Psoriasis - Traditional Chinese MedicineTraditional Chinese Medicine Summary

Traditional Chinese Medicine

TCM Summary

Studies in Australia, Europe, and the United States have estimated that psoriasis is found in one to five percent of the general population.[1] Psoriasis is not only a skin disease and may also affect a person’s joints,[2] cardiovascular system,[3] and psychological state.[2,4,5]

In Traditional Chinese Medicine (TCM), psoriasis (白疕, bai bi or white mange), can develop from a number of underlying imbalances in the body. The main imbalances causing psoriasis are heat as well as the stasis of Qi and blood.[6,7]

Treatment Philosophy

TCM focuses on how psoriasis relates to lack the type and intensity of the heat causing the psoriasis. The goal of TCM therapy is to correct the underlying imbalance causing the psoriasis by removing heat, stimulating blood circulation and nourishing dryness.

Symptoms and Causes

Psoriasis is a chronic, inflammatory skin rash that can affect the skin, hair, and nails. It most commonly begins in adolescence and young adulthood but can occur at any age. It often appears as red skin plaques with silvery-white scales found on the body or scalp. The affected skin can itch, burn, become scaly, or have no associated symptoms at all. Less common forms of psoriasis can look like small scaly rain drops on the skin (guttate psoriasis), pus-filled bumps known as pustules (pustular psoriasis), scaling of only hands and feet (hand and foot psoriasis), and pitting or yellowing of the nails (nail psoriasis), to name a few. Beyond affecting skin, inflammation of the joints is a condition known as psoriatic arthritis. Psoriasis is thought to be due to an imbalance in the immune system that leads to areas of increased inflammation in the skin.

Chinese Herbs

Herbal medicine is the main therapy for psoriasis in TCM. Traditional Chinese Medicine doctors may write an herbal formula consisting of multiple herbs with a focus on resolving the underlying imbalance. Herbs can be prepared for external application or can be ingested internally.

Many Chinese herbs have been shown to reduce inflammation. Here is a profile of just a few common herbs used for different types of psoriasis:

  • For treating heat, the herbal formula will focus on herbs that are cooling. Sheng di huang (Rehmania glutinosa) and Zi cao (Lithospermum erythrohizon) are both cooling herbs that are central in the treatment of heat. These herbs have been shown to reduce the levels of the inflammatory cytokine TNF-α which is active in psoriasis.[9]
  • For addressing blood stagnation, the herbal formula will include herbs that stimulate the movement of blood and nourish the blood. Dan shen (Salvia miltiorriza) is known for moving and nourishing the blood. Dan shen has been shown to inhibit the secretion of inflammatory cytokines IFN-γ and IL-12 which are active in psoriasis.[9]
  • Licorice root, or gan cao (Glycyrrhiza uralensis), is widely used in Chinese medicine for all types of psoriasis, as it boosts Qi and harmonizes the effects of other herbs. It has long been known to reduce inflammation but also enhance the immune system. [9]

Diet and Lifestyle

Nutrition and diet

  • Diet: Diets high in processed fats and refined sugar also injure our digestive energy and lead to the development of dampness and heat. Chinese medicine recommends staying away from rich fatty foods, particularly some types of seafood, because they can lead to accumulation of heat in the body. Instead, eat fish rich in omega-3 fatty acids such as salmon and sardines. Focusing on a diet rich in omega-3 fatty acids has been suggested to help psoriasis.[10]
  • Alcohol: Consuming too much alcohol leads to the development of dampness and damp heat. It will injure the digestive energy impairing the body’s ability to maintain overall health.

Lifestyle

  • Exercise: Exercise will help increase the circulation of Qi and relieve stress, and can lead to psoriasis improvement.
  • Stress reduction: Circulation and flow of Qi, our body’s energy, is imperative for a healthy life. Stress inhibits the flow of Qi leading to stagnation.
  • Smoking: Smoking has been associated with worsening of psoriasis.[11] Smoking adds heat to the body, which will exacerbate the underlying heat condition in psoriasis. s
  1. Parisi R, Symmons DP, Griffiths CE, et al. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol.2013;133(2):377-385; PMID: 23014338 Link to research.
  2. Truong B, Rich-Garg N, Ehst BD, et al. Demographics, clinical disease characteristics, and quality of life in a large cohort of psoriasis patients with and without psoriatic arthritis. Clin Cosmet Investig Dermatol.2015;8:563-569; PMID: 26622188 Link to research.
  3. Ogdie A, Yu Y, Haynes K, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis.2015;74(2):326-332; PMID: 25351522 Link to research.
  4. Connor CJ, Liu V, Fiedorowicz JG. Exploring the Physiological Link between Psoriasis and Mood Disorders. Dermatol Res Pract.2015;2015:409637; PMID: 26550011 Link to research.
  5. Cohen BE, Martires KJ, Ho RS. Psoriasis and the Risk of Depression in the US Population: National Health and Nutrition Examination Survey 2009-2012. JAMA Dermatol.2015;10.1001/jamadermatol.2015.3605PMID: 26421371 Link to research.
  6. Yang X, Chongsuvivatwong V, McNeil E, et al. Developing a diagnostic checklist of traditional Chinese medicine symptoms and signs for psoriasis: a Delphi study. Chin Med.2013;8(1):10; PMID: 23663296 Link to research.
  7. Zhang GZ, Wang JS, Wang P, et al. Distribution and development of the TCM syndromes in psoriasis vulgaris. J Tradit Chin Med.2009;29(3):195-200; PMID: 19894384 Link to research.
  8. Menter A, Stoff B. Psoriasis. London: Manson Publishing Ltd; 2010.
  9. Tse TW. Use of common Chinese herbs in the treatment of psoriasis. Clin Exp Dermatol.2003;28(5):469-475; PMID: 12950329 Link to research.
  10. Millsop JW, Bhatia BK, Debbaneh M, et al. Diet and psoriasis, part III: role of nutritional supplements. J Am Acad Dermatol.2014;71(3):561-569; PMID: 24780177 Link to research.
  11. Fortes C, Mastroeni S, Leffondre K, et al. Relationship between smoking and the clinical severity of psoriasis. Arch Dermatol.2005;141(12):1580-1584; PMID: 16365261 Link to research.