Psoriasis: Symptoms, Causes, Treatments, and Natural Approaches

Affecting about 8 million people in the United States, psoriasis is the most common autoimmune condition.

There are several types of psoriasis, though plaque psoriasis is most common. Illustrations by The Epoch Times, Shutterstock

Psoriasis, a complex genetic-based autoimmune disorder, is a chronic disease affecting the skin, nails, and joints. Diagnosis is typically clinical, and its impact on quality of life is significant, causing pain, disfigurement, and disability. It is also associated with some serious comorbidities, including cardiovascular disease. About 8 million individuals in the United States are affected by this condition, making it one of the most prevalent autoimmune conditions.

What Are the Types of Psoriasis?

There are many types of psoriasis, including the following:

• Plaque: The most prevalent type, plaque psoriasis, accounts for 85 percent to 90 percent of all psoriasis cases. Depending on skin color, it manifests as raised skin patches that may be red with silvery scales on light skin or purplish-brown with gray scales on darker skin. The patches typically appear symmetrically on the scalp, trunk, limbs, soles of feet, genitals, and hands, especially elbows and knees. Scratching or scraping the plaques may cause tiny bleeding spots, known as the Auspitz sign, due to inadequately protected capillaries, the body’s smallest vessels.
• Scalp: Scalp psoriasis affects 45 percent to 56 percent of psoriasis patients, primarily those with plaque psoriasis. In children, psoriasis often initially appears on the scalp. Scalp psoriasis can manifest as single or multiple patches or cover the entire scalp. Characterized by red, thickened skin with silvery scales resembling dandruff, this condition may extend beyond the hairline. While hair loss is rare, it can occur in severe cases due to scratching and excessive combing.
• Guttate: Guttate psoriasis, the second most common type, typically manifests as red dots, spots, or plaques less than 1 inch in diameter on the torso or limbs, often in children or young adults. It can occur suddenly and may precede the development of plaque psoriasis later in life or manifest as an exacerbation of plaque psoriasis. It frequently resolves on its own without the need for treatment over several months.
• Nail: Nail psoriasis involves various nail changes, affecting over 80 percent of individuals with plaque psoriasis and only 5 percent of people with other forms of psoriasis. Sometimes, nail psoriasis can be the sole symptom, with fingernails more commonly affected than toenails. This condition is frequently misdiagnosed as nail fungus. Nail changes may include small pits, white lines or dots, nail disintegration, yellow-red patches, separation of the nail from the bed, excessive skin cell buildup, and faint red lines caused by capillary bleeding.
• Inverse: Inverse psoriasis, also called intertriginous or flexural psoriasis, manifests as smooth, red, itchy patches in skin folds such as under the breasts, in the groin, armpits, between the buttocks, and around the genitals. This type can be challenging to treat, and it may be mistaken for a fungal or yeast infection due to its location in skin folds, which is atypical for other types of psoriasis. Due to it being located in skin folds and on sensitive skin, it is exacerbated by rubbing and sweating. Since it develops in skin creases, it can lead to painful cracks or fissures that may bleed.
• Pustular: Pustular psoriasis is a rare type characterized by pus-filled bumps, or pustules, surrounded by red skin. Fortunately, as pus is only composed of white blood cells, these pustules are sterile and don’t contain bacteria.
• Erythrodermic: Erythrodermic psoriasis, the rarest and most severe type, covers over 80 percent of the body with red, scaly lesions. It occurs in approximately 1 percent to 2 percent of people with psoriasis, more commonly in adult males. It can cause intense itching and burning, particularly in scaly areas. Additional symptoms may include fever, chills, malaise, rapid heart rate, joint pain, and lymph node swelling. The condition can be life-threatening as it resembles a severe widespread burn. This condition may develop gradually in those with unstable plaque psoriasis or suddenly in individuals without prior psoriasis.
• Seborrheic: Also called sebopsoriasis, seborrheic psoriasis typically impacts regions with increased sebum production, including the scalp, forehead, and nasolabial folds. The symptoms of this type are usually red, scaly patches on the scalp, behind the ears, above the shoulder blades, on the upper chest, underarms or groin, or in the middle of the face.
• Psoriatic arthritis: One common condition associated with psoriasis is psoriatic arthritis (PsA), an inflammatory condition causing stiff, tender joints, affecting 10 percent to 20 percent of individuals with psoriasis. Around 80 percent of PsA cases involve nail psoriasis, and skin and joint flare-ups often coincide. Psoriatic arthritis is not always considered a type of psoriasis but rather its own condition.

