Omega-3 Fatty Acids
Studies suggest consuming a diet high in good fats (omega-3’s) can reduce psoriasis flare-ups. The balance between inflammatory and anti-inflammatory agents (eicosanoids) is influenced by the type of dietary fatty acids consumed. Diets rich in omega-3 reduce sensitivity to pain, relax blood vessels, increase blood flow, and support the anti-inflammatory response. Foods that contain Omega-3 include cold water fish, nuts, seeds, olive oil, whole grains, legumes, vegetables, and fruits. Traub & Marshall, 2007, pp. 324-325).
Traub, M., & Marshall, K. (2007). Psoriasis-pathophysiology, conventional, and alternative approaches to treatment. Alternative Medicine Review, 12(4), 319-330.
A study conducted in Barcelona, Spain examined the efficacy of omega-3 fatty acids in patients with mild or moderate plaque psoriasis. The study included 30 subjects. Fifteen subjects were part of the control group and received tacalcitrol, which “reduces excessive cell turnover in the epidermis by interacting with vitamin D receptors on keratinocytes” (Tacalcitol, 2012). The other fifteen subjects received 2 capsules of Oravex daily in addition to tacalcitrol. Oravex contains “280 mg of eicosapentaenoic acide, 40 mg of docosahexaenoic acid, 50 mg of thyme extract, 50 mg of olive leaf extract, 20 mg of green tea extract, 7.5 mg of zinc, and 27.5 micrograms of selenium per capsule,” (Balbas, Regana, & Millet, 2011). This capsule includes 640 mg of EPA and DHA. The World Health Organization Recommends a minimum daily intake of 300 mg of EPA and 500 mg of DHA in the general population (Balbas, Regana, & Millet, 2011). The experiment involved a prospective, open, single-center, controlled observational study with a 2-month follow-up. The study measures used included Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Dermatology Life Quality Index (DLQI), the presence of pruritus, scalp psoriasis, clinical evolution of the target plaque according to erythema, infiltration, scaling, and blood analyses were performed at baseline and end visits (Balbas, Regana, & Millet, 2011). The results for the study demonstrated significant improvement in the group treated with Oravex compared to the control group. The PASI showed an improvement of 6.8 points in the Oravex group compared to 3.5 points in the control group. The NAPSI score showed a reduction in the Oravex from 2.91 at baseline to 1.68 at the 8 week visit. The control group NAPSI score did not improve at baseline. The DLQI score was greater in the Oravex group, with an improvement in 6.67 points compared to the control group, with a score of 3.03. Scalp lesions, lesions of target plaque-erythema, infiltration, and scaling were improved in the Oravex group compared to the control group (Balbas, Regana, & Millet, 2011). Overall, supplementary treatment with omega-3 fatty acids significantly reduces the multiple adverse complications of psoriasis.
Balbas, M. G., Regana, S. M., & Millet, U. P. (2011, June 20). Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Journal of Clinical, Cosmetic, and Investigative Dermatology, 73-77.
Benefits of fish oil have also been demonstrated when applied topically. One study suggests that EPA, a component of fish oil, has a potential role in the treatment of psoriasis as an active anti-inflammatory agent by itself or used in combination with other anti-psoriatic treatments. When applied topically, patients saw a reduction in plaque thickness and scaling.
Zulfakar, M., Edwards, M., & Heard, C. (2007). Is there a role for topically delivered eicosapentaenoic acid in the treatment for psoriasis? Eur J Dermatol, 17(4), 284-291.
Traub, M., & Marshall, K. (2007). Psoriasis-pathophysiology, conventional, and alternative approaches to treatment. Alternative Medicine Review, 12(4), 319-330.
