Psoriasis - Prescribed Treatments, Risks, and Possible Alternatives
What is Psoriasis?
Psoriasis is a genetic autoimmune disease, triggered by environmental factors. It is not contagious (1) and is characterised by raised areas of abornal skin (2) that can be red (or purple on people with darker skin) (3) that can be itchy, dry and/or scaly (1)).
The five main types of psoriasis are plaque, guttate, pustular, inverse and erythrodermic. (2)
Plaque psoriasis, or psoriasis vulgaris as its is medically known, makes up about 9 out of 10 cases. It usually presents as red patches with white scales on top. (1)
Most people that suffer with psoriasis already know there is unfortunately no cure for this autoimmune disease (1), as many sufferers will already know, there are things that bring relief and certain things that can make it symptoms worse.
The cause of psoraisis is still unknown, but many people testify they have seen worsening of their condition based on (but not limited to):
Environmental factors - changes in temperature, weather or climate.
Lifestyle factors - diet, alcohol intake, infections, stress, smoking (including cannabis and other controlled drugs)
Other medical conditions - Other autoimmune diseases, infections, cuts, HIV, strep throat, stress, and particularly in guttate psoriasis tonsillitis or pharyngitis.
Medications - Drug-induced psoriasis can occur with beta blockers, lithium anti malarial medications, Nonsteriodal anti inflammatory drugs, terbinafine, calcium channel blockers, captopril, glyburide, granulocyte colony stimulating factor, interlukins, interferons, lipid lowering medications and paradoxically TNF inhibitors such as infliximab and adalimumab. Withdrawal of corticosteriods can also aggrevate psoriasis due to the rebound effect. (4, 5, 6, 7)
How Doctors Treat Psoriasis
Treatments fall into 3 categories:
- topical – products that are applied to your skin
- phototherapy – this is where you expose your skin to different types of ultraviolet light
- systemic – oral and/or injected medications that take effect throughout the entire body
Different types of treatment are often used in combination. (8)
Topical treatments
Topical treatments are usually the first treatments used for mild to moderate psoriasis. These are creams and ointments you apply to affected areas.
Some people find that topical treatments are all they need to control their condition, although they usually take some time to shows signs of benefit.
If you have scalp psoriasis, a combination of shampoo and ointment may be recommended by your Doctor. (8)
Emollients
Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. If you have mild psoriasis, an emollient is probably the first treatment your GP will suggest.
The main benefit of emollients is to reduce itching and scaling. (8)
Risks Associated with Emollients
The main risks of prescribed or over the counter emollients are skin reactions such as a burning or stinging reaction in the skin, usually due to a reaction with ingredient(s) within the products, blocked or inflamed hair follecules, and due to blocking hair follecules, that can in some cases cause boils. Rashes have also been a noted side effect from these treatments.
These products can also contain paraffin and other flammable products, these have potential for long term damage to you skin as well as the obvious risks of burns and scalds (8).
The risks of petroleum based skin treatments are not usually well known or discussed with patients prior to long term exposure but these can be extremely dangerous, these serious risks are outlined in the link below and it's vitally important for anyone who is prescribed or buys these products over the counter, that they understand the risks associated with these products - please read more about these dangers here (9)
Steroid Creams or Ointments
Steroid Creams or ointments (topical corticosteroids) are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.
Topical corticosteroids range in strength from mild to very strong. Only use them when recommended by your doctor.
Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches (8)
Risks of steroid creams or ointments
The most common side effect of topical corticosteroids is a burning or stinging sensation when the medicine is applied. This is however usually temporary. (8)
Less common side effects can include:
Worsening or spreading of a skin infection you already have, inflamed hair follicles (folliculitis), thinning of the skin, which can make the affected skin more vulnerable to damage; for example, you may bruise more easily, stretch marks, which are likely to be permanent, contact dermatitis, which is a skin irritation caused by a mild allergic reaction to the substances in a particular topical corticosteroid, acne, or worsening of acne, rosacea, which is a condition that causes the face to become red and flushed, changes in skin colour – this is usually more noticeable in people with dark skin, excessive hair growth on the area of skin being treated
Side effects are more likely if you're using a more potent corticosteroid or using it for a very long time, or over a large area.
