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Psoriasis Treatments

Traditionally, in India, for skin diseases, Neem oil has always been considered a drug of choice and is often used with that of karanj oil (Pongamia pinnata), another oil with a reputation for skin treatment. It is applied on pustules, hard abcesses, obstinate types of wounds, leprotic lesions, ringworm, eczema and itch. It is particularly recommended for hair care problems such as psoriasis and dandruff, for killing lice and for relief of itching.

The effect of nimbidin, the bitter principle of Neem, was studied by Rajasekharan et al. in 1980 [Effect of nimbidin in psoriasis - a case report. Journal of Research in Ayurveda and Siddha, 1, 52-58]. Nat et al. (1991) in their review article after studying the literature, which is quite extensive, concluded that the immunostimulating property of Neem may possibly be the reason for the recovery of patients with skin diseases [Ethnopharmacognostical survey of Azadirachta indica. Journal of Ethnopharmacology, 35, 1-24].
There are several reports confirming the efficacy of Neem in the treatment of psoriasis. In India, to mask the smell, and some research suggests that it increases potency, it is often blended with Sandalwood or Himalayan Cedarwood (Cedrus deodora G. Don. f.).

Psoriatic arthritis.

Psoriatic arthritis (or psoriatic arthropathy) is an inflammatory seronegative arthritis occurring in patients with psoriasis. In some patients the spine may be involved when the condition may be indistinguishable from ankylosing spondylitis. Less frequently some patients have a form of symmetrical arthritis resembling rheumatoid arthritis. The psoriasis and the arthritis usually require separate treatment.

As many will know, aromatherapy can provide one of the most effective treatments for arthritis, not only in retaining the mobility of joints but in giving pain relief and helping to relieve swellings and inflammation. In all cases of arthritis, however, the first area of attack must be diet which, when changed, can in some patients completely change their condition.

Several mention that it is a good idea to write down the date and time of pain attacks and the foods eaten previously. It is important to be thorough about this. In some people a crippling effect can be felt just half an hour after eating the guilty food, in others it may be several weeks. Obviously for this latter group identifying the cause will be a problem, but keep a food diary and a pattern may emerge.

There is much evidence also that daily supplementation with vitamin C, vitamin E, B-complex and beta-carotene can assist, but check with a nutritionist. Cod liver oil is also beneficial. Take at least a dessertspoon with 5 drops of Evening Primrose oil (Oenothera biennis L.) or Borage Seed oil (Borago officinalis L.) added.

Nevertheless, as far as aromatherapy is concerned, many propose a 14 day detox. treatment in the form of daily baths. Valerie Ann Worwood, in her ‘household manual of the future’ - The Fragrant Pharmacy - suggests that to each bath you add two handfuls of Epsom salts and one of rock salt, and then 4 drops of the following blend: 30 drops Sweet Fennel (Foeniculum vulgare var. dulce Batt. & Trab.); 16 drops Cypress (Cupressus sempervirens L.); and 10 drops Juniper Berry (Juniperus communis L.). These quantities should be enough for 14 days. Do not follow any other treatments during this time, even those using essential oils.

After that, and because the term arthritis applies to several diseases of the joints, it is necessary to discern the particular cause of the discomfort - rheumatoid arthritis, osteoarthritis, juvenile chronic arthritis, or any of the spondyloarthropathies such as ankylosing spondylitis - and tailor the treatment accordingly.

The treatment of psoriasis on the other hand is tricky, according to Patricia Davis, because neither orthodox nor complementary medicine has had much success in doing more than alleviating symptoms temporarily and cases treated by aromatherapists have seldom shown more than slight improvement. Is this so?

Diet and supplements can play a big role.

Stress certainly plays a very important part in the onset of psoriasis, and symptoms may come and go as the individual becomes more relaxed.

Aromatherapy can be a valuable de-stressing technique, so in this area at least may be a great help. All the sedative and antidepressant oils are suitable, though Bergamot (Citrus aurantium var. bergamia Risso & Poit) has been reported by several as being most beneficial. Also I would mention that we have had some success with a blend of Seabuckthorn Seed oil (Hippophae rhamnoides L.), Evening Primrose oil (Oenothera biennis L.), and Lavender (Lavandula angustifolia Mill.).