A study conducted in Barcelona, Spain examined the efficacy of omega-3 fatty acids in patients with mild or moderate plaque psoriasis. The study included 30 subjects. Fifteen subjects were part of the control group and received tacalcitrol, which “reduces excessive cell turnover in the epidermis by interacting with vitamin D receptors on keratinocytes” (Tacalcitol, 2012). The other fifteen subjects received 2 capsules of Oravex daily in addition to tacalcitrol. Oravex contains “280 mg of eicosapentaenoic acide, 40 mg of docosahexaenoic acid, 50 mg of thyme extract, 50 mg of olive leaf extract, 20 mg of green tea extract, 7.5 mg of zinc, and 27.5 micrograms of selenium per capsule,” (Balbas, Regana, & Millet, 2011). This capsule includes 640 mg of EPA and DHA. The World Health Organization Recommends a minimum daily intake of 300 mg of EPA and 500 mg of DHA in the general population (Balbas, Regana, & Millet, 2011). The experiment involved a prospective, open, single-center, controlled observational study with a 2-month follow-up. The study measures used included Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Dermatology Life Quality Index (DLQI), the presence of pruritus, scalp psoriasis, clinical evolution of the target plaque according to erythema, infiltration, scaling, and blood analyses were performed at baseline and end visits (Balbas, Regana, & Millet, 2011). The results for the study demonstrated significant improvement in the group treated with Oravex compared to the control group. The PASI showed an improvement of 6.8 points in the Oravex group compared to 3.5 points in the control group. The NAPSI score showed a reduction in the Oravex from 2.91 at baseline to 1.68 at the 8 week visit. The control group NAPSI score did not improve at baseline. The DLQI score was greater in the Oravex group, with an improvement in 6.67 points compared to the control group, with a score of 3.03. Scalp lesions, lesions of target plaque-erythema, infiltration, and scaling were improved in the Oravex group compared to the control group (Balbas, Regana, & Millet, 2011). Overall, supplementary treatment with omega-3 fatty acids significantly reduces the multiple adverse complications of psoriasis.
Balbas, M. G., Regana, S. M., & Millet, U. P. (2011, June 20). Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Journal of Clinical, Cosmetic, and Investigative Dermatology, 73-77.
Benefits of fish oil have also been demonstrated when applied topically. One study suggests that EPA, a component of fish oil, has a potential role in the treatment of psoriasis as an active anti-inflammatory agent by itself or used in combination with other anti-psoriatic treatments. When applied topically, patients saw a reduction in plaque thickness and scaling.
Zulfakar, M., Edwards, M., & Heard, C. (2007). Is there a role for topically delivered eicosapentaenoic acid in the treatment for psoriasis? Eur J Dermatol, 17(4), 284-291.
Find Your Ideal Body Weight
Psoriasis is frequently associated with obesity (Traub & Marshall, 2007, p. 324). A higher percentage of body fat can contribute to inflammation, which exacerbates the effects of psoriasis. The hormones released from excess adipocytes (fat cells) play a negative role in the inflammatory response. With weight loss, through a healthy diet and exercise, levels of proinflammatory cytokines and macrophages decrease in white adipose tissue (Calder, 2009, pp. 12-14).
Calder, P. e. (2009). Inflammatory disease processes and interactions with nutrition. British Journal of Nutrition, 1-45.
A study published in 2006 in Medical Hypotheses showed that excess weight is linked to the development psoriasis and to a decreased success rate for long-term recovery. The numerous deepened skin folds present in overweight individuals can lead to increased chafing and sweating, both of which hamper the healing of psoriasis lesions (Obestity and Psoriasis, 2009).
Obestity and Psoriasis. (2009, April 13). Retrieved from About.com: http://psoriasis.about.com/lw/Health-Medicine/Conditions-and-diseases/Obesity-and-Psoriasis.htm
Weight loss has also been attributed to increasing the effectiveness of conventional psoriasis therapy. A study published in The American Journal of Clinical Nutrition investigated whether moderate weight loss (5-10% of body weight) increased the therapeutic response to a low dose of cyclosporine in obese patients with moderate-to-severe chronic plaque psoriasis (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The experiment involved a 24-week, randomized, controlled, investigator-blinded clinical trial. Sixty-one patients with moderate-to-severe psoriasis were divided into two groups. The intervention group was administered 2.5 mg of cyclosporine and was placed on a low-calorie diet. The control group was administered 2.5 mg of cyclosporine without dietary restrictions. The primary endpoint was a >75% improvement in Psoriasis Area and Severity Index (PASI) from baseline to week 24 (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The findings of the study demonstrated that the intervention group had an average weight loss of 7% at week 24. The control group had a weight loss of 0.2% at week 24. A 75% PASI score was achieved by 66.7% of patients in the intervention group, whereas only 29% of patients in the control group demonstrated a PASI score of 75% (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The study concluded that weight loss can significantly increase the effectiveness of cyclosporine treatment.
Gisondi, P., Del Giglio, M., Di Francesco, V., Zamboni, M., & Girolomoni, G. (2008, November). Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: A randomized, controlled, investigator-blinded clinical trial. The American Journal of Clinical Nutrition, 88(5), 1242-1247.
Calder, P. e. (2009). Inflammatory disease processes and interactions with nutrition. British Journal of Nutrition, 1-45.
A study published in 2006 in Medical Hypotheses showed that excess weight is linked to the development psoriasis and to a decreased success rate for long-term recovery. The numerous deepened skin folds present in overweight individuals can lead to increased chafing and sweating, both of which hamper the healing of psoriasis lesions (Obestity and Psoriasis, 2009).