The elderly and very young are more vulnerable to side effects.
If potent or very potent topical corticosteroids are used for a long time or over a large area, there's a risk of the medicine being absorbed into the bloodstream and causing internal side effects, such as decreased growth in children and/or Cushings Syndrome.
Even this is not a full list of all the possible side effects. For more information on side effects, see the leaflet that comes with the particluar medicine.
Withdrawal side effects
If you stop using topical corticosteroids after using them continuously for a long time (usually over 12 months in adults), you may have a withdrawal reaction. These can sometimes be severe.
Withdrawal side effects can include:
- redness or changes in skin colour (this may not be as noticeable on darker skin)
- burning, stinging, itching or peeling of the skin, or oozing, open sores
If you’ve been using topical corticosteroids for a long time, it’s a good idea to ask your doctor to review your treatment, or if you are talking to your doctor about being prescribed these it is important to understand the potential risks prior to use, to decide with your doctor if this is the correct treatment path for you. (10)
Vitamin D analogues
Vitamin D analogue creams are commonly used along with or instead of steroid creams for mild to moderate psoriasis affecting areas such as the limbs, trunk or scalp. They work by slowing the production of skin cells. They also have an anti-inflammatory effect.
Examples of vitamin D analogues are calcipotriol, calcitriol and tacalcitol. There are very few side effects as long as you do not use more than the recommended amount. (8)
Risks of Vitamin D analogues
There are very few side effects as long as you do not use more than the recommended amount, however, this alone often does not provide sufferers with enough relief (8).
If overused, the main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness, and frequent urination. Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones (8).
Calcineurin Inhibitors
Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are ointments or creams that reduce the activity of the immune system and help to reduce inflammation. They're sometimes used to treat psoriasis affecting sensitive areas, such as the scalp, the genitals and folds in the skin, and usually only prescribed if if steroid creams are not effective (8)
Risks of Calcineurin inhibitors
These medications can cause skin irritation or a burning and itching sensation when they're started, but this usually improves within a week.
Other adverse effects may include; allergic contact dermetitus, folleculitis, Reactivation of infection of herpes or viral warts, Enhancement of facia flushing after alcohol ingestion, roscia -like dermatitis, Facial acne, Molliscum conagiosum, (a skin infection that can last anywhere from a few months to two years), Tinea Incognita (a fungal infection on the skin requiring an anti-fungal topical treatment (8)
Coal tar
Coal tar is a thick, heavy oil and is probably the oldest treatment for psoriasis. How it works is not exactly known, but it can reduce scales, inflammation and itchiness.
It may be used to treat psoriasis affecting the limbs, trunk or scalp if other topical treatments are not effective. (8)
Risks of Coal tar
Irritation the skin, it can cause a rash or acne-like breakout, lead to easily burned skin from the sun or a tanning bed because it makes your skin more sensitive to ultraviolet (UV) light, Stain skin, light-colored hair, and clothing, Leave an unpleasant odor, Make hair dry and brittle when used to treat scalp psoriasis, It can even worsen psoriasis (11)
In California, you’ll find cancer warnings on some coal tar products you can use to treat psoriasis. This warning was added to products in California due to:
-
Animal studies (where the animals were exposed to a lot more coal tar than we would use to treat psoriasis)
-
Occupational studies (where a person works with industrial coal tar)
To date, as opposed to animals studies, human studies fail to show an increased risk of cancer in humans who use coal tar to treat psoriasis or atopic dermatitis (eczema). People who work with industrial coal tar, however, have an increased risk of developing cancer of the lungs, scrotum, and skin. (11)
Dithranol
Dithranol has been used for more than 50 years to treat psoriasis. It has been shown to be effective in suppressing the production of skin cells and has few side effects. However, it can burn if it's too concentrated. (8)
Risks associated with Dithranol
It's typically used as a short-term treatment, under hospital supervision, for psoriasis affecting the limbs or trunk, as it stains everything it comes into contact with, including skin, clothes and bathroom fittings.
It's applied to your skin (by someone wearing gloves) and left for 10 to 60 minutes before being washed off.
