Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Drug Therapies
Complementary and Alternative Therapies
Following Up
Special Considerations
Supporting Research

Psoriasis is a skin disorder that appears as raised, reddish-pink areas covered with silvery scales and red borders. Psoriasis most commonly appears on the scalp, elbows, knees, groin, and lower back. It "comes and goes," and may appear as a few spots or involve large areas. It is not contagious, either to other body parts or other people. More than 6 million people in the United States have psoriasis, which is seen in both sexes and all age groups. It can be triggered by emotional stress and can run in families. Severe cases can be physically painful and emotionally traumatic due to its unsightly appearance. Approximately 10 percent of psoriasis sufferers develop psoriatic arthritis, a painful arthritic condition.

Signs and Symptoms

The following are symptoms of psoriasis.

  • Raised skin lesions, deep pink with red borders and silvery surface scales; may be cracked and painful
  • Blisters oozing with pus (usually occurs on the palms or soles)
  • Pitted, discolored, and possibly thickened fingernails or toenails
  • Itchy skin in some people
  • Joint pain (psoriatic arthritis) in some people

What Causes It?

The cause of psoriasis is uncertain, but researchers do know that it involves a higher-than-normal rate of skin-cell production. Dead skin cells accumulate and form thick patches. Several underlying factors may trigger the disorder or flare-ups, including the following.

  • Faulty immune system
  • Genetics (hereditary)
  • Emotional stress
  • Obesity
  • Skin injuries or sunburn
  • Streptococcal (strep) infection (symptoms sometimes first appear two weeks after strep throat)
  • Certain drugs (gold, lithium, beta-blockers)
  • Acidic foods
  • Alcohol

What to Expect at Your Provider's Office

Your health care provider will examine your skin and ask questions about your physical and emotional health. You may need a blood test to check levels of calcium, zinc, and certain other elements.

Treatment Options

Your provider may suggest one or several different treatment options.

  • Topical creams and lotions
  • Medications
  • Light therapy
  • Changes in your diet
  • Vitamin or mineral supplements
  • Exercise
  • Elimination therapy (in which you discontinue taking certain medications or eating certain foods)

Drug Therapies

Topical creams include the following.

  • Corticosteroids—reduce inflammation and irritation; can only be used for a short period of time at the beginning of treatment 
  • Salicylic acid ointments—help the scales to shed 
  • Capsaicin ointment—blocks chemicals in the skin that cause inflammation; painful if used on open wounds 
  • Calcitriol ointment—may be as effective as corticosteroids with fewer side effects 
  • Etretinate—for severe cases that do not respond to other treatments 

Systemic drugs are taken orally and are used for more severe conditions.

  • Methotrexate—an anti-cancer drug that reduces symptoms; serious side effects 
  • Psoralen—used with UV therapy; least toxic oral medication 
  • Tegison—inhibits rapid cell growth; more effective with UV therapy; numerous side effects 

Over the Counter
  • Nonsteroidal anti-inflammatory drugs (such as ibuprofen)—reduces inflammation and pain especially for psoriatic arthritis; various side effects 
  • Petroleum jelly—softens skin, helps it to retain moisture
  • Coal tar ointments and shampoos—relieves symptoms; helps UV light therapy to work more effectively; possibly serious side effects

Complementary and Alternative Therapies

You may benefit from mind-body therapies and stress management. Exercise can help too, as can drinking plenty of water.

  • Eliminate alcohol, simple sugars, inflammatory fats (meat, dairy). Avoid acidic foods (pineapple, oranges, coffee, tomato) and any allergic foods (wheat, citrus, milk, corn, eggs).
  • Essential fatty acids: omega-3 (oily fish, flaxseed oil, 1,000 mg two times per day)
  • Vitamins: B12 (100 to 1,000 mcg) may need to be intramuscular injections, folate (400 mcg per day), vitamin E (400 to 800 IU per day)
  • Minerals: zinc (30 mg per day), selenium (200 mcg per day)
  • Quercetin: 500 mg three times per day before meals
  • Digestive enzymes taken with each meal help with proper protein digestion.


Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

  • Milk thistle (Silybum marianum) stops breakdown of substances that contribute to psoriasis, protects the liver.
  • Yellowdock (Rumex crispus), red clover (Trifolium pratense), and burdock (Arctium lappa) are alternatives.
  • Sarsaparilla (Smilax sarsaparilla) can be effective in psoriasis.
  • Coleus forskohlii (tincture, 1 ml three times a day) has been historically used for psoriasis.

Mix equal parts of the above herbs and use 1 cup tea three times per day or 30 to 60 drops tincture three times per day. This is especially effective if sipped. Take 5 to 15 minutes before meals to stimulate digestion.

Topical creams may relieve discomfort. Chickweed (Stellaria media) relieves itching, and marigold (Calendula officinalis) speeds healing of open lesions.


There have been few studies examining the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for Psoriasis based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

  • Apis mellifica —for skin rashes that feel hot and dry and are sensitive to touch; symptoms are relieved by cool baths and worsened by heat; this remedy is most appropriate for individuals who often feel sad, disappointed, or even depressed; they tend to cry easily but may also be irritable and envious by nature
  • Calendula —used topically, particularly if the affected area becomes inflamed; this remedy will soothe but not cure the skin condition
  • Rhus toxicodendron — used for skin disorders accompanied by intense itching that worsens at night and improves with the application of heat; this remedy is most appropriate for individuals who are generally restless and unable to get comfortable at night
  • Sulphur —for skin disorders that are accompanied by intense itching; this remedy is most appropriate for individuals who are thirsty, irritable when not feeling well, lazy and messy under ordinary circumstances, and who describe a sensation of internal heat and burning; symptoms tend to improve with open, cold air and worsen with warmth


No well-designed studies have evaluated the effect of chiropractic on individuals with psoriasis, but there have been a few case reports about spinal manipulation reducing skin lesions in some individuals. One expert, for example, wrote about a 52-year old man with severe psoriasis who experienced significant improvement after receiving chiropractic care (even more than the improvement seen with conventional medication). Although this report is encouraging, researchers are still not clear whether chiropractic care is helpful for all people with psoriasis.

Following Up

See your provider regularly until your psoriasis is under control.

Special Considerations

In pregnancy, oral medications can be damaging to a fetus and topical creams can be absorbed into the bloodstream.

Supporting Research

Behrendt M. Reduction of psoriasis in a patient under network spinal analysis care: a case report. J Vertebr Sublux Res. 1998; 2(4):196-200.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:169-170.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 227, 319-320, 345-346.

The Editors of Time-Life Books. The Medical Advisor. Alexandria, Va: Time-Life Books; 1996.

Ergil KV. Medicines from the Earth: Protocols for Botanical Healing. Harvard, Mass: Gaia Herbal Research Institute; 1996:207-211.

Gruenwald J, Brendler T, Jaenicke C, et al., eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co; 1998:903-904, 114, 1157.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 263-265.

Syed TA, et al. Management of psoriasis with aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1:505-509.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995.

Walker JP, Brown EH. The Alternative Pharmacy. Paramus, NJ: Prentice Hall Press; 1998.

Werbach MR. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1988:370-373.

Review Date: August 1999
Reviewed By: Participants in the review process include: Constance Grauds, RPh, President, Association of Natural Medicine Pharmacists, San Rafael, CA; Gary Guebert, DC, DACBR, (Chiropractic section October 2001) Login Chiropractic College, Maryland Heights, MO; Lonnie Lee, MD, Internal Medicine, Silver Springs, MD; Scott Shannon, MD, Integrative Psychiatry, Medical Director, McKee Hospital Center for Holistic Medicine, Fort Collins, CO; Joseph Trainor, DC, (Chiropractic section October 2001) Integrative Therapeutics, Inc., Natick, MA; Tom Wolfe, P.AHG, Smile Herb Shop, College Park, MD.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

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