To date, what do we really know about psoriasis? Well, other than psoriasis being a red raised rash that is often covered with silvery-white scales, we know that it is a very stubborn and chronic skin problem. We know that is often genetically inherited, with children having a 30% chance of developing the disease if one parent has it, and between a 60-70% chance if both parents have it. We know that some patients will have very intense itching with their psoriasis, whereas others may have absolutely none, thus differing from eczema which has itch as its main trademark sign. But more than anything, the most important thing we know about psoriasis is that this condition is associated with a wide variety of other health complaints, including arthritis, diabetes, heart disease and depression, which thus shows that psoriasis is truly a systemic disease. Proper management of psoriasis must involve some type of internal medicine.
Differing from my previous post on psoriasis, which showed how topical herbal treatments can be good at alleviating psoriasis, I still believe that without internal medicines the disease will likely be hard to keep under control. The trick is finding the right medicine for the job. I recently started seeing a patient who had just finished a trial study on the effects of using an injectable biologic immune-suppressing drug to help control psoriasis. This was in fact the third study he had participated in, a process that had lasted over the past 7 years. The first two studies proved non-beneficial, with no clearing of his psoriasis observed, but on the last round of injections he actually cleared completely. Good right? An injection every month or so was able to completely eradicate his psoriasis and, for him anyways, there was no noticeable side effects (in the short term anyways).
The problem was that after about a month his psoriasis would soon creep back in. Basically his body could not keep the rash at bay without the drug. Similar drugs that are in use right now run about six thousand dollars per injection, with an average cost of more than thirty thousand dollars a year, for the rest of the patients life! Long term side effects aside (a fact that we simply do not understand very well yet with these newly designed drugs), the cost of these medicines are completely prohibitive to the average person, particularly to this fellow who was cut off from the free injections once the study had ended.
Last year I received a call from a woman in regards to her husband’s psoriasis. He was about 35 years old and together they had a couple kids. Apparently he had signed the waiver to try an ‘experimental’ drug program for his psoriasis, much similar to the above case I just mentioned, which allowed the man to receive his injections for free. A few months later his widespread psoriasis had disappeared but, also like the case above, the psoriasis would soon re-appear a month or two after stopping the injections. Unfortunately, this man’s case became worse, as he soon developed very severe pneumonia (a likely consequence of suppressing the immune system too strongly) and he was hospitalized. He had become very weak and lethargic. Blood tests revealed that this man had also become severely anemic, and so it seemed that the drug had stopped his body from being able to produce healthy amounts of red blood cells. Unfortunately I never heard back from the man’s wife, who was the one that had originally phoned in, so I do not know what happened after he was admitted to the hospital. I do hope he turned out ok and has bounced back into his previously strong self.
The treatment for psoriasis must involve internal medicines, so in this regard I think that these newer injectable medicines are stemming from the right thinking, but the medicines have to be deemed safe. They must show that they work, but they must not add extra health burdens upon the individual who ingests them. For me, the safest, most time proven, methods for safely alleviating psoriasis are through the use of Chinese herbal medicine. These herbs have generally been used for thousands of years, being administrated by thousands of doctors for many millions of patients. When properly administrated, side effects are very rare and usually only involve temporary changes to the digestive system, like a looser stool or more gas and flatulence. Unless the herbs themselves had been tainted with some toxic substance, extreme side effects like that mentioned above are very very rare. Let us all remember that dermatology in China is one of the oldest continuously practiced specialties in the world, with its first mention appearing in scrolls dating back to around 300 BC. Psoriasis, as a disease, seems to have been recorded at least by the 6th century AD, thus the Chinese medical system has certainly gained much experience when treating such complicated health problems.
My mentor, Mazin Al-Khafaji, who is well respected around the world for his ability to treat complex skin and autoimmune disorders using herbal medicines, has found, in his 30 years of treating many thousands of patients with psoriasis, that about 65% will clear completely. Upon a 3 year follow up, after stopping the herbal medicines, about 60% of those patients will still be clear. While not perfect, this is a much better statistic than anything I have seen with patients using western pharmaceutical methods. The great result is most likely due to the complex nature of the herbal medicines themselves, as they all contain many hundreds of chemical compounds that will work in their own unique way on the body, but even more importantly, these herbs are always made into a formulation that is entirely based on the individual, not just the disease. Chinese medicine doctors do not give every patient with psoriasis the same medicine. They create and change the formulation to match the person in front of them, which has been the way for thousands of years, and is truly a reason behind the great success of Chinese medicine for complex skin diseases.
The treatment of psoriasis accounts for about 30 to 40% of my current clinical practice, thus I am privileged to see a lot of it! Everyone is photographed to monitor their progress, which I do say is generally good. The 16th century scholar-physician Chen Shigong showed in his book, entitled ‘Wai Ke Zheng Zhong (An Orthodox Manual of External Diseases)’, that equal attention should be paid to internal and external therapies for skin diseases such as psoriasis, and this is exactly how I practice. All patients with psoriasis receive custom designed herbal formulations to drink, as well as special herbal pastes and creams that they apply directly to their skin.
Psoriasis is a systemic disease and needs internal medicines, particularly medicines that are safe. While herbal medicines are certainly messier to use, and do not taste as good as a western pill (or injection), they do have a long history of safe use, with many doctors proving that they do indeed work.
Wishing you all good health,
Dr. Trevor Erikson