Dithranol can be used in combination with phototherapy (NHS UK)
Dithranol can cause skin irritation, such as redness, itching and a burning sensation, this can become severe, which is why this is usually a short term treatment applied under medical supervision. (12)
Phototherapy
Phototherapy uses natural and artificial light to treat psoriasis. Artificial light therapy can be given in hospitals and some specialist centres, usually under the care of a dermatologist. These treatments are not the same as using a sunbed. (8)
Ultraviolet B (UVB) phototherapy
UVB phototherapy uses a wavelength of light invisible to human eyes. The light slows down the production of skin cells and is an effective treatment for some types of psoriasis that have not responded to topical treatments.
Each session only takes a few minutes, but you may need to go to hospital 2 or 3 times a week for 6 to 8 weeks. In these times of covid taking precedent over treatments for many people, this can be impossible. (8)
Psoralen plus ultraviolet A (PUVA)
For this treatment, you'll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light.
Your skin is then exposed to a wavelength of light called ultraviolet A (UVA). This light penetrates your skin more deeply than ultraviolet B light.
This treatment may be used if you have severe psoriasis that has not responded to other treatment.
Side effects include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts.
Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer. (8)
Combination light therapy
Combining phototherapy with other treatments often increases its effectiveness.
Some doctors use UVB phototherapy in combination with coal tar, as the coal tar makes the skin more receptive to light. Combining UVB phototherapy with dithranol cream may also be effective – this is known as Ingram treatment. (8)
Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer. (8)
Tablets, capsules and injections
If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments work throughout the entire body.
These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.
If you're planning for a baby, become pregnant or are thinking of breastfeeding, you should also speak to your doctor first before taking any new medicine to check it's suitable for use during pregnancy or breastfeeding.
There are 2 main types of systemic treatment, called non-biological (usually given as tablets or capsules) and biological (usually given as injections). (8)
Non-biological medications
Methotrexate
Methotrexate can help control psoriasis by slowing down the production of skin cells and suppressing inflammation. It's usually taken once a week.
Risks and Side effects of Methotrexate
Methotrexate can cause nausea and may affect the production of blood cells. Long-term use can cause liver damage. People who have liver disease should not take methotrexate, and you should not drink alcohol when taking it.
Methotrexate can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while they take this drug and for at least 3 months after they stop.
The safety for men fathering a pregnancy while taking methotrexate is less clear. As a precaution, men are advised to delay trying for a baby until at least 3 months since their last dose of methotrexate (8)
Ciclosporin
Ciclosporin is a medicine that suppresses your immune system (immunosuppressant). It was originally used to prevent transplant rejection but has proved effective in treating all types of psoriasis. It's usually taken daily.(8)
Risks of Ciclosporin
Ciclosporin increases your chances of kidney disease and high blood pressure, which will need to be monitored - patients using this medication should ensure this is monitored. (8)
Acitretin
Acitretin is an oral retinoid that reduces skin cell production. It's used to treat severe psoriasis that has not responded to other non-biological systemic treatments. It's usually taken daily. (8)
Risks and Side effects of Acitretin
Acitretin has a wide range of side effects, including dryness and cracking of the lips, dryness of the nasal passages and, in some cases, hepatitis.