What Are the Symptoms and Early Signs of Psoriasis?

The early signs of plaque psoriasis are small, 1/8 inch-wide skin patches that typically appear symmetrically on the body. These gradually enlarge, forming thick, dry plaques.

People may experience varying psoriasis symptoms, with the common ones being the following:

• Patches of thick, red skin with silvery-white scales.
• Dry, cracked skin that may itch or bleed.
• Nail changes (thick, yellow-brown, dented, or lifted nails).
• Poor sleep quality due to itchiness of the skin.
• Joint or tendon discomfort.
• Severe dandruff.

For the specific symptoms of different types of psoriasis, please refer to the previous section.

The National Psoriasis Foundation categorizes psoriasis symptom severity based on the affected percentage of the body’s skin surface, as follows:

• Less than 3 percent is mild.
• Three percent to 10 percent is moderate.
• Over 10 percent is severe.

For reference, a person’s palm (not including fingers) is approximately 1 percent of their body surface area.

Also, the impact on a person’s quality of life is considered. At least 20 percent of individuals with this condition have moderate to severe psoriasis.

In addition, psoriasis is characterized by unpredictable periods of flaring and remission. During psoriasis flares or flare-ups, psoriasis symptoms worsen. These are typically brought on by triggers, covered in the following section.

When psoriasis symptoms temporarily disappear due to treatment, this is called remission, which may last from a few months to several years but usually 1 to 12 months.

What Causes Psoriasis?

Psoriasis arises from an abnormal immune system response where the immune system mistakenly targets the body, leading to an inflammatory response and causing damage. This misguided autoimmune attack accelerates skin cell production, leading to the rapid development and accumulation of new skin cells on the surface. In a natural process known as cell turnover, skin cells originating deep within the skin typically reach the surface in about a month. However, in psoriasis, this occurs within days as the cells rise too rapidly, resulting in the characteristic plaques and red, inflamed areas of skin.

The exact cause of psoriasis remains unknown, but the condition is believed to have a significant genetic component. It is thought that the abnormal immune response in psoriasis is triggered by cytokines, enzymes, and substances controlling skin cell division, as well as environmental factors.

The immune system’s main defense components are white blood cells, particularly lymphocytes, whose two subtypes are B cells that produce antibodies to attack antigens (i.e., foreign substances that induce immune responses) and T cells. In psoriasis, helper T cells, a type of T cell, instruct B cells to produce autoantibodies (i.e., antibodies that react with self-antigens), attacking the skin cells. Helper T cells release cytokines, immune factors normally crucial for healing, but excess levels lead to inflammation and injury.

In this autoimmune condition, activated immune cells release cytokines that prompt skin cells to turn over more rapidly than usual. Instead of turning over in weeks, cells turn over in days, accumulating scaly plaques on the skin’s surface. Illustrations by The Epoch Times, Shutterstock

Triggers

Psoriasis is thought to be triggered by a combination of factors, including genetic and environmental.

1. Genetics

Psoriasis has an estimated heritability of 60 percent to 90 percent. Genetics are also the main factor of psoriasis onset in patients under age 40.

Many individuals with psoriasis exhibit an association with specific human leukocyte antigens (HLA), genes responsible for encoding proteins that distinguish between the body’s own cells and foreign substances. Nine crucial psoriasis susceptibility genes called PSORS 1 to 9 appear to play a role, and specific variations in these genes may increase the risk for psoriasis.

