Treating Psoriasis With Traditional Chinese Medicine

Using Chinese herbs to treat psoriasis is considered an alternative therapy in the West with little clinical evidence to support its use. But, for the billion-plus people living in China, traditional medicines—such as sheng di huang, qing dia, qian cao gin, and bai hua she she cao—are considered mainstream options for the treatment of this skin condition.

Although many people want to embrace a more "natural" approach to psoriasis given the side effects of methotrexate and Soriatane (acitretin), there are pros and cons to the use of traditional Chinese medicine.

The way in which psoriasis is approached in traditional Chinese medicine (TCM) is fundamentally different from how it is diagnosed and treated in the West. Psoriasis, known as bai bi in traditional Chinese culture, is said to be caused by "heat pathogens" that trigger the characteristic redness of the skin.

As the disease progresses, blood "dryness" and "stagnation" are believed to cause the itching, discomfort, and scaly plaque formations that typify the autoimmune disorder.

Because TCM is based largely on impression and personal experience, recommended treatments can vary from one practitioner to the next. Unlike Western medicine, TCM remedies don't so much treat the disease as correct the imbalances that give rise to conditions like heat, dryness, and stagnation.

TCM remedies are often mixed and matched to target individual imbalances. If blood heat is the primary concern, herbs that "clear heat" would be used in greater quantity than those used to relieve stagnation or dryness.

While the effectiveness of TCM in treating psoriasis in largely unproven, there have been some promising findings.

Qian cao gin is the Chinese name for the herb common madder (Rubix rubiae). It is believed to have blood-cooling and anti-proliferative properties that may temper, if not prevent, the formation of psoriasis plaques.

Among the handful of early investigations, a 2012 study in the Journal of Ethnopharmacology "unequivocally confirmed" the anti-psoriatic effect of R. rubiae in human tissue. In their research, the scientists showed that an extract containing R. rubiae significantly tempered the hyperproliferation of cultured skin cells, suggesting a model for drug development.

While promising, few researchers would consider the results unequivocal given that lab studies on tissues rarely translate to the same effect in humans themselves. Not only is there little evidence that an extract like this would work, but there is no way to know how safe it would be at the effective dose.

Moreover, the study ignored the impact of liver toxicity inherent with many Chinese herbal remedies. A 2015 study in the Annals of Hepatology identified no less 28 popular Chinese herbs that can cause liver injury, sometimes severe.

Concerns about liver toxicity were echoed in earlier research from Italy, which listed R. rubiae as one of the TCM herbs known to cause acute hepatitis when overused.

Qing dai, known in the West as indigo naturalis, is an herb believed to have powerful heat-clearing properties, as well as anti-proliferative and anti-inflammatory effects.

A 2012 review in the Archives of Dermatology reported that the topical use of qing dai was able to improve scaling, itching, and redness in people with psoriasis after eight weeks of use.

Although the measures used by researchers (comparative photographs, rather than the PASI scores typically used in psoriasis research) were largely subjective, no less than 69% of the targeted lesions were completely cleared.

Side effects, mainly itching and skin irritation, were generally mild. The only major downside of the treatment was the deep blue color of the ointment, which made it impractical to use on the face or exposed skin when in public. Others complained that it stained their clothes permanently.

Sheng di huang is the root of the Chinese foxglove herb (Radix rehmanniae). It is one of the more common TCM remedies used for psoriasis, which is believed to have potent blood-cooling properties and relieve pain caused by wind-dampness (one of the properties that obstruct qi).

A 2013 study from the General Hospital of Beijing reported that an R. rehmanniae extract used in mice increased the production of skin glutathione when used with ultraviolet (UV) light therapy. Glutathione is an antioxidant used in many health supplements that is believed to have anti-aging properties.

Proponents believe that these effects can be beneficial to people with psoriasis, although it is unclear how. As with qian cao gin, sheng di huang has the potential for liver toxicity if used in excess.

Bai hua she she cao is a plant known in the West as snake-needle grass (Herba hedyotis). It, like other TCM herbs, is believed to have potent blood-cooling properties.

Test tube studies have also shown that bai hua she she cao is able to reduce inflammatory compounds associated with psoriasis and other inflammatory diseases, such as tumor necrosis factor-alpha (TNF-a) and interleuken-6 (IL6). Whether the same effect might occur in humans is unclear.

The overuse of bai hua she she cao may not only cause liver injury but impair kidney function.

At present, it is too early to endorse the use of TCM for the treatment of psoriasis. If you decide to use traditional Chinese herbs to treat psoriasis, let your doctor know. In this way, the doctor can monitor liver enzymes and kidney function and identify any side effects or drug interactions before they become serious.