Acitretin can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while taking this drug, and for at least 3 years after they stop taking it. However, it's seen as safe for a man taking acitretin to father a baby (8)
Newer drugs
Apremilast and dimethyl fumarate are newer medicines that help to reduce inflammation. They are taken as daily tablets. These medicines are only recommended for use if you have severe psoriasis that has not responded to other treatments, such as biological treatments (8)
Apremilast Side Effects
- diarrhea
- nausea
- stomach pain
- vomiting
- headache
- sore throat, cough, and fever
- sneezing, runny nose, and nasal congestion
- Apremilast may also cause other side effects (13))
Dimethyl Fumarate Side Effects
- warmth, redness, itching, or burning of the skin
- diarrhea
- nausea
- vomiting
- heartburn
Some side effects can be serious. If you experience any of these symptoms, stop taking dimethyl fumarate and call your doctor immediately or get emergency medical treatment:
- difficulty swallowing or breathing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hives
- rash
- itching
- hoarseness
- vision problems
- weakness on one side of the body or clumsiness of the arms or legs that worsens over time
- changes in vision
- changes in your thinking, memory, or awareness that leads to confusion and personality changes
- extreme tiredness, loss of appetite, pain in upper right side of your stomach, dark urine, or yellowing of the skin or eyes
- weakness on one side of the body that worsens over time; clumsiness of the arms or legs; changes in your thinking, memory, walking, balance, speech, eyesight, or strength that last several days; headaches; seizures; confusion; or personality changes
- burning, tingling, itching, or skin sensitivity on one side of the body or face with painful rash or blisters appearing several days later (14)
Biological treatments
Biological treatments reduce inflammation by targeting overactive cells in the immune system. They are usually used if you have severe psoriasis that has not responded to other treatments, or if you cannot use other treatments. (8)
Etanercept
Etanercept is injected twice a week, and you'll be shown how to do this (8)
Etanercept Side Effects
The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there's a risk of serious side effects, including severe infection (8) These side effects include;
- redness, itching, pain, or swelling at the site of injection
- headache
- nausea
- vomiting
- heartburn
- stomach pain
- weakness
- cough
Some side effects can be serious. If you experience any of the following side effects or those mentioned in the IMPORTANT WARNING SECTION, call your doctor immediately or get emergency medical help:
- seizures
- bruising
- bleeding
- pale skin
- blistering skin
- rash
- hives
- itching
- swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- rash on the face and arms that worsens in the sun
- numbness or tingling
- vision problems
- weakness in the arms or legs
- dizziness
- red, scaly patches or pus-filled bumps on the skin
Adults who receive etanercept injection maybe at greater risk of developing lymphoma, leukemia (cancer that begins in the white blood cells), skin cancer, and other types of cancer than adults who do not receive this medication. (15)
Adalimumab (humira)
Adalimumab is injected once every 2 weeks, and you'll be shown how to do this. If there's no improvement in your psoriasis after 16 weeks, the treatment will be stopped.(8) As we mentioned earlier, paradoxically in some cases, this can even make psoriasis worse.
Adalimumab (humira) Side effects and Risks
The main side effects of adalimumab include headaches, a rash at the injection site and nausea. However, as adalimumab affects the whole immune system, there's a risk of serious side effects (8)
This medicine may cause other unwanted effects that may not occur until months or years after this medicine is used. A small number of people (including children and teenagers) who have used this type of medicine have developed certain types of cancer (eg, leukemia). Some patients also developed a rare type of cancer called lymphoma. Talk with your doctor if you or your child suffer unusual bleeding, bruising, or weakness, swollen lymph nodes in the neck, underarms, or groin, or unexplained weight loss. Also, check with your doctor right away if your or your child's skin has red, scaly patches, or raised bumps that are filled with pus.
Adalimumab may cause serious allergic reactions (eg, anaphylaxis and angioneurotic edema), which can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have a cough, difficulty swallowing, dizziness, fast heartbeat, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs, rash, itching, trouble breathing, or unusual tiredness or weakness after you receive the medicine.
Check with your doctor right away if you have swelling of the face, fingers, feet, or lower legs, or sudden weight gain. These may be signs of a heart condition called congestive heart failure (CHF).
Some people who have used this medicine developed lupus-like symptoms during treatment and got better after the medicine was stopped. Check with your doctor right away if you start having chest pains, joint pain, or a rash on the cheeks or arms that is sensitive to the sun.
Do not have any live vaccines (immunizations) while you are being treated with adalimumab. Your child's vaccines need to be current before using adalimumab. Be sure to ask your doctor if you have any questions about this.
The needle cover of some prefilled syringes and pens contain dry natural rubber (a derivative of latex), which may cause allergic reactions in people who are sensitive to latex. Tell your doctor if you have a latex allergy before using this medicine.
Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you suffer has blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while using this medicine. (16)
Infliximab
Infliximab is given as a drip (infusion) into your vein at the hospital. You'll have 3 infusions in the first 6 weeks, then 1 infusion every 8 weeks. If there's no improvement in your psoriasis after 10 weeks, the treatment will be stopped (8)
Infliximab Side effects and Risks
The main side effect of infliximab is a headache. However, as infliximab affects the whole immune system, there's a risk of serious side effects, including severe infections.
