Psoriasis is a common disease that produces silvery, scaly plaques on the skin. A dermatologist should be consulted to confirm the diagnosis of psoriasis.

Dietary changes that may be helpful: Ingestion of alcohol appears to be a risk factor for psoriasis in men but not women.^{1 2} It would therefore be prudent for men with psoriasis to drink moderately, if at all.

Anecdotal evidence suggests that people with psoriasis may improve on a hypoallergenic diet.³ Two studies reported that eliminating gluten (found in wheat, oats, rye, and barley) improved psoriasis for some people.^{4 5} A doctor can help individuals with psoriasis determine whether gluten or other foods are contributing to their skin condition.

Some doctors have been impressed with the effectiveness of flaxseed oil (usually 1–3 tablespoons per day) against psoriasis, although there have been no published studies to support that observation.

The vitamin D that is present in food or manufactured by sunlight is converted in the body into a powerful hormone-like molecule called 1,25-dihydroxyvitamin D. That compound and a related naturally occurring molecule (1 alpha-hydroxyvitamin D3) have been found to be helpful when given orally to people with psoriasis.¹³ Topical application of these compounds has worked well in some,^{14 15 16 17} but not all, studies.^{18 19} These activated forms of vitamin D are believed to work by preventing the excessive proliferation of cells that occurs in the skin of people with psoriasis. Because these potent forms of vitamin D can cause potentially dangerous increases in blood levels of calcium, they are available only by prescription. The use of these compounds (under the supervision of a qualified dermatologist) may be considered in difficult cases of psoriasis. The form of vitamin D that is available without a prescription is unlikely to be effective against psoriasis.

Folic acid antagonist drugs have been used to treat psoriasis. In one preliminary report, extremely high amounts of folic acid (20 mg taken four times per day) combined with an unspecified amount of vitamin C led to significant improvement within three to six months in people with psoriasis who had not been taking folic acid antagonists, but those who had previously taken these drugs saw a worsening of their condition.²⁰

Fumaric acid, in the chemically bound form known as fumaric acid esters, has been shown in some studies to be effective against psoriasis.^{21 22 23} However, because fumaric acid esters can cause significant side effects, they should be taken only under the supervision of a doctor familiar with their use.

Herbs that may be helpful: Cayenne contains a resinous and pungent substance known as capsaicin. This chemical relieves pain and itching by depleting certain neurotransmitters from sensory nerves. In a double-blind study, application of a capsaicin cream to the skin relieved both the itching and the skin lesions in people with psoriasis.²⁴ Creams containing 0.025–0.075% capsaicin are generally used. There may be a burning sensation the first several times the cream is applied, but this should gradually become less pronounced with each use. The hands must be carefully and thoroughly washed after use, or gloves should be worn, to prevent the cream from accidentally reaching the eyes, nose, or mouth and causing a burning sensation. Do not apply the cream to areas of broken skin.

A clinical study in Pakistan found that topical application of an aloe extract (0.5%) in a cream was more effective than placebo in the treatment of adults with psoriasis.²⁵ The aloe cream was applied three times per day for four weeks.

In traditional herbal texts, burdock root is described as a blood purifier or alterative.²⁶ Burdock root was believed to clear the bloodstream of toxins. It was used both internally and externally for psoriasis. Traditional herbalists recommend 2–4 ml of burdock root tincture per day. For the dried root preparation in tablet or capsule form, the common amount to take is 1–2 grams three times per day. Many herbal preparations will combine burdock root with other alterative herbs, such as yellow dock, red clover, or cleavers.

Some doctors believe that "sluggish" liver function is a contributing factor in psoriasis, possibly explaining why milk thistle seeds, which promote normal liver function, can be beneficial. Milk thistle can be taken in an amount that provides 420 mg of silymarin per day. Milk thistle is available in capsules, tablets, or an extract that is standardized to contain 70–80% silymarin. Once improvement occurs, intake is often reduced to 280 mg of silymarin per day. This lower amount may also be used for preventive purposes.

Psyllium husk powder is sometimes used by psoriasis sufferers, since maintaining normal bowel health is believed to be important for managing psoriasis. Psyllium acts as a bulk-forming laxative to cleanse the bowel and encourage normal elimination. Some doctors suggest taking 7.5 grams of the seeds or 5 grams of the husks one to two times per day, with water or juice. It’s important to maintain adequate fluid intake when using psyllium.

Sarsaparilla may be beneficial as an anti-inflammatory agent. Capsules or tablets should provide at least 9 grams of the dried root per day, usually taken in divided doses. Tincture is used in the amount of 3 ml three times per day.

An ointment containing Oregon grape has been shown in a clinical study to be mildly effective against moderate psoriasis and not more severe cases.²⁷ Whole Oregon grape extracts were shown in one laboratory study to reduce inflammation (often associated with psoriasis) and to stimulate the white blood cells known as macrophages.²⁸ In this study, isolated alkaloids from Oregon grape did not have these effects. This suggests that there are other active ingredients besides alkaloids in Oregon grape. Barberry, which is very similar to Oregon grape, is believed to have similar effects. An ointment made from a 10% extract of Oregon grape or barberry can be applied topically three times per day.

Although clinical studies are lacking, there are modern references to use of the herb coleus for psoriasis.²⁹ Coleus extracts standardized to 18% forskolin are available, and 50–100 mg can be taken two to three times per day. Fluid extract can be taken in the amount of 2–4 ml three times per day.

Other integrative approaches that may be helpful: Acupuncture treatments may be helpful in some patients with psoriasis. An uncontrolled study treated 61 patients with psoriasis that did not respond to conventional medical therapies. After an average of nine acupuncture treatments, 30 (49%) of the patients demonstrated almost complete clearance of the lesions and 14 (23%) of the patients experienced a resolution of 2/3 of the lesions.³⁰ However, a controlled trial of 56 patients with psoriasis found acupuncture and "fake" acupuncture resulted in similar modest effects.³¹ More controlled trials are necessary to determine the usefulness of acupuncture in the treatment of psoriasis.

Stress reduction has been shown to accelerate healing of psoriatic plaques in a blinded study.³² Thirty-seven people with psoriasis about to undergo light therapy were randomly assigned to receive either light therapy alone or light therapy in combination with a mindfulness meditation-based stress reduction technique guided by audiotape. Those who received the stress-reduction intervention showed resolution of their psoriasis significantly faster than those who did not.

Information about the effects of a particular supplement or herb on a particular condition has been qualified in terms of the methodology or source of supporting data (for example: clinical, double blind, meta-analysis, or traditional use). For the convenience of the reader, the information in the table listing the supplements for particular conditions is also categorized. The criteria for the categorizations are: "Primary" indicates there are reliable and relatively consistent scientific data showing a health benefit. "Secondary" indicates there are conflicting, insufficient, or only preliminary studies suggesting a health benefit or that the health benefit is minimal. "Other" indicates that an herb is primarily supported by traditional use or that the herb or supplement has little scientific support and/or minimal proven health benefit.