Obestity and Psoriasis. (2009, April 13). Retrieved from About.com: http://psoriasis.about.com/lw/Health-Medicine/Conditions-and-diseases/Obesity-and-Psoriasis.htm
Weight loss has also been attributed to increasing the effectiveness of conventional psoriasis therapy. A study published in The American Journal of Clinical Nutrition investigated whether moderate weight loss (5-10% of body weight) increased the therapeutic response to a low dose of cyclosporine in obese patients with moderate-to-severe chronic plaque psoriasis (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The experiment involved a 24-week, randomized, controlled, investigator-blinded clinical trial. Sixty-one patients with moderate-to-severe psoriasis were divided into two groups. The intervention group was administered 2.5 mg of cyclosporine and was placed on a low-calorie diet. The control group was administered 2.5 mg of cyclosporine without dietary restrictions. The primary endpoint was a >75% improvement in Psoriasis Area and Severity Index (PASI) from baseline to week 24 (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The findings of the study demonstrated that the intervention group had an average weight loss of 7% at week 24. The control group had a weight loss of 0.2% at week 24. A 75% PASI score was achieved by 66.7% of patients in the intervention group, whereas only 29% of patients in the control group demonstrated a PASI score of 75% (Gisondi, Del Giglio, Di Francesco, Zamboni, & Girolomoni, 2008). The study concluded that weight loss can significantly increase the effectiveness of cyclosporine treatment.
Gisondi, P., Del Giglio, M., Di Francesco, V., Zamboni, M., & Girolomoni, G. (2008, November). Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: A randomized, controlled, investigator-blinded clinical trial. The American Journal of Clinical Nutrition, 88(5), 1242-1247.
Herbs
Decrease inflammation by simply adding the following herbs to your diet: turmeric, ginger, cumin, anise, fennel, basil, rosemary, garlic, and pomegranate seeds. These seasonings can block the inflammatory white blood cells responsible for psoriasis and other skin afflictions (Kane, 2010, p. 22)
Aryuvedic herbs, Majoon Ushba and Roghane Hindi, are safe and effective herbs to use in the management of psoriasis. According to a study conducted to test the efficacy of Majoon Ushba and Roghane Hindi, patients experienced decreased itching, scaling, and erythema. Thirty patients were selected to be in this randomized, single-blinded, placebo-controlled study. The subjects were divided into an experimental group and a control group. The experimental group, which consisted of 20 patients, received 5 g of Majoon Ushba orally twice daily and Roghane Hindi was applied locally twice daily. The control group, which consisted of 10 patients, were given placebo drugs, which were applied orally and topically twice daily. The severity of psoriasis and efficacy of the drug were measured using the Psoriasis Area and Severity Index (PASI) (Lone, Ahmad, & Naiyar, 2011, p. 26). Before treatment, 8 subjects in the experimental group reported having severe itching, 8 had moderate itching, and 4 patients had mild itching. After treatment,10 patients showed complete cure from itching, 4 patients had moderate itching, 6 patients had mild itching, and no patients reported severe itching (Lone, Ahmad, & Naiyar, 2011, p. 28). The results demonstrated that these herbs were effective in treating itching over the course of the 8 week trial. Before treatment, 10 patients in the experimental group showed severe scaling, 6 patients had moderate scaling, and 4 patients complained of mild scaling. After treatment, 12 patients showed complete cure from scaling, 1 patient had moderate scaling, 6 patients had mild scaling, and 1 patient still had severe scaling (Lone, Ahmad, & Naiyar, 2011, p. 28). The results show that Majoon Ushba and Roghane Hindi are effective in treating scaling associated with psoriasis. Before treatment, 12 patients in the experimental group had severe erythema, 6 patients had moderate erythema, and 2 patients had mild erythema. After treatment, 10 patients showed complete cure from erythema, 2 patients had moderate erythema, 7 patients had mild erythema, and 1 patient had severe erythema after treatment (Lone, Ahmad, & Naiyar, 2011, p. 28). The results show that these aryuvedic herbs improve psoriatic erythema. At the 8 week end point, there was a significant reduction reduction in PASI score in the experimental group versus the control group. The results demonstrate that the herbal therapy with Majoon Ushba and Roghane Hindi contribute to significant improvement in three physical manifestations of psoriasis, itching, scaling, and erythema. Toxicology parameters were within normal limits after 2 months of treatment, concluding that the herbs are safe and effective in the management of psoriasis (Lone, Ahmad, & Naiyar, 2011, p. 26).