Infliximab may cause an infusion reaction, including a heart attack, stroke, changes in blood pressure, or heart rhythm problems (eg, arrhythmia), while you are receiving it or right after the infusion ends. Check with your doctor or nurse right away if you have chest pain, fever, chills, itching, hives, rash, dizziness, fainting, lightheadedness, headache, joint pain, difficulty with swallowing, trouble breathing, or swelling of the face, tongue, and throat.
Your body's ability to fight an infection may be reduced while you are using infliximab. It is very important that you call your doctor at the first sign of any infection. Check with your doctor right away if you or your child have a fever, chills, cough, flu-like symptoms, or unusual tiredness or weakness.
Serious skin reactions can occur while you are receiving this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, fever, itching, joint or muscle pain, red skin lesions, sore throat, sores, ulcers, or white spots in your mouth, or unusual tiredness or weakness.
This medicine may increase your risk of having a lupus-like syndrome or a liver disease called autoimmune hepatitis. Check with your doctor right away if you have dark brown-colored urine, fever or chills, a general feeling of discomfort, illness, or weakness, joint pain, light-colored stools, nausea, vomiting, a rash on the cheeks or arms that gets worse under the sun, severe tiredness, upper right-sided stomach pain, or yellow eyes and skin.
A small number of people (including children and teenagers) who have used this medicine have developed certain types of cancer. This is more common in patients who have lung diseases (eg, emphysema, COPD) or are heavy smokers, and in psoriasis patients who have had phototherapy treatment for a long time. Some teenagers and young adults with Crohn disease or ulcerative colitis also developed a rare type of cancer called hepatosplenic T-cell lymphoma. Talk with your doctor if you have unusual bleeding, bruising, or weakness, swollen lymph nodes in the neck, underarms, or groin, unexplained weight loss, or red, scaly patches, or raised bumps with pus on the skin.
Receiving this medicine may increase your risk of getting skin cancer (eg, melanoma, Merkel cell carcinoma) or cervical cancer. If you have any changes or growths on your skin, abnormal vaginal bleeding or pelvic pain, tell your doctor right away.
While you are being treated with infliximab, do not have any immunizations (vaccines) without your doctor's approval. Live virus vaccines should not be given with infliximab. Your child's vaccinations must be current before receiving infliximab. Talk to your child's doctor if you have any questions about this.
Women: If you have a baby while receiving infliximab, make sure the baby's doctor knows that you are receiving this medicine. You will need to wait a few months before giving certain vaccines to your baby. Talk to the baby's doctor if you have questions.
You will need to have a skin test for tuberculosis before you start receiving this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.
It is important to have your heart checked closely if you receive infliximab. Call your doctor right away if you have trouble breathing, swelling in the ankles and feet, or a sudden weight gain. (17)
Ustekinumab
Ustekinumab is injected at the beginning of treatment, then again 4 weeks later. After this, injections are every 12 weeks. If there's no improvement in your psoriasis after 16 weeks, the treatment will be stopped. (8)
Ustekinumab Side Effects
The main side effects of ustekinumab are a throat infection and a rash at the injection site. However, as ustekinumab affects the whole immune system, there's a risk of serious side effects, including severe infections.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. (8)
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain, chills, cough, cough producing mucus, difficulty with breathing, ear congestion, fever, headache, hoarseness, itching of the vagina or genitals, loss of voice, lower back or side pain, painful or difficult urination, runny or stuffy nose, sneezing, sore throat, stomach pain, thick, white vaginal discharge with mild or no odor, tightness in the chest, unusual tiredness or weakness
Less common
Bladder pain, bloody or cloudy urine, burning feeling while urinating, diarrhea, depression, dizziness, frequent urge to urinate, itching skin, lower back or side pain, pain or tenderness around the eyes and cheekbones, vomiting
Rare
Blurred or loss of vision, clear or bloody discharge from the nipple, confusion, dimpling of the breast skin, disturbed color perception, double vision, halos around lights, inverted nipple, itching, pain, redness, swelling, tenderness, or warmth on the skin, lump in the breast or under the arm, night blindness, overbright appearance of lights, persistent crusting or scaling of the nipple, redness or swelling of the breast, seizures, sore on the skin of the breast that does not heal, tunnel vision
Incidence not known
Chest pain, difficulty with swallowing, dry cough, fast heartbeat, general feeling of tiredness or weakness, hives or welts, skin rash, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, rapid breathing, redness of the skin (18)
Newer drugs
There is an increasing number of newer biological treatments that are given as injections. These include guselkumab and brodalumab.
