Psoriasis Advance
15 herbal/essential nutrient remedies used to treat psoriasis

From November/December 2005 Psoriasis Advance

Related article: Herbal remedies: A growing body of knowledge

15 herbal/essential nutrient remedies used to treat psoriasis Researched and compiled by Sharon E. Jacob, M.D., and Tace Steele, B.A.
Name	Scientific name	Forms	Active ingredient	Scientific evidence	Adverse effects	Herb-drug interactions
1. Aloe	Aloe vera	To/In/D/T/C	Anthraquinone, salicylic acid	Controlled clinical trial (CCT): topical, greater clearing of psoriasis in treated versus placebo (83% vs. 6%) (6)	Diarrhea, kidney inflammation, red urine, seizures, low potassium, electrolyte abnormalities, rash	Antiarrhythmics, diuretics, digoxin, glyburide, topical hydrocortisone
2. Cayenne	Capsicum annum	To/C/T/D/In	Capsaicin	CCT: topically, reduced scale and redness (3,4)	Skin burning at application sites, excessive mucous secretion from the nose, profuse perspiration, excessive tear production, colic, kidney toxicity, excessive bleeding, respiratory symptoms, rash in babies breastfeeding from mothers taking cayenne	ACE-inhibitor, acetaminophen, aspirin, anticoagulants, antihypertensives, MAO-inhibitors, sedatives, theophylline
3. Chamomile	Matricaria recutita	C/To/In	Chamazulene, quercetin	No studies (NS)	Allergic reaction in people with allergies to ragweed and chrysanthemum; increased time to stop bleeding and clot	Anticoagulants, antiplatelets, sedatives
4. Dong Quai	Radix angelic	C	Psoralens, osthole	CCT: two-thirds of patients experienced clearing of their disease with oral supplements (22)	Bloating, loss of appetite, diarrhea, light sensitivity and rash, breast development in men, increased bleeding and clot time, fever, dizziness, may enhance response to radiation therapy	Anticoagulants, oral contraceptives
5. Emu oil	Dromaius novaehollandiae	To/C	Unknown	NS	No known adverse effects	None reported
6. Evening Primrose oil	Oenothera biennis	C/To/In	cis-Gamma- linolenic acid	CCT: no benefit (36) CCT: evening primrose oil and fish oil combined demonstrated no clinical benefit in PsA (37)	Contraindicated in pregnancy; headache, gastrointestinal upset, nausea	Anticoagulants, antiplatelets, phenothiazines
7. Fish oil	N/A	To/C/IV/D	Omega-3 fatty acids	CCT topical: -improved scale, plaque thickness and erythema, but not itch (8) oral supplements: -CCT: Reduced itch, erythema and scale (9) -CCT: Fish oil plus UVB improved psoriasis. (10) VERSUS: CCT/Uncontrolled clinical trial (UCT) demonstrate no difference in disease activity. (11, 12, 13)	Increased levels of vitamins A and D, bleeding, fishy aftertaste, loose stools, nausea; decreased triglycerides (TGs) and increased low-density lipoproteins (LDLs), which are cholesterol test components; increased bleeding time	Anticoagulant/antiplatelet agents, including warfarin
8. Flaxseed oil	Linum usitatissimum	C/To	Omega-3 unsaturated fatty acids, lignans	NS	Menstrual cycle abnormalities, constipation, flatulence, decreased nutrient absorption	Anticoagulants, estrogenics: tamoxifen, raloxifene, HRT
9. Glucosamine (for psoriatic arthritis)	N/A	C/IV/IM	2-Amino-2- deoxyglucose	NS	Affects insulin level and glucose metabolism in the body, gastrointestinal complaints, headache, leg pain, peripheral swelling, itching, allergic reactions	Insulin or oral hypoglycemic agents
10. Milk thistle	Silybum marianum	T/C/In	Flavonoids	NS	Diarrhea, uterine stimulation-cramping, altered liver function tests, increased perspiration, gastrointestinal upset	Butyrophenones, inhibits cytochrome P-450 3A4, phenothiazines, phentolamine
11. Shark cartilage from spiny dogfish shark and hammerhead	Squalus acanthias, Sphyrna lewini	C/T	Sphyrnastatin 1 and 2	CCT: statistically significant improvement in Psoriasis Area Severity Index (PASI) with increasing dose, severity of itch, and the Physicians Global Assessment (PGA) (33)	Taste alteration, acne, rash, flatulence, nausea, vomiting, indigestion, constipation, diarrhea, loss of appetite, low blood sugar, jaundice, low-grade fever, abnormal liver function tests	None reported
12. Slippery elm	Ulmus rubra	C/T/To/In	Mucilage	Case report (CP): 5 patients improved with oral supplements (25)	No adverse reactions reported	May slow absorption of oral medications
13. Tea tree oil	Melaleuca alternifolia	To/C	Terpinen-4-ol, alpha-terpineol, alpha-pinene	NS	Systemic contact dermatitis, disorientation, coma, abnormalities in white blood cell numbers	No drug interactions reported
14. Turmeric	Curcuma longa, Curcuma domestica	C/T/To/In/D	Sesquiterpenes, zingiberene, curcuminoids	CCT: reduction in the severity of psoriasis (44)	Contraindicated in patients with bile duct obstruction, gallstones, and intestinal disorders; contact dermatitis	Anticoagulants/antiplatelets, camptothecin, cyclophosphamide, doxorubicin, indomethacin, mechlorethamine, reserpine
15. Wintergreen	Gaultheria procumbens	To/In/C	Methyl salicylate	NS	Ringing in the ears, vomiting, rapid breathing, changes in acidity and alkalinity of the blood, fluid on the lungs, increased bleeding and time to clot	Warfarin

Key: Forms of Administration: To (topical), C (capsule), T (tablet), IV (intravenous), In (infusion drink/tea), IM (intramuscular), D (dietary modification)
Scientific evidence: CCT (controlled clinical trial), CP (case report), NS (no reported clinical studies for psoriasis in pubmed.gov), UCT (uncontrolled clinical trial)

Editor's note: These 15 herbal/essential nutrient remedies are among many discussed on the Psoriasis Foundation message boards at www.psoriasis.org/forum

For more information on drugs and drug categories, visit www.nlm.nih.gov/medlineplus/druginformation.html

For more information on complementary and alternative treatments, go to http://nccam.nih.gov

Always check with your physician before using any herbal/alternative treatment.

References
The following references include all sources used for this chart; however, only references referring to controlled clinical trials for psoriasis are specifically indicated in the chart with numerals.

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