Lone, A. H., Ahmad, T., & Naiyar, A. (2011, Jan). Clinical evaluation of efficacy of majon ushba and roghane hindi in the management of psoriasis: a randomized single-blind, placebo-controlled study. Journal of Ayurveda & Integrative Medicine, 2(1), 26-31.
Aryuvedic herbs, Majoon Ushba and Roghane Hindi, are safe and effective herbs to use in the management of psoriasis. According to a study conducted to test the efficacy of Majoon Ushba and Roghane Hindi, patients experienced decreased itching, scaling, and erythema. Thirty patients were selected to be in this randomized, single-blinded, placebo-controlled study. The subjects were divided into an experimental group and a control group. The experimental group, which consisted of 20 patients, received 5 g of Majoon Ushba orally twice daily and Roghane Hindi was applied locally twice daily. The control group, which consisted of 10 patients, were given placebo drugs, which were applied orally and topically twice daily. The severity of psoriasis and efficacy of the drug were measured using the Psoriasis Area and Severity Index (PASI) (Lone, Ahmad, & Naiyar, 2011, p. 26). Before treatment, 8 subjects in the experimental group reported having severe itching, 8 had moderate itching, and 4 patients had mild itching. After treatment,10 patients showed complete cure from itching, 4 patients had moderate itching, 6 patients had mild itching, and no patients reported severe itching (Lone, Ahmad, & Naiyar, 2011, p. 28). The results demonstrated that these herbs were effective in treating itching over the course of the 8 week trial. Before treatment, 10 patients in the experimental group showed severe scaling, 6 patients had moderate scaling, and 4 patients complained of mild scaling. After treatment, 12 patients showed complete cure from scaling, 1 patient had moderate scaling, 6 patients had mild scaling, and 1 patient still had severe scaling (Lone, Ahmad, & Naiyar, 2011, p. 28). The results show that Majoon Ushba and Roghane Hindi are effective in treating scaling associated with psoriasis. Before treatment, 12 patients in the experimental group had severe erythema, 6 patients had moderate erythema, and 2 patients had mild erythema. After treatment, 10 patients showed complete cure from erythema, 2 patients had moderate erythema, 7 patients had mild erythema, and 1 patient had severe erythema after treatment (Lone, Ahmad, & Naiyar, 2011, p. 28). The results show that these aryuvedic herbs improve psoriatic erythema. At the 8 week end point, there was a significant reduction reduction in PASI score in the experimental group versus the control group. The results demonstrate that the herbal therapy with Majoon Ushba and Roghane Hindi contribute to significant improvement in three physical manifestations of psoriasis, itching, scaling, and erythema. Toxicology parameters were within normal limits after 2 months of treatment, concluding that the herbs are safe and effective in the management of psoriasis (Lone, Ahmad, & Naiyar, 2011, p. 26).
Lone, A. H., Ahmad, T., & Naiyar, A. (2011, Jan). Clinical evaluation of efficacy of majon ushba and roghane hindi in the management of psoriasis: a randomized single-blind, placebo-controlled study. Journal of Ayurveda & Integrative Medicine, 2(1), 26-31.
Accupuncture
Acupuncture may be effective in treating inflammation associated with psoriasis. A study that examined the effects of acupuncture on a group of individuals with psoriasis compared to a group of individuals without psoriasis, demonstrated positive effects of this alternative treatment. The percentage of individuals with skin itching significantly decreased in the treatment group after treatment (p<0.05). The treatment group also experienced a significant decrease in prostaglandin levels after treatment (Lung-Cheng Hsiao, Vinjamuray, Li, & Wu, 2008, p. 22).
Lung-Cheng Hsiao, E., Vinjamuray, S. P., Li, J.-T., & Wu, W.-S. (2008). Efficacy of TCM for psoriasis - a scientific review. The American Acupuncturist, 20-33.
Lung-Cheng Hsiao, E., Vinjamuray, S. P., Li, J.-T., & Wu, W.-S. (2008). Efficacy of TCM for psoriasis - a scientific review. The American Acupuncturist, 20-33.
Topical Vitamin D3
Topical D3 is a therapeutic option for psoriasis. Topical Vitamin D formulations have been used in Europe and other parts of the world as successful therapy for the treatment of psoriasis (Kircik, 2009).