They're sometimes recommended by doctors or dermatologists for people who have severe psoriasis that has not improved with other treatments or when other treatments are not suitable. (8)
These unfortunately carry many of the same side effects and risks as other biological treatments.
Summary of traditional treatments, an opinion
Although I cannot advise any change to medical treatments prescribed by Doctors, GPs, Consultants or Dermatologists, it does seem that from the above, a lot of these treatments provide temporary relief, not permanent - and they also come with sometimes extremely serious risks/side effects that are seldom explained to patients prior to use. Hopefully the above will be of some warning to patients and potential patients and help people understand the risks associated with prescribed treatments.
With these severe side effects and risks in mind, I'm blown away (as I often am) by healthcare providers not looking at natural treatments, first and foremost, which often come with vastly reduced side effects and risks, and can sometimes be just as effective or even more effective than prescribed medications.
Alternative Natural Options
CBD (cannabigerol)
Firstly, and for good reason, it's not legal for CBD companies to refer to CBD as a treatment, cure, preventative or even to help with symptoms of any disease, illness or ailment, so firstly we'll look at other natural potential solutions. then look at the research studies and other information that indicate that cannabinoids may assist and why.
Firstly we'll look at the natural remedies available over the counter and in our lifestyle, that show some evidence of helping symptoms of psoriasis.
1. Apple Cider Vinegar, this has been found to help people with scalp psoriasis, its thought diluted is best as this comes with less risk of irritation, although some people have shown results from undiluted full strength, with use several times a week. This works as a natural anti inflammatory and its best to rinse this off after is dries so it doesn't cause irritation, it also can't be used on open woulds, as this is likely to cause burning.
2. Dead Sea or Epsom salts. You can add these into a tub with warm water. Soak for about 15 minutes, and use a natural moisturizer when you're finished to seal in the moisture.
3. Turmeric (curcumin) - You might know it as the yellow herb that shows up in foods with a curry sauce. Studies show it may cut down your psoriasis flare-ups (19). It's highly advised that for best results this is taken with piperine (black pepper), as this can increase the bioavailability of curcumin by up to 2000% (20). It can be found in balms, but this stains almost everything it touches which is why most people take this either in foods or a specially made supplement.
4. Tea Tree Oil - It comes from a plant that's native to Australia and New Zealand. Shampoos with this ingredient may help psoriasis on your scalp, though more research is needed.
5. Soaking in Oats - It's a natural way to soothe your skin. Put some ground-up oats in your bath, sit back, and relax. Just make sure the water is warm, not hot, so you don't irritate your skin.
6. Meditation and Yoga - This can down your stress that could possibly reduce symptoms. Meditation can help many psychological surrounding issues of conditions. Yoga is especially helpful if you have psoriatic arthritis, also, because it eases joint pain and expands your ranges of motion.
7. Wrapping - This is the action of applying a natural moisturiser on your skin at bedtime and cover the area with plastic wrap. Then add a layer of tight clothing -- like gloves or socks. The idea is to seal the moisturizer in while you sleep and let your skin absorb it.
8. Omega 3 fatty acids - they fight inflammation, and you can find them in fatty fish like salmon, mackerel, tuna, and sardines. You can also buy fish oil supplements and as you'll see below they are found in abundance in hemp seed oil.
9. Oregon Grape - It's an evergreen plant. The formal name is Mahonia aquifolium. Look for creams where it's at least 10% of the ingredients. It's shown some promise in studies.
10. A Mediterranean Diet - This eating plan puts the focus on fish, veggies and fruits, and whole grains. A small study shows it might tone down your symptoms (21). Lots of people have found cutting out or lowering intake of dairy, gluten and alcohol helps symptoms as well, although the evidence is mostly anecdotal.
