Low Dose Naltrexone for Psoriasis Treatment

Psoriasis is a chronic and inflammatory skin condition that has numerous symptoms, including itchiness and pain. There is no psoriasis treatment that leads to an absolute cure for the condition, but symptomatic control is possible. Management of psoriasis can be difficult and frequently changes over time. As a result, alternative treatment methods are becoming more popular and sought after. One that has been gaining popularity in recent years is called Low Dose Naltrexone.

Low dose naltrexone, as the name implies, is a reduced dosage of the medication naltrexone, which is an opioid antagonist used to block the effects of opioids. Naltrexone is used to reverse drug and alcohol overdose and to reduce the dependence on morphine, other medical opioids, and heroin.  Research projects have evaluated its effectiveness for several different conditions including Crohn’s disease,^[1] multiple sclerosis,^[2] fibromyalgia,^[3] and even major depressive disorder,^[4] though high-quality research on the use of low dose naltrexone for psoriasis treatment is lacking.

Low Dose Naltrexone at the Cellular Level

Cells in the body have membrane protein receptors that help with cellular communication and biological functions. One of these receptors, called the mannose receptor, is found in the skin’s immune cells (known as Langerhans cells) in patients with psoriasis, while it is not found in human skin without psoriasis.^[5]  One study showed that low dose naltrexone will decrease the presence of the mannose receptor^[6] on another type of skin immune cells, known as macrophages, which could possibly be a positive connection to psoriasis.

On the other hand, the same study also showed that low dose naltrexone may cause the release of inflammatory signals from the macrophages. What this means is that there are some reasons to believe that low dose naltrexone may be helpful and some reasons to think that it might not be helpful. The only way to truly know is to have further studies that directly test naltrexone in patients with psoriasis.   Although this does not explain if low dose naltrexone is helpful or harmful for psoriasis, it may provide a possible link that could be studied further.

Low Dose Naltrexone for Itchiness and Pain

There has been research on the use of low dose naltrexone for psoriasis treatment of several symptoms including itchiness and pain. Some of the research seems to be slightly conflicting, with one study showing that low dose naltrexone can be significantly effective, highly tolerable, and inexpensive for treating itchiness.^[7] However, another study demonstrated that low dose naltrexone did not actually reduce the itch sensation, but rather decreased the pleasure that was derived from scratching.^[8] 

Additional research shows that low dose naltrexone may have anti-inflammatory properties for pain.^[9] The mechanism for the symptomatic control is not fully understood, though attempts have been made to understand the reason.

Does Naltrexone Work for Psoriasis? 

Low dose naltrexone may reduce itch but this may be due to either direct reduction of itch or reduction of the pleasure that comes with itching. It may also reduce pain in those with chronic pain. However, none of these studies were performed in people with psoriasis. There are no high-quality long-term projects that have specifically evaluated the usefulness of low dose naltrexone for patients with psoriasis.

Even though it seems like low dose naltrexone could be helpful, until studies are done in people with psoriasis, there is currently no proof that low dose naltrexone works in people with psoriasis. It is important to always approach treatment with caution and under the direction of a trained professional.