Treating Psoriasis With Traditional Chinese Medicine

Using Chinese herbs to treat psoriasis is considered an alternative therapy in the West with little empirical evidence to support its use. But, for the billion-plus people living in China, traditional medicines are considered mainstream and are "evidenced" by their reported benefits over generations and even centuries.

Although many people understandably want to embrace a more "natural" approach to psoriasis treatment (particularly given the side effects of drugs like retinoids and methotrexate), there are pros and cons to the use of traditional Chinese medicine (TCM) for such purpose.

The ways in which practitioners of TCM approach conditions like psoriasis are fundamentally different from those practiced in Western medicine. This is true not only with regards to treatment but also the ways in which psoriasis is observed and diagnosed.

One of the basic tenets of TCM is that the body's vital energy, called qi, circulates through channels that interconnect all body functions. If these channels, called meridians, are blocked, it will disrupt the balance of the five "cardinal functions" of the body (actuation, warming, defense, containment, and transformation), resulting in illness.

While the holistic approach to illness has influenced Western medicine, TCM is based mainly on tradition rather than scientific knowledge. As such, there is often great divergence in the way that disease is diagnosed and treated by one practitioner versus the next.

While one might argue that the same occurs in Western medicine, TCM has few quantitative measures (like blood tests or imaging studies) to render a definitive diagnosis. Rather, a diagnosis is based largely on impression, observation, and personal or collective experience.

With regards to psoriasis specifically—a condition called bai bi in traditional Chinese culture—the symptoms are believed caused by "heat pathogens" that trigger the characteristic redness of the skin. The size, shape, and shade of the redness will indicate the type of heat involved. The deeper the redness, the greater the heat

As the disease progresses, blood "dryness" and "stagnation" may develop. Blood dryness is associated with itching and discomfort, while blood stagnation is evidenced by the formation of thick, irregular, or hardened plaques.

This stands in stark contrast to Western medicine in which psoriasis is approached as an autoimmune disorder. Rather than a disease characterized by heat or blood, psoriasis is regarded as an immune system malfunction in which the body inadvertently attacks normal cells in the dermis, leading to inflammation and the overproduction of cells in the epidermis.

So, while Western doctors will focus on tempering the immune response at the cellular level, TCM practitioners will aim to temper blood heat, dryness, or stagnation at the symptomatic level.

TCM relies heavily on herbal treatments that are frequently mixed and matched to treat a variety of illnesses. Many are boiled as a strong tea, called a decoction, or taken in pill form. The herbs are typically personalized to target your individual imbalances. If blood heat is the primary concern, herbs that "clear heat" may be used in greater quantity than those that improve stagnation or dryness.

While the effectiveness of TCM in treating psoriasis is poorly supported by research, there have been suggestions that certain remedies may curb the inflammation and hyperproliferation (overproduction) of skin cell characteristic of the disease.

Qian Cao Gin

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 rarely translate to the same effect in humans. 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.

Qing Dai

Qing dai, known in the West as indigo naturalis, is an herb believed to have powerful heat0clearing 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 were largely subjective (comparative photographs rather than the PASI scores typically used in psoriasis research), no less than 69 percent of the targeted lesions were completed cleared.

Side effects, mainly itching and skin irritation, were generally mild. The only major downside 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

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. Moreover, as with qian cao gin, sheng di huang has the potential for liver toxicity if used in excess.

Bai Hua She She Cao

Bai hua she she cao is a plant known in the West as snake-needle grass (Herba hedyotis). As with the other TCM herbs, it 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, such as tumor necrosis factor-alpha (TNF-a) and interleuken-6 (IL6), associated with psoriasis and other inflammatory diseases. Whether the same effect might occur in humans is unclear.

A Word From Verywell

At present, it is difficult to endorse the use of TCM herbs in treating symptoms of psoriasis. This is not to suggest, however, that TCM has no place in the treatment of psoriasis. It is simply that any claims of benefit are either unsupported by research or are over-reaching in their conclusions.

Even with promising remedies like sheng di huang, there has yet to be evidence of long-term safety. While many people presume that "natural" means "safe," the Natural Center for Complementary and Integrative Health reports that TCM remedies imported into the United States are sometimes tainted with heavy metals, sulfites, pesticides, and even drugs (including blood thinners and nonsteroidal anti-inflammatory drugs).