2. Environmental Factors

Some environmental factors can trigger or exacerbate psoriasis, although they may not be direct causes. They are as follows:

• Infections: Several bacterial and viral infections can lead to psoriasis, including streptococcal, human immunodeficiency virus (HIV), and one type of human papillomavirus (HPV) infection.
• Certain medications: These drugs include angiotensin-converting enzyme (ACE) inhibitors and beta blockers for high blood pressure and heart issues, chloroquine for malaria, lithium for bipolar disorder, indomethacin (an NSAID), and progesterone in female hormone therapies. Corticosteroids or the rapid withdrawal of oral psoriasis medications can also trigger psoriasis.
• Vaccines: COVID-19 mRNA vaccines, including Moderna and BioNTech/Pfizer, were questioned in a literature review study as a trigger to psoriasis onset and exacerbation. Due to largely incomplete data on the type of vaccine (other non-COVID vaccines were included) and the retrospective nature of the review, a causal link could not be determined, and the authors noted further controlled studies were needed. However, the study authors did find cases of psoriasis onset and exacerbations, with all doses contributing to psoriasis incidents and the second dose most commonly associated with flares. Onset varied from two to 21 days for new cases and one to 90 days for flares. Generally, patients saw positive outcomes, with improvement or resolution within three days to four months. In rare cases, other vaccines, such as the BCG and H1N1, tetanus-diphtheria, and influenza vaccines, have also been linked to psoriasis.
• Smoking: Recent research suggests a potential link between smoking and genes associated with psoriasis susceptibility. Smoking can lead to oxidative stress and the production of harmful substances that interfere with key pathways in psoriasis.
• Stress: Studies propose that stress may activate certain immune factors linked to psoriasis flare-ups.
• Alcohol: Excessive alcohol intake is linked not only to a higher incidence of severe psoriasis but also to a distinct pattern and distribution of the disease. Psoriasis patients with alcohol overconsumption often experience more severe inflammation, with minimal scaling, commonly appearing on the face, groin, and flexures, or as hyperkeratotic lesions primarily on the extremities.
• Chemical exposure and pollution: Psoriasis can be exacerbated by various pollutants, heavy metals, and volatile organic compounds (VOCs). Cadmium, in particular, is linked to the development of the condition.
• Skin trauma: The appearance of new psoriatic outbreaks in the areas of even slight trauma (such as a pinprick or scratching) in psoriatic patients is called the Koebner phenomenon.

Who Is at Risk of Psoriasis?

Although anyone can develop psoriasis, the following factors, including people who experience the above triggers, make one more likely to develop it:

• Family history: Around one-third of individuals with psoriasis have a first-degree relative who also has it. If a person has one parent with psoriasis, the likelihood of this individual developing the disorder is around 14 percent. However, the risk increases to 41 percent if both parents have psoriasis. Among the genes linked to the condition, PSORS1 is recognized as the primary gene.
• Race: One study discovered that in the United States, psoriasis is most prevalent among white individuals at a rate of 3.6 percent. Multiracial individuals have a prevalence rate of 3.1 percent, while Asians have a rate of 2.5 percent.
• Age: Psoriasis onset peaks occur within two age groups, with the first occurring between 20 and 30 years and the second between 50 and 60 years.
• Obesity: Obesity is a significant risk factor for psoriasis. In obesity, the skin undergoes several changes, including more water loss due to the affected outer skin barrier, more sebum production, poor lymphatic flow, and increased thickness of the fat layer that causes more sweating.
• Pregnancy: Pregnant women with a family history of psoriasis are more likely to develop pustular psoriasis.
• Celiac disease.
• Colder climates: Research suggests that psoriasis tends to manifest earlier and more frequently in colder climates. For instance, blacks and whites alike who reside in colder climates exhibit a higher prevalence of psoriasis than individuals of any ethnicity living in Africa.

How Is Psoriasis Diagnosed?

To diagnose psoriasis, a dermatologist assesses your skin, nails, and scalp for signs of the condition and inquires about your symptoms, family history, and recent habits that might be associated with psoriasis. The dermatologist may also explore recent life changes, such as illness or increased stress.

A dermatologist may also perform a skin biopsy. For this, he or she takes a sample of skin cells for detailed examination under a microscope, typically performed by a specialized pathologist. This test is performed to rule out other possible conditions.

To evaluate complications or comorbidities of psoriasis, a dermatologist may recommend an individual see a specialist or primary care physician for tests such as X-rays, complete blood count (CBC), electrocardiograms, or rheumatoid factor tests.

What Are the Complications of Psoriasis?