11. Aloe Vera - Studies suggest aloe vera could improve psoriasis (22). Aloe vera is a known anti-inflammatory and helps decrease redness on the skin. There's no evidence that aloe vera tablets or drinks help, so its best used topically by cutting the plant leaves and applying the gel like substance found in the leaf, directly onto the skin.
12. Coconut Oil - Coconut oil is a natural moisturiser, it can be used on the scalp and skin, it can also be mixed with other ingredients to provide further relief, however, it doesn't help everyone on it's own and some people may be allergic to coconut, so it is not suitable for everyone.
13. Beeswax - Beeswax has a long history of being used for certain skin issues, thanks to its antibacterial properties,. Historically, this has included treating burns and wounds. It's often used in more recent times to soothe symptoms of some skin conditions, such as psoriasis (23)
14. Hemp Seed Oil - According to several studies hemp seed oil can help psoriasis. (24) Hemp seed oil is a natural humectant, meaning it helps reduce dryness and strengthen skin by drawing water from nearby sources. It also contains omega 3, 6 and 9 omega fatty acids which have been known to have anticancer and anti-inflammatory properties. Hemp seed oil is also known to have anti microbial properties, all of which can be helpful in managing psoriasis symptoms.
15. Vitamin E - At least one study (25) has linked topical vitamin E to a reduction in psoriasis symptoms. Even better, the study showed that there were no serious side effects.
Here at Bio Med CBD - we've formulated a natural balm containing Beeswax, Hemp seed oil, Vitamin E and Coconut Oil - all of which show in studies to help psoriasis symptoms. We've added a Full spectrum CBD rich hemp flower Extract, containing over 140+ cannabinoids, flavanoids, terpenes and all other compounds found naturally in hemp flower. This can be found here for a discounted price, theres a lot of evidence to suggest that the natural ingredients contained within the balm (12-15) could help psoriasis symptoms, and we've added a CBD rich full spectrum CBD extract, as this has shown promise that this could also be of help, which we'll look at why and how next.
How could Cannabinoids Potentially help Psoriasis? And what do the studies say?
There are two main natural cannabinoids that have shown in studies to potentially have benefits in helping with psoriasis, namely CBD (canabidiol) and CBG (cannabigerol), CBD is abundant in Hemp Flower, CBG is abundant in early stages of growth in both Cannabis and Hemp, although this is many times more expensive than CBD to extract, so its often rarer and in products where it is found, the products are often more expensive. For more information about CBG, please refer to our article found here.
What do the studies say?
In this study found here (26), it suggests that cannabinoids and their receptors may help control and limit the production of immature skin cells. Researchers add that cannabinoids may be useful in treating several conditions involving keratinocytes, including psoriasis and wound healing.
Cannabinoids, including CBG, as stated in a previous Bio Med CBD Article found here, may be more effective than opioids in controlling acute and neuropathic pain. It may also be useful in reducing chronic pain, according to this article in
Although more research is needed, some studies indicate that cannabinoids reduces the severity of inflammation associated with some conditions, including autoimmune disorders like psoriasis. An article published in the journal Pharmacology (28) indicates that cannabis can suppress the immune system.
Psoriasis and stress often go hand in hand, high stress has been shown in some sufferers to increase psoriasis symptoms and low doses of CBD rich hemp extracts have been shown they may relieve stress in this study (29)
So whilst there is a lot of anecdotal evidence to suggest that CBD and CBG would help various primary symptoms and secondary symptoms of psoriasis, and even though some Doctors (like Dr. Ethan Russo) have stated that cannabinoids may hold the key to treating incurable auto immune diseases, such as psoriasis, more research needs to be completed on this for anyone to be able to make any medical claims.
There hasn't been any studies that have shown CBD or CBG could be detrimental to psoriasis symptoms at this stage, so that is very positive. There are the same risks with most cbd balms as there are with some non-paraffin containing emollients, and some risks that are applicable with immune system repression, but due to the ingredients and the way cannabinoids work, including their increased benefits, many of these risks are greatly reduced.
To gain most potential benefit, its thought that an internal and external introduction of cannabinoids could be most helpful for a wide range of related issues - but this is dependent on many factors, such as severity - for information on dosages see here. We'd recommend an internal oil is best combined with an organic natural balm, such as the one previously linked.