A cross-sectional study examined the immunomodulatory effects of vitamin D deficiency and psoriasis. The subjects included 145 patients with chronic plaque psoriasis, 112 patients with rheumatoid arthritis, and 141 healthy controls. Study measures included parathyroid hormone and calcium serum tests and analysis of demography, comorbidities, disease severity, and exposure to sunlight. The results of the study demonstrated that “vitamin D deficiency was associated with psoriasis independent of age, sex, body mass index, calcium, PTH levels, and season of blood sampling” (Gisondi, et al., 2012). This study supports the needs for psoriasis management through supplementation of vitamin D.
Gisondi, P., Rossini, M., Cesare, D., Idolazzi, L., Farina, S., Beltrami, G. P., & Girolomoni, G. (2012, March). Vitamin D status in patients with chronic plaque psoriasis. British Journal of Dermatology, 166(3), 505-510.
Recently, Calcitriol, the naturally occurring active form of vitamin D3, was approved for use in the United States as an effective, safe, and well-tolerated psoriasis treatment (Kircik, 2009). In two short-term randomized, double-blind clinical trials, application of calcitriol ointment (3 microg/g), two times a day, for eight weeks demonstrated clearing of psoriasis in 34% of patients compared to 12% and 22% of patients treated with the control ointment. The calcitriol ointment demonstrated improvement in ratings of psoriasis plaque elevation, erythema, scaling, and pruitus. Two long-term studies, conducted over a year or longer demonstrated improvement in physician-related and patient-related psoriasis severity (Kircik, 2009). The long-term studies also demonstrated safety, as calcitriol has a low risk of adverse events and did not cause fluctuation in lab values (Kircik, 2009). Calcitriol ointment is a beneficial treatment option to be used alone or in conjunction with other psoriasis therapies.
Kircik, L. (2009, August). Efficacy and safety of topical calcitriol 3 microg/g ointment, a new topical therapy for chronic plaque psoriasis. The Journal of Drugs in Dermatology, 8, 9-16.
A cross-sectional study examined the immunomodulatory effects of vitamin D deficiency and psoriasis. The subjects included 145 patients with chronic plaque psoriasis, 112 patients with rheumatoid arthritis, and 141 healthy controls. Study measures included parathyroid hormone and calcium serum tests and analysis of demography, comorbidities, disease severity, and exposure to sunlight. The results of the study demonstrated that “vitamin D deficiency was associated with psoriasis independent of age, sex, body mass index, calcium, PTH levels, and season of blood sampling” (Gisondi, et al., 2012). This study supports the needs for psoriasis management through supplementation of vitamin D.
Gisondi, P., Rossini, M., Cesare, D., Idolazzi, L., Farina, S., Beltrami, G. P., & Girolomoni, G. (2012, March). Vitamin D status in patients with chronic plaque psoriasis. British Journal of Dermatology, 166(3), 505-510.
Recently, Calcitriol, the naturally occurring active form of vitamin D3, was approved for use in the United States as an effective, safe, and well-tolerated psoriasis treatment (Kircik, 2009). In two short-term randomized, double-blind clinical trials, application of calcitriol ointment (3 microg/g), two times a day, for eight weeks demonstrated clearing of psoriasis in 34% of patients compared to 12% and 22% of patients treated with the control ointment. The calcitriol ointment demonstrated improvement in ratings of psoriasis plaque elevation, erythema, scaling, and pruitus. Two long-term studies, conducted over a year or longer demonstrated improvement in physician-related and patient-related psoriasis severity (Kircik, 2009). The long-term studies also demonstrated safety, as calcitriol has a low risk of adverse events and did not cause fluctuation in lab values (Kircik, 2009). Calcitriol ointment is a beneficial treatment option to be used alone or in conjunction with other psoriasis therapies.
Kircik, L. (2009, August). Efficacy and safety of topical calcitriol 3 microg/g ointment, a new topical therapy for chronic plaque psoriasis. The Journal of Drugs in Dermatology, 8, 9-16.
Whey Protein Isolate
Whey protein isolate has been validated in clinical trials as an effective treatment for mild-to-moderate psoriasis. A double-blind, placebo-controlled study was conducted to determine the effects of whey protein isolate on psoriasis. The study included 84 subjects with mild to moderate psoriasis who consumed 5g of whey protein isolate per day for 56 days. The results demonstrated that their Physician Global Assessment Score, which measures complications of psoriasis, decreased significantly compared to the placebo. There were no adverse affects associated with whey protein isolate consumption for this study.
Poulin, Y., Bissonnette, R., & Juneau, C. e. (2006). XP-828I in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study. Journal of Cutaneous Medicine and Surgery, 10, 241-428.
Poulin, Y., Bissonnette, R., & Juneau, C. e. (2006). XP-828I in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study. Journal of Cutaneous Medicine and Surgery, 10, 241-428.