Complications of psoriasis may include the following:

• Secondary infections: Scratching and rupturing of psoriatic patches and pustules may lead to secondary infections.
• Hypothermia: Hypothermia is the involuntary decrease in body temperature below 95 F (35 C). This is more prevalent among erythrodermic psoriasis cases.
• Heart failure: Erythrodermic psoriasis can lead to heart failure.
• Folate deficiency: Severe psoriasis can lead to folate deficiency.

Psoriasis also has several serious comorbidities, which include the following:

• Psoriatic arthritis.
• Risk of lymphoma: Psoriasis has been suggested to potentially increase the risk of lymphoma, either through its disease mechanism, treatments, or a combination of factors. However, the actual risk linked directly to psoriasis remains low, considering the rarity of lymphoma and the moderate association magnitude.
• Increased risk of cardiac events: These include cardiovascular disease, heart attack, and stroke.
• Mental health problems: These may include anxiety and depression.
• Type 2 diabetes.
• Increased risk of various conditions: People with psoriasis are more at risk of certain cancers, metabolic syndrome, obesity, osteoporosis, eye problems, liver disease, and kidney disease.

What Are the Treatments for Psoriasis?

Currently, there’s no known cure for psoriasis. Psoriasis treatment aims to manage the condition effectively, typically starting with milder options and progressing to stronger treatments based on the type, severity, and affected skin areas. Treatment options are often used in combination.

1. Topical Treatments

Topical treatments, such as creams and ointments, are typically the initial choice for mild to moderate psoriasis. Topical treatments include the following:

• Emollients: These moisturizers soften, smooth, and hydrate the skin. They are usually applied three or four times a day.
• Corticosteroids: Topical corticosteroids are steroid creams and ointments that reduce inflammation, slow skin cell production, and dampen itchiness. They are usually applied once daily for several days, as more applications don’t yield additional benefits.
• Vitamin D analogs: Vitamin D analogs are synthetic compounds that mimic the action of natural vitamin D in the body. Commonly used on areas such as the limbs, trunk, or scalp, they slow skin cell production and reduce inflammation with minimal side effects. Examples include calcipotriol, calcitriol, and tacalcitol. Keep calcipotriol away from pets, as it may be fatally poisonous to small ones.
• Calcineurin inhibitors: Calcineurin inhibitors, including tacrolimus and pimecrolimus, are immune system-modulating ointments or creams that alleviate inflammation. They are commonly used on areas with thinner skin, such as the face, neck, or body folds. They are not recommended for long-term use since they may negatively affect kidney function. In addition, pregnant and breastfeeding mothers should avoid using them.
• Salicylic acid: Salicylic acid, typically used to treat acne, can reduce psoriasis plaques by softening keratin, a protein that forms the epidermis (the skin’s outer layer). However, it should not be used to treat children, and pregnant mothers should consult a dermatologist before using it.
• Retinoids: These are synthetic vitamin A-based treatments, tazarotene the most effective among them. They remove dead cells from the skin and reduce plaques, scaling, and redness. Safe for most people, they’re used for eight to 12 weeks. However, pregnant women should avoid them due to the risk of birth defects.
• Coal tar: Coal tar preparations, used for over one century in psoriasis treatment, are now primarily available in over-the-counter shampoos and gels for use on limbs, trunk, or scalp. Crude coal tar inhibits enzymes contributing to psoriasis and curbs new cell production. Different preparations have varying effectiveness. Their potential side effects include photosensitivity, contact dermatitis, and hair follicle infection. In addition, coal tar stains and has a bad smell. Their safety for pregnant or lactating women is uncertain, so it’s not recommended for them.
• Dithranol (anthralin): Also known as anthralin, this hinders skin cell reproduction, inducing lasting remissions. Though less commonly prescribed today, it is highly effective in treating psoriasis with minimal side effects, although it may cause burning if it is too concentrated, and it can stain the skin. It’s recommended for chronic or inactive psoriasis, not for acute or inflamed outbreaks. Caution is advised for those with kidney problems, and its use on the face is discouraged, especially for fair-skinned individuals.
• Tapinarof cream: Approved by the FDA in 2022, this is a small molecule-modulating agent of the aryl hydrocarbon receptor (AhR), which plays a role in the development of psoriasis. Tapinarof cream can be applied to any part of the body once daily. In studies, approximately 40 percent of patients achieved clear or almost clear skin after 12 weeks, and those who cleared and stopped using the cream enjoyed a remission period for an average of 12 weeks.
• Roflumilast cream: Roflumilast cream is the first topical phosphodiesterase 4 (PDE4) inhibitor approved by the FDA (in 2022) for treating plaque psoriasis. PDE4 is an enzyme that regulates inflammation in the skin and joints. It’s also effective in treating inverse psoriasis. In studies, the cream quickly reduced itching and cleared psoriasis.
• Occlusive tapes: These can be especially helpful for psoriasis on palms and soles and aid healing by retaining sweat to restore skin moisture and prevent scaling. They may be used with topical medicines for added benefit, but side effects include skin irritation, increased risk of infections, and a higher chance of symptoms returning posttreatment.