We cannot claim that CBD, CBG or any other cannabinoid will do ANYTHING AT ALL, and we certainly can't claim it will treat, cure or prevent any illness or disease including Psoriasis, but the circumstantial and anecdotal evidence is very promising. If anyone would like to try this, to see if this would help them personally, we're currently running a special offer for a CBD/CBG Oil and Organic CBD Balm combination, where you can gain a huge 25% discount when 2 products are bought together - this is an discount that is applied automatically when two products from the above pictures, are added to your shopping cart at www.biomedcbd.co.uk.
We hope that you've found this article informative and helpful - as always, our team of dedicated team of professionals and qualified cannabis experts would always be happy to answer any questions you have relating to cannabinoids and healthcare, either by using the blue messenger button on our website or sending us a message via the "contact us' tab at the top of the page.
Many thanks,
The Bio Med CBD Team
Citations/References
(1) Boehncke WH, Schön MP (September 2015). "Psoriasis". Lancet. 386 (9997): 983–94. doi:10.1016/S0140-6736(14)61909-7. PMID 26025581. S2CID 208793879.
(2) "Questions and Answers About Psoriasis". National Institute of Arthritis and Musculoskeletal and Skin Diseases. 12 April 2017. Archived from the original on 22 April 2017. Retrieved 22 April 2017.
(3) LeMone P, Burke K, Dwyer T, Levett-Jones T, Moxham L, Reid-Searl K (2015). Medical-Surgical Nursing. Pearson Higher Education AU. p. 454. ISBN 9781486014408.
(4) Prieto-Pérez R, Cabaleiro T, Daudén E, Ochoa D, Roman M, Abad-Santos F (August 2013). "Genetics of psoriasis and pharmacogenetics of biological drugs". Autoimmune Diseases. 2013 (613086): 613086.
(5) Clarke P (July 2011). "Psoriasis" (PDF). Australian Family Physician. 40 (7): 468–73. PMID 21743850.
(6) Richard MA, Barnetche T, Horreau C, Brenaut E, Pouplard C, Aractingi S, et al. (August 2013). "Psoriasis, cardiovascular events, cancer risk and alcohol use: evidence-based recommendations based on systematic review and expert opinion". Journal of the European Academy of Dermatology and Venereology. 27 Suppl 3 (Supplement 3): 2–11. doi:10.1111/jdv.12162. PMID 23845148. S2CID 2766931.
(7) Ko SH, Chi CC, Yeh ML, Wang SH, Tsai YS, Hsu MY (July 2019). "Lifestyle changes for treating psoriasis". The Cochrane Database of Systematic Reviews. 7: CD011972. doi:10.1002/14651858.CD011972.pub2. PMC 6629583. PMID 31309536. CD011972.
(8) https://www.nhs.uk/conditions/psoriasis/
(9) https://theskincareedit.com/2014/10/16/petroleum-mineral-oil-skin-products
(10) https://www.nhs.uk/conditions/topical-steroids/
(11) https://www.aad.org/public/diseases/psoriasis/treatment/medications/coal-tar
(12) https://patient.info/medicine/dithranol-for-psoriasis-dithrocream
(13) https://medlineplus.gov/druginfo/meds/a614022.htm
(14) https://medlineplus.gov/druginfo/meds/a613028.html
(15) https://medlineplus.gov/druginfo/meds/a602013.html
(16) https://www.mayoclinic.org/drugs-supplements/adalimumab-subcutaneous-route/side-effects/drg-20066817?p=1
(17) https://www.mayoclinic.org/drugs-supplements/infliximab-intravenous-route/side-effects/drg-20068387?p=1
(18) https://www.mayoclinic.org/drugs-supplements/ustekinumab-injection-route/side-effects/drg-20073360
(19) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816303/
(20) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/
(21) https://jamanetwork.com/journals/jamadermatology/article-abstract/2687981
(22) https://www.karger.com/Article/Abstract/114871
(23) https://pubmed.ncbi.nlm.nih.gov/32012913/
(24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134971/
(25) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976416/
(26) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628749/
(27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/
(28) https://www.karger.com/Article/PDF/356512
(29) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/