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Discerning dermatological diseases.
Epidermolysis bullosa acquisita (EBA) which causes painful sores and very dry skin. There doesn’t seem to be any treatment. Oils that might be able to help

The skin is subject to such a wide range of lesions - Acne, Alopecia, Burns, Darier’s disease, Dermatitis herpetiformis, Drug-induced skin reactions, Eczema, Epidermolysis bullosa, Erythema multiforme, Hyperhidrosis, Ichthyosis, Keratinisation disorders, Lichen planus, Pemphigus and pemphigoid, Pigmentation disorders, Pruritus, Psoriasis, Pyoderma gangrenosum, Rosacea, Seborrhoeic dermatitis, Urticaria and angioedema, Warts, Wounds and ulcers.

For a start, some may be characteristic of specific systemic diseases and fade as the disease regresses. Some are caused by specific local infections and are best treated by the appropriate antimicrobial. The skin is also subject to damage from environmental hazards. Exposure to solar radiation is associated with malignant neoplasms of the skin. Many skin disorders are side-effects of therapeutic and other agents, ranging from mild hypersensitivity to the life- threatening Stevens-Johnson syndrome or toxic epidermal necrolysis. There is also a wide range of skin disorders whose aetiology is poorly understood.

Then there is the question of the distribution and morphological description of the lesion - its shape, colour, and surface characteristics are important in the diagnosis. However, there are many terms used to describe skin lesions and the uneducated glossary of ‘pimples’, ‘rashes’ ‘sores’ and ‘spots’ doesnt help. Be more specific, urge the experts.

Dermatologic terms: Abcess, bulla, comedo, ecchymosis, erythema, fissure, horn, keratosis, lichenification, macule, nodule, papilloma, papule, petechia, plaque, purpura, pustule, scale, stria, telangiectasia, vesicle, wheal.....

Epidermolysis bullosa.

Epidermolysis bullosa consists of a group of similar congenital disorders characterised by severe blistering of the skin. Sometimes the mucosae, especially of the mouth and oesophagus, are also affected. The blistering may be caused by various structural and metabolic defects and occurs at different levels in the skin. Blistering, which may resemble bullous pemphigoid, can follow even a minor wound or injury or can arise spontaneously. In some patients blistering and scarring can cause marked tissue loss of the affected areas and the most severe forms are fatal in early infancy due to infection of the blisters. Milder forms may be managed by avoiding injury and keeping the blisters clean and dry, but there is no truly effective treatment for the severe forms. Therefore the best that can probably be achieved is short-term healing of skin and mucous membrane lesions, longer term disease remission, and improvement of quality of life with minimal adverse effects.

Epidermolysis bullosa acquisita is an acquired form of the disease, and it too is difficult to treat

Allopathic medicine may try corticosteroids and immunosuppressants, and individual patients have responded to high-dose intravenous immunoglobulins or extracorporeal photochemo- therapy

Alternative treatment
There are few suggestions for such a rare disease (estimated annual incidence of 0.22 per million population in Western Europe), but Evening Primrose Oil (Oenothera biennis L.) might be worth a try though evidence in favour of a useful therapeutic effect is poor. Also Seabuckthorn (Hippophae rhamnoides L.) might assist, because it does seem extremely effective for some skin conditions.

From Russian publications Tode [Tode, A: Sanddorn in der russischen Medizin. Dtsch. Apoth. Ztg. 136, Suppl. 14. Jan., 4 (1991)] cites the following activities on the skin for Seabuckthorn: It enhances the formation of cell tissue and accelerates wound healing; it strengthens granulation and has a pain killing effect. For this reason Seabuckthorn is used to prevent skin damage due to high energy radiation, either in case of sunburn or for radiotherapy of the larynx or the gullet. During the Soviet-Afghan war it was used in the Russian camp for the treatment of burns. It is useful for the treatment of pressure sores, necrotic wounds or abcesses after antibiotic pretreatment, and has been used successfully for oral, genital and anal affections. Seabuckthorn oil also shows activity against phlegmonic acne.

These unsaturated fatty acids in Seed oil are physiologically active, are already recognized for the treatment of atopical eczemas and can replace cortisone preparations in less severe cases. Their activity is supported by unsaponifiable components including tocopherols, phytosterols, carotenoids, alkanes and alkanols. Externally, it is used in skin preparations for the treatment of neurodermatitis, skin impurities and regeneration and, internally, as a food supplement in case of fatty acid deficiency, for regulation of fat metabolism, prevention of arterial affection, and treatment of skin allergy and skin impurities.

Finally, there is fair clinical evidence that acupuncture can assist dermatological problems.

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