2. Phototherapy

Also known as light therapy, phototherapy uses natural or artificial light to treat psoriasis. It should only be administered under dermatologist supervision. Self-treatment may cause skin damage, exacerbate psoriasis, and result in skin cancer. Different types of light therapy include the following:

• Heliotherapy: This is the use of natural sunlight. While it can reduce psoriasis extent and severity, it seldom clears psoriasis completely, and in 10 percent of cases, sun exposure worsens psoriasis.
• UVB: UVB phototherapy, using shortwave ultraviolet radiation, treats psoriasis by reducing inflammation through the suppression of DNA synthesis of skin cells. Administered within a specially designed cabinet or stand-up booth, fluorescent light tubes target affected areas, including the entire body. The sessions typically last a few minutes, but the therapy requires two to three weekly office visits for six to eight weeks.
• Psoralen plus ultraviolet A (PUVA): The PUVA treatment involves taking a light-sensitizing medication called psoralen before the treatment, or psoralen may be applied directly to the skin. UVA light penetrates deeper than UVB, with nearly 90 percent experiencing marked improvement within 20 to 30 sessions. While effective for severe psoriasis, it carries a higher risk of skin cancers than UVB phototherapy. Short-term side effects include nausea, headache, burning, and itching, while long-term risks include sun sensitivity and an increased risk of skin cancer. Prolonged use is discouraged.

3. Systemic Treatments

For severe psoriasis or psoriasis unresponsive to other treatments, systemic treatments, administered orally or through injection, may be prescribed. Instead of treating only the skin, these treatments affect the entire body. They fall into two main categories: non-biological (typically in tablet or capsule form) and biological (usually given as injections), each with potential side effects.

Non-biological medicines include the following:

• Apremilast: Available in oral tablet form, apremilast is an immunosuppressant. It can clear plaques, alleviate itchiness, improve nail psoriasis, and address scalp psoriasis.
• Cyclosporine: This immunosuppressant hinders the release of specific cytokines involved in inflammation and the autoimmune response in psoriasis. Its use is restricted due to potential side effects, including an increased risk of kidney disease and high blood pressure.
• Methotrexate: Methotrexate controls psoriasis by slowing skin cell production and reducing inflammation. Its potential side effects include impacts on blood cell production and liver damage, and it poses risks during pregnancy, including infertility, miscarriage, and birth defects. Reserved for severe cases, its use mandates abstaining from alcohol.
• Oral retinoids: Oral retinoids, including acitretin and isotretinoin, are first-line treatments for severe psoriasis. These drugs regulate cell reproduction, possess anti-inflammatory properties, and may alleviate psoriatic arthritis. However, they should not be taken by women of child-bearing age due to potential birth defects.

Biological response modifiers, or biologics, are genetically engineered drugs designed to target specific components of the autoimmune response. Unlike general immunosuppressants, they have precise targets. However, they are often more expensive. Another type of drug, biosimilars, is similar to biologics but may offer a more cost-effective alternative. There are several types of biologics, including the following:

• TNF-alpha inhibitors: TNF-alpha inhibitors block tumor necrosis factor (TNF), a signaling molecule that triggers an immune response against the skin in psoriasis. By inhibiting this signal, these medications prevent the body from attacking itself, improving skin clearance and reducing symptoms. These may include adalimumab and etanercept.
• Interleukin inhibitors: Interleukin inhibitors target specific proteins involved in immune system regulation. By blocking the action of interleukins, these medications can help regulate the immune response and reduce inflammation associated with psoriasis.

