Psoriasis is a chronic skin condition. It causes an itchy rash that appears scaly and silvery. It can also cause other symptoms such as lesions that bleed or weep, or pitting and thickening of the nails.
There are different types of psoriasis based on how it affects the skin:
- Plaque—inflamed patches of skin topped with silvery, white scales (most common type)
- Guttate—small, dot-like lesions
- Pustular—weeping lesions and intense scaling
- Inverse—inflamed patches of skin in body folds (armpits, groin, under breasts)
- Erythrodermic—intense sloughing and inflammation of nearly the entire skin
Psoriasis can be difficult to manage. Treatments may include:
- Peeling agents to expose underlying skin
- Topical steroids, moisturizers, or coal tar preparations
- Medicine that lowers the effect of the immune system
Treatment options will depend on the severity of the psoriasis.
Alternative therapies may be helpful to manage symptoms in mild to moderate cases when used in combination with standard treatment.
- Traditional Chinese herbal medicine (TCHM) —Various herbs that are applied topically or taken by mouth.A1-A3
- Oregon grape creams or lotions (Mahonia aquifolium)B1-B2
- Capsaicin creams or lotionsC1-C2
- Aloe vera creams or lotionsD1-D3
- Balneotherapy (spa therapy)E1-E4
- Note: Excessive exposure to heat can be dangerous with certain medical conditions.
- Topical indigo naturalis —A type of Chinese herb.F1-F2
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Herbs and Supplements to Use Only With Caution
Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions.
- TCHM—Toxicities and side effects of TCHM vary depending on the herb and amount used.
- Balneotherapy—Exposure to excessive heat may be harmful in:
- Young children
- Pregnant women
- People with heart or other medical conditions
- People under the influence of alcohol or other drugs
Traditional Chinese Herbal Medicine
A1. Li FL, Li B, Xu R, Song X, Yu Y, Xu ZC. [Qinzhu Liangxue Decoction in treatment of blood-heat type psoriasis vulgaris: a randomized controlled trial]. Zhong Xi Yi Jie He Xue Bao. 2008;6(6):586-590.
A2. Zhang CS, Yu JJ, Parker S, Zhang AL, May B, Lu C, Xue CC. Oral Chinese herbal medicine combined with pharmacotherapy for psoriasis vulgaris: a systematic review. Int J Dermatol. 2014;53(11):1305-1318.
A3. Yan Y, Liu W, Andres P, et al. Exploratory clinical trial to evaluate the efficacy of a topical traditional Chinese herbal medicine in psoriasis vulgaris. Evid Based Complement Alternat Med. 2015;2015:719641.
B1. Gulliver WP, Donsky HJ. A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis. Am J Ther. 2005;12(5):398-406.
B2. Bernstein S, Donsky H, Gulliver W, Hamilton D, Nobel S, Norman R. Treatment of mild to moderate psoriasis with Reliéva, a Mahonia aquifolium extract--a double-blind, placebo-controlled study. Am J Ther. 2006;13(2):121-126.
C1. Bernstein JE, Parish LC, Rapaport M, Rosenbaum MM, Roenigk HH Jr. Effects of topically applied capsaicin on moderate and severe psoriasis vulgaris. J Am Acad Dermatol. 1986;15(3):504-507.
C2. Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol. 1993;29(3):438-442.
D1. Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1(4):505-509.
D2. Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19(3):326-331.
D3. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J Eur Acad Dermatol Venereol. 2010;24(2):168-172.
E1. Halevy S, Giryes H, Friger M, et al. The role of trace elements in psoriatic patients undergoing balneotherapy with Dead Sea bath salt. Isr Med Assoc J. 2001;3(11):828-832.
E2. Eysteinsdóttir JH, Ólafsson JH, Agnarsson BA, Lúðvíksson BR, Sigurgeirsson B. Psoriasis treatment: faster and long-standing results after bathing in geothermal seawater. A randomized trial of three UVB phototherapy regimens. Photodermatol Photoimmunol Photomed. 2014;30(1):25-34.
E3. Baros DN, Gajanin VS, Gajanin RB, Zrnić B. Comparative analysis of success of psoriasis treatment with standard therapeutic modalities and balneotherapy. Med Pregl. 2014;67(5-6):154-160.
E4. Dawe RS, Yule S, Cameron H, Moseley H, Ibbotson SH, Ferguson J. A randomized controlled comparison of the efficacy of Dead Sea salt balneophototherapy vs. narrowband ultraviolet B monotherapy for chronic plaque psoriasis. Br J Dermatol. 2005;153(3):613-619.
F1. Lin YK, Wong WR, Chang YC, et al. The efficacy and safety of topically applied indigo naturalis ointment in patients with plaque-type psoriasis. Dermatology. 2007;214(2):155-161.
F2. Lin YK, Chang CJ, Chang YC, Wong WR, Chang SC, Pang JH. Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis. Arch Dermatol. 2008;144(11):1457-1454.
G1. Jerner B, Skogh M, Vahlquist A. A controlled trial of acupuncture in psoriasis: no convincing effect. Acta Derm Venereol. 1997;77(2):154-156.
G2. Coyle M, Deng J, Zhang AL, et al. Acupuncture therapies for psoriasis vulgaris: a systematic review of randomized controlled trials. Forsch Komplementmed. 2015;22(2):102-109.
Last reviewed February 2019 by EBSCO NAT Review Board Richard Glickman-Simon, MD Last Updated: 2/22/2019