Chinese Herbal Medicine for Psoriasis

Updated August. 15, 2021

Psoriasis is a relatively common skin disease, occurring in about 2% of the population. Onset is usually between 10 and 30 years of age, and tends to run in families. In its most common form. it presents itself with thickened patches of inflamed, red skin, covered with waxy silvery scales which tend to occur on elbows, knees, scalp, trunk, and back. This is known as plaque psoriasis. It is considered incurable by allopathic medicine, although acute flare-ups can subside, while severity and suffering vary considerably.

Modern medicine treats psoriasis with ultraviolet light, topical steroid creams, tar creams, and even anti-cancer drugs such as methotrexate. While these treatments may help in the short term, they can cause rebound reactions which are more severe than the initial attack, or in the case of topical steroids, cause immediate worsening if the psoriasis is currently very active.

On the other hand, Chinese herbal medicine can treat this illness completely in 60% of sufferers, and partially in the remaining 40%, over a period of several weeks.¹ By the third to seventh week of treatment, there should be unmistakable reduction in symptoms, motivating the patient to persevere with the treatment until all plaques have gone.

The main TCM diagnostic pattern in psoriasis is “Heat in the Blood,” and it is the pivot around which other secondary pathologies revolve. The Heat is clearly reflected in the redness of the skin lesions, as well as the often red tongue of the patient. Western medicine has identified that in psoriasis, skin cells are produced 10 times faster than normal, and this over-activity is another manifestation of excess “heat.” It is also noted that the guttate psoriasis subtype often occurs after a sore throat, which is localized invasion of Heat and Fire Poison. Unresolved, it can ‘spread’ its Heat to the skin. Unlike eczema and acne, psoriasis does not feature much Dampness in its presentation. This is shown in the lack of moisture, i.e. no weeping, crusting, or exudation. In fact, even where there are small, fluid filled pustules in pustular psoriasis, their contents are sterile.

Having determined then that Heat in the Blood is the main pathology in psoriasis, the TCM practitioner must assess what co-factors are present, by looking at the visual characteristics of each patient’s skin. This step is important, and part of the reason why no generalized “psoriasis formula” can be very effective. Each patient’s presentation has to be addressed specifically.

If the patient has a severe outbreak of new lesions, especially on the nails or palms and soles, recurring sore throat, and yellowish scales — in other words, if the psoriasis is very widespread and intense — it indicates Fire Poison is also present. Treatment will aim to cool the Blood and clear Fire Poison, with herbs such as Rx. Rhemannia Sheng Di Huang and Rx. Isatidis Ban Lan Gen.

If plaques are covered in large amounts of scales and there is itching, which is not that common in psoriasis, this indicates Wind, and herbs like Rx. Ledebourielae Fang Feng must be added to the formula.

If plaques are more purple than red, and the psoriasis is fairly inactive, Blood Stasis will be suspected. Purple, as we all know from observing bruising, is a clear indication of impaired blood circulation. This means Heat is bound with Stasis in a stubborn deadlock, manifested in this subtype’s poor response to many treatments. It can, however, respond well when herbs like Fl. Carthami Hong Hua are used in the prescription. There is a visual confirmation that the Stasis is improving in these cases: the lesions tend to enlarge slightly as they begin to heal, much as we might enlarge a knot’s surface area as we untangle it.

TCM treatment for psoriasis works best in the form of herbal decoctions. This means that a formula composed of eight to 12 herbs is boiled together for about half an hour, and two cups of this liquid are drunk daily for the duration of the treatment. Lifestyle recommendations exclude anything that may add to Blood Heat, i.e. spicy foods, great mental and emotional stress, and skin damage such as tattoos and hard contact sports.

1. Statistics and training received from Mazin Al-Khafaji, internationally renowned TCM dermatologist.