Treating Psoriasis With Chinese Herbs

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 like these are considered mainstream and are "evidenced" by their reported benefits over generations and even centuries.

While many people understandably want to embrace a more "natural" approach to treating psoriasis, what is the basis of the claims and are there are any real benefit or risks of taking these remedies?

Before one can even debate the veracity of the various medical approaches, it is important to understand what psoriasis is and how the various treatments are meant to treat or cure it.

From that perspective, there is a lot that we still don't know about psoriasis. In the past, we considered it to be a purely dermatological condition but, in recent decades, have come to realize that it is an autoimmune disorder.

As with other autoimmune diseases, like lupus and rheumatoid arthritis, psoriasis is caused when the body's immune system inadvertently attacks normal cells (in this case, the skin and joints). This gives rise to a sudden and sometimes severe buildup of skin cells and the formation of scaly, flaky plaques.

The cause of the disorder is not entirely clear, although it is believed strongly linked to genetics and possibly to certain types of bacteria. Beyond that, psoriasis remains something of a mystery.

Traditional Chinese medicine (TCM) relies heavily on herbal treatments which are often mixed and matched to treat a variety of different illnesses. While the effectiveness of TCM in treating psoriasis is uncertain and poorly supported, there have been some suggestions that certain remedies may interfere with the hyperproliferation (excessive accumulation) of skin cells seen in the disease.

On at least a theoretical basis, the herbaceous plant Radix rubiae (called Qian Cao Gin in Chinese) is believed to have an anti-proliferative effect that may temper, if not prevent, the formation of plaques. With that being said, the weight of evidence is relatively small and mostly constrained to test tube studies.

One animal study conducted in 2012 at the School of Chinese Medicine at the Chinese University of Hong Kong "unequivocally confirmed" the anti-psoriatic effect of R. rubiae in mice.

In truth, while promising, the evidence was far from conclusive and could more be rightly be considered an interesting first step. This applies to not only this study but any animal study. By and large, the results of an animal trial do not translate directly to humans but rather provide us a suggestion of what may or not have occurred.

Moreover, when administered to levels where it could trigger a beneficial effect, the toxicity of traditional medicines can often become intolerable and even dangerous. In fact, a 2015 study published in the Annals of Hepatology identified 28 popular TCM herbs that caused liver toxicity, sometimes severe, in their users.

In terms of R. rubiae itself, no research to date has yet evaluated the toxicity profile of the herb, particularly with regards to the potency prescribed in the animal studies.

One of the barriers to validating TCM research is the absence of English-language translations. This makes the process of peer review (the unbiased assessment of evidence by colleagues not associated with the research) difficult if not impossible.

One such example is a 2008 study in which 109 participants were treated with either narrow-band UVB phototherapy (sometimes used in persons who are unresponsive to topical psoriasis treatment) or narrow-band UVB used with a Chinese herbal mixture called Yuyin.

According to the study abstract, persons given the latter treatment for eight weeks had fewer side effects, needed lower doses of UV light, and showed an improvement of PASI scores (indicating a reduction in psoriasis lesions).

Again, while promising, the evidence was impossible to validate given that the body of research was not (and has still not been) translated from the original Chinese text.

None of this is meant to suggest that TCM has no benefit with regards to psoriasis. It is simply that any claims of such benefit have not been supported. This also doesn't mean that either Qian Cao Gin or Yuyiin are harmful when used to treat long-term disease. We simply don't know, and that's a problem.

From this perspective alone, you should never take a chance and experiment with any herbal remedy based on hearsay or pseudoscientific claims. This is especially true if using any form of UV therapy as certain herbs are known to increase light sensitivity, leading to inflammation and even sunburn.

It is also important to remember that "natural" does not imply safe. Unlike pharmaceutical drugs that are strictly regulated by the U.S. Food and Drug Administration, Chinese herbs, homeopathic drugs, and even nutritional supplements are not. These should always be used with caution and with the considered input of your primary health provider.