How Does Mindset Affect Psoriasis?

A positive mindset can influence psoriasis in several different ways.

Stress is a common trigger for psoriasis flare-ups, and emotional stress can lead to the release of certain chemicals and hormones that may exacerbate inflammation, potentially worsening symptoms. Stress can even lead to mental problems such as depression and anxiety, which are also complications of psoriasis. Therefore, it’s essential to manage stress levels.

A positive mindset can also help build social support, which has been shown to help with psoriasis symptoms.

What Are the Natural Approaches to Psoriasis?

Many of the synthetic drugs used for treating psoriasis have adverse effects, including some serious ones. Some natural treatment options are effective and considered safe. However, before adopting such treatments, you must consult your doctor.

According to one study, as many as 51 percent of psoriasis patients use complementary and alternative medicine (CAM) in treating their disorder. The following are a few CAM treatments:

1. Herbal Medicines

• Indigo naturalis: Indigo naturalis is a dark blue powder and traditional Chinese herbal medicine derived from plant leaves and stems of plants, extensively used to treat psoriasis topically. In a 12-week trial, individuals with chronic plaque psoriasis applied a 10 percent indigo ointment once daily, and the indigo therapy reduced symptoms by 81 percent. No side effects have been reported with topical treatment. Oral ingestion should be avoided due to adverse effects.
• Turmeric (Curcuma longa): The yellow spice turmeric is a perennial plant from the ginger family. Curcumin is a polyphenol produced from turmeric with antioxidant and anti-inflammatory properties. Curcumin has the potential to downregulate pro-inflammatory cytokines, thus offering relief from psoriasis flares. Per one meta-analysis of 26 studies, both treatment with curcumin alone and in combination with other medicines demonstrated improvement in psoriasis symptoms. Curcumin also inhibited cell proliferation and the cell cycle and downregulated certain inflammatory cytokines. It also enhanced the skin appearance of psoriasis patients and reduced the inflammatory microenvironment.
• Aloe vera (Aloe barbadensis): Aloe vera is a cactus-like tropical plant with antibacterial components acemannan and aloe-emodin, which can improve psoriasis symptoms. The salicylic acid contained in the plant can also remove psoriatic plaques. In a study involving mice, aloe vera extract demonstrated 81.95 percent effectiveness against psoriasis, slightly lower than the 87.94 percent effectiveness observed with tazarotene.
• Oregon grape (Mahonia aquifolium): Oregon grape, also known as barberry, is an evergreen shrub native to the United States. Its healing effect of psoriasis is due to berberine, a natural anti-inflammatory alkaloid found in the plant’s extract. According to a review of several studies, in which either a 10 percent Oregon grape cream or ointment was applied over 12 weeks, the psoriasis patients’ symptoms were significantly reduced.
• Dong quai (Angelica sinensis): Dong quai root has long been used as a spice and medicinal herb in East Asia. It is known as the “female ginseng” and is a commonly used herbal medicine for psoriasis. It is also one of the ingredients of Yinxieling, an herbal medicine specifically designed to treat psoriasis. As dong quai extract contains psoralen, when patients undergo PUVA therapy after consuming dong quai, this process promotes DNA cross-linking, thus slowing epidermal DNA synthesis. In one study, oral psoralen with UV-A significantly improved the Psoriasis Area Severity Index score by at least 75 percent in two-thirds of patients after 12 weeks.

2. Nutrition

Dietary modification and nutritional therapy can improve psoriatic skin lesions and reduce the risk of comorbidities and complications of psoriasis. The diets found to be capable of improving psoriasis symptoms include fasting, low-energy diets, vegetarian diets, and diets rich in fish oil due to their anti-inflammatory effects. In addition, including essential antioxidants such as vitamins A, C, and E, carotenoids, flavonoids, and selenium, as well as dietary fibers and probiotics, is crucial.

