Integrating alternative medicine, psoriasis treatment

the Clinical Advisor take:

Complementary and alternative medicine is being used more among patients, but review findings published in the American Journal of Clinical Dermatology suggests clinicians need to take a closer look at the harms and benefits of integrating these alternative treatments into care for patients with psoriasis.

Complementary and alternative medicine (CAM) modalities include traditional Chinese medicine, herbal therapies, dietary supplements, climatotherapy, and mind/body interviews.

“There is a large amount of evidence from controlled trials that have shown that the combination of TCM with traditional therapies for psoriasis is more efficacious than traditional therapies alone,” wrote Whitney Talbott, of the University of Rochester in New York, and colleagues.

Among herbal therapies, Mahonia aquifolium and indigo naturali have the most evidence for efficacy, according to the researchers. There is a smaller amount of evidence for aloe vera, neem, and extracts of sweet whey.

Consistent evidence supports the use of fish oil supplementation. Zinc supplementation, however, has not been proven effective. Some evidence is available (albeit conflicting) for vitamin D, vitamin B12, and selenium supplementation, noted the investigators. Mindfulness-based stress reduction may be helpful ad adjuvant treatment of psoriasis.

Despite these findings, “there are potential benefits to these modalities, but also potential side issues,” noted the scientists. Concerns with CAM therapies include contamination of traditional Chinese medicine products with heavy metals or corticosteroids and contact dermatitis from herbal supplements.

“[Clincians] should be aware of these benefits and side effects to allow for informed discussions with their patients,” concluded the investigators.