Chinese Herbs For Psoriasis

Traditional Chinese Medicine (TCM) has a long history of discussing the Chinese herbal treatment of psoriasis in medical literature.^[1] In modern China, TCM is one of the most common treatments for psoriasis. 

Psoriasis is called bai bi (白疕, ) or white mange due to the characteristic white scales that develop. To determine the nature of the psoriasis, which dictates the creation of the best herbal formula for treatment, the TCM doctor will consider the appearance and feel of the skin along with body symptoms such as digestion, the frequency of sore throats, ease of getting colds, body feelings of hot and cold, and others.  

TCM understands the health of the individual in relationship to the environment. It also uses the language of the natural world to describe the processes of disease in the body. 

Skin diseases caused by heat pathogens manifest as redness on the skin and are often involved in inflammatory diseases. Heat is the primary factor in psoriasis because hot type conditions often cause redness on the skin. The size, shape, and shade of red will indicate the type of heat. In the early stages of the condition, the heat is often combined with wind. The plaques are lighter and new lesions may often be forming which are continually developing with light white scale. Blood heat may also manifest in the early stages of the condition with darker red plaques. The darker red plaques show more heat. 

As the condition persists, blood dryness and blood stagnation may develop.^[2-4] In blood stagnation, psoriatic plaques are irregular, thick or hard, and may be purplish in color. In blood dryness, the skin is very dry and pale, and the disease has had a long duration with the rare occurrence of new skin lesions, but itch and discomfort may be a consistent issue.  

Some research has suggested that the different psoriasis patterns have unique inflammatory markers, which may be why different herbs work for different patterns.^[5] Further research is needed to explore this idea.   

Chinese Herbal Treatment for Psoriasis

Chinese herbal medicine is most often given in multi-herb formulas that are boiled into a strong tea called a decoction, or taken as pills. Creams, ointments, and soaks are also given. The herbs in the formula are personalized to target the imbalance causing the psoriasis. For example, if blood heat predominates, herbs that clear heat will be the focus of the formula. But if blood stagnation is dominant, herbs that move stagnation will be used.  In the clinic these imbalances are often combined, so herbs that clear heat and move stagnation are often used together.  In addition, scholars assert that herbs which clear heat and resolve toxicity help psoriasis because these herbs are thought to inhibit the overgrowth of skin cells.^[6] 

A number of small studies have shown various TCM formulas to be effective at reducing psoriasis.^[7,8] Many have focused on treating wind heat psoriasis with herbs that reduce heat and toxicity.^[9]   

Sheng Di Huang (Radix Rehmanniae Glutinosae)

Sheng di huang (Radix Rehmanniae Glutinosae) is one of the most commonly used herbs to treat psoriasis. It clears heat and cools the blood. This herb is the unprocessed root of rehmannia. It is known for its wide range of anti-inflammatory effects. Extracts of sheng di huang have been shown to have an anti-inflammatory effect as well as antiproliferative effects on cells.^[7]

Bai Hua She She Cao (Herba Hedyotis Diffusae)

Bai hua she she cao (Herba Hedyotis Diffusae) is a commonly used herb for psoriasis. It clears heat and reduces toxicity.  It is well known as an anti-tumor herb because it has been found to have anti-proliferative effects.^[7] In laboratory studies, bai hua she she cao has been shown to inhibit inflammatory chemicals, such as TNF-α and IL-6 which are involved in psoriasis.^[10] Extracts from this herb have been shown to enhance epidermal barrier function and increase ceramide production.^[7]

Qing Dai (Indigo Naturalis)

Herbs that reduce heat and toxicity are often used topically for psoriasis. Qing dai (indigo naturalis) is one such herb that is known to be a very cold and very powerful heat clearing substance. A number of small research studies have shown indigo has a profound positive effect on clearing psoriasis plaque lesions as well as nail psoriasis without any reported side effects.^[11-13] Laboratory studies have shown that indigo has antiproliferative^[14] and anti-inflammatory effects.^[15,16] While indigo was shown to be safe in studies, it is a natural dye and has a distinct blue color that some people may not like, and it may stain clothing. Attempts have been made to remove the coloring in order to make indigo more friendly to the patient’s needs while retaining the clinical effect. One study showed that the refined indigo without the dye was still effective at clearing psoriasis plaques.^[17]  

Overall View of Psoriasis Treatment With Chinese Herbs

Chinese herbal medicine has a long history of treating psoriasis with a refined body of traditional knowledge. The main types of psoriasis in the TCM view are blood heat, blood stagnation, and blood dryness. This classification depends on the appearance of the skin, the length of time the condition has been present and overall body symptoms. Herbal formulas for treatment are personalized to the patient’s needs and the particular type of psoriasis. Many herbs have shown anti-inflammatory effects that improve psoriasis. Topically, herbs that clear heat and reduce toxicity are often used along with herbs that move the blood.

Practical Tips

1. A number of small studies have shown TCM herbal medicine to be an effective treatment for some forms of psoriasis. 
   
   
2. If your patient is interested in adding another therapy to their treatment plan or trying an alternative to conventional medicine, a customized herbal formula may be recommended by your local TCM practitioner.