The following supplements may improve psoriasis symptoms:

• Fish oil: Fish oil, rich in omega-3 polyunsaturated fatty acids, positively affects serum lipids. These components exhibit anti-inflammatory properties and contribute to immune response and metabolic regulation. One review of 18 studies involving almost 1,000 participants discovered that when used alongside conventional treatments, fish oil may improve psoriasis and some of its comorbidities, including obesity, cardiovascular disease, and metabolic disorders.
• Vitamin D: Vitamin D is found in cod liver oil, salmon, tuna, beef, eggs, milk, and cheese. It has been found to influence both B and T cells, impact the adaptive immune response, and inhibit the production of certain cytokines. Vitamin D may have therapeutic effects on psoriatic skin by affecting T-cell growth and cytokine expression. One review discovered that only a few studies have demonstrated oral vitamin D’s effectiveness in treating psoriasis since the 1980s. Thus, more research is needed to confirm its efficacy.
• Lycopene: Lycopene, a carotenoid found in tomatoes, is known for its robust antioxidant properties. One animal study found lycopene capable of inhibiting intercellular adhesion molecules, which play a critical role in psoriasis development, and decreasing the inflammatory response associated with the condition. Therefore, applying lycopene topically may help alleviate certain symptoms of psoriasis.
• Genistein: Soybean is considered a possible anti-psoriasis remedy due to the potent anti-proliferative and anti-inflammatory properties of genistein, one of its isoflavones. As per one study, in individuals with mild to moderate psoriasis, genistein influenced key inflammatory markers and signaling pathways associated with the disorder, with positive outcomes. The treatment was also safe and well-tolerated, with no significant side effects or discontinuation.

3. Apitherapy

In traditional folk medicine, apitherapy involves using honey bee products such as honey, propolis, royal jelly, bee wax, and bee venom to treat diseases.

Propolis is a natural resinous blend made by honey bees using substances gathered from plants, and it offers many health benefits, including reducing inflammation and regulating the immune system. As per one study with over 850 participants, patients with palmoplantar psoriasis treated with a mixture of 50 percent propolis and 3 percent aloe vera showed significant improvement, thus highlighting the effectiveness of this combination in treating mild to moderate psoriasis.

4. Moving Cupping Therapy

Moving cupping therapy is an alternative therapy that uses suction cups on the skin to enhance energy flow and promote healing. It has been used in China for thousands of years and is still used extensively in hospitals there to treat psoriasis. A review of 16 trials involving over 1,100 participants discovered that this therapy significantly improved psoriasis patients’ symptoms and symptom recurrence rate. Also, moving cupping alone or combining it with pharmaceutical medications showed better results than just using pharmaceutical medications alone for treating plaque psoriasis. This may be because moving cupping reduced serum tumor necrosis factor-alpha and vascular endothelial growth factor levels more than the medicines. However, more trials are needed to confirm the therapy’s effectiveness.

It should be noted that the occasional patient may have worsening with cupping due to a Koebner response.

5. Essential Oils

The following essential oils have some evidence supporting their use for psoriasis:

• Tea tree oil: Tea tree oil (TTO) is an essential oil derived from the leaves of Melaleuca alternifolia in Australia. With its potent antimicrobial and anti-inflammatory properties, TTO can reduce certain substances in the body associated with inflammation. Its main component, terpinen-4-ol, has strong anti-inflammatory properties, making it a potential candidate for managing psoriasis.
• Lavender oil: Lavender oil is derived from Lavandula angustifolia and is usually used as an aromatherapy massage oil. As per one animal study, applying lavender oil topically at 10 percent concentrations resulted in a 73.67 percent improvement in Psoriasis Area Severity Index.

6. Dead Sea Climatotherapy

Dead Sea climatotherapy (DSC) in Israel involves extensive sun exposure and bathing in the Dead Sea. After analyzing some skin biomarkers associated with different immune cells and cellular processes, one study discovered that almost all tested biomarkers became normalized after DSC, which is considered highly effective in treating psoriasis in the short term. Another study of a four-week DSC treatment program concluded that individualized DSC treatment had an immediate effect on psoriatic symptoms. Indoor baths with saltwater also have beneficial effects, as such baths combined with UVB therapy yielded better treatment results than UVB therapy alone.

How Can I Prevent Psoriasis?

Since the exact causes of psoriasis are unknown, preventing psoriasis entirely is impossible. However, you can lower your risk by maintaining a healthy lifestyle and minimizing the number of psoriasis flare-ups by avoiding the aforementioned environmental triggers.