (from 10 to 30 minutes). After that, the tar is washed off.

Pure tar drug Berestin is capable at the level of macromolecules of intercellular interaction, or even at the genetic level, to modify the division and development of epidermal cells towards its normalization, in particular, the granular layer of the epidermis, which is absent in psoriasis, is restored.
Thus, Berestin normalizes the development of the epidermis changed in psoriasis. Berestin can be used as a single drug, but more often it is used in the complex therapy of psoriasis, which is determined by the attending physician, taking into account all the features of the course of the disease.

Berestin is a medicine that has passed state registration, all the necessary studies, has a stable composition and is free from impurities. It has an approved instruction for medical use, which indicates the indications, method of use, contraindications and side effects. All these data were reflected in the monograph for doctors “Berestin” (M. , JSC “Retinoids”, 2011).

3 components of effective treatment

• Years of experience
  Doctors of the Scientific Dermatological Center “Retinoids” for 15 years of work have accumulated vast experience in helping patients with psoriasis. Despite the complexity of treating this disease, in most cases we manage to achieve a significant improvement in the condition of the skin even in the most severe forms of the disease, and significantly improve the quality of life of patients. Reception is conducted by dermatologists of the highest category, doctors and candidates of sciences.

• Individual approach
  When making a diagnosis and choosing the most effective treatment regimen, we use an individual approach, taking into account the history of the disease, the characteristics of the course, and the reactivity of the patient.

• Modern drugs
  In the treatment of skin diseases, modern highly effective methods and drugs are used, including those produced by Retinoids JSC.