Dr. Bryant Esquejo, ND • Holistic Acne & Eczema Healing

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Psoriasis: Integrative, Root-Cause Treatment

Intro

According to the American Academy of Family Physicians, psoriasis is characterized as a chronic inflammatory skin condition with systemic symptoms and affects 2% of adults in the US. In this blog post, you will learn:

  1. The different types of psoriasis

  2. Causes of psoriasis

  3. Integrative & root-cause options for psoriasis


1) Types of psoriasis

To many people’s surprise, there are 7 different types of psoriasis. And, each can look different from each other and can appear in different locations on the body.

  1. Plaque psoriasis:

    This is the most common type of psoriasis, and occurs in 90% of people with psoriasis. Plaque psoriasis is characterized as red, scaly plaques on the skin that can be itchy and painful.

    Common locations of plaque psoriasis are:

    • Elbows

    • Legs

    • Scalp

    • Buttocks

    • Abdomen

  2. Inverse psoriasis:

    Inverse psoriasis looks different from plaque psoriasis in that it does not look as scaly, and looks like smooth, red plaques that feel sore. Inverse psoriasis usually occurs in places where skin touches skin.

    Common locations of inverse psoriasis are:

    • Armpits

    • Groin

    • Underneath the breasts

    • In between butt cheeks

  3. Guttate psoriasis:

    Guttate psoriasis occurs in 2% of those with psoriasis and tends to happen in people 30 years old and younger, and it looks very different from the other types of psoriasis in that guttate psoriasis appears as small, inflamed spots that are scaly. And, this tends to happen after infections.

    These spots can be widespread throughout the body, but common locations of guttate psoriasis are

    • Abdomen

    • Legs

    • Arms

  4. Erythrodermic psoriasis:

    Erythrodermic psoriasis is an uncommon and aggressive type of psoriasis that is widespread throughout the body and appears as a red, peeling rash. Severe, uncontrolled plaque psoriasis can morph into erythrodermic psoriasis, and can also have systemic symptoms of fever, chills, and dehydration that can all be life-threatening.

  5. Pustular psoriasis:

    Pustular psorasis is characterized as pus-filled lesions and usually do not have plaques on the skin.

    Common locations for pustular psoriasis are:

    1. Palms of the hands

    2. Soles of the feet

  6. Nail psoriasis:

    Nail psoriasis can occur in 80-90% of those with psoriasis, and causes the appearance of pitting in the nails, nail discoloration, or even the nail lifting off the the nail bed.

    Common locations for nail psoriasis are:

    1. Fingernails

  7. Psoriatic arthritis:

    Psoriatic arthritis is when psoriasis affects the joints, and can develop when someone has had psoriasis for more than 12 years. Although, it is also possible that some can experience psoriatic arthritis before getting skin symptoms. If psoriatic arthritis isn’t treated, it can possibly lead to irreversible deterioration of joints, which can lead to lifelong disability.

    Psoriatic arthitis can appear as stiffness in the morning that gets better throughout the day, swelling of a joint in fingers/toes, and more


2) Causes of psoriasis

Psoriasis is an immune-mediated condition where immune cells (T-cells) and immune cell signals (interleukins and inflammatory cytokines) cause activation of skin cells that lead to the skin symptoms found in psoriasis. There are multiple causes of this immune activation, and it is worthwhile to know the causes to understand how psoriasis can be treated with conventional and alternative options. Root causes of psoriasis include:


3) Integrative Options for psoriasis

Licensed naturopathic doctors (NDs) are trained in Integrative medicine, which mean that we understand how to treat patients with conventional/pharmaceutical therapies and natural options. With all conditions, licensed naturopathic doctors aim to identify and treat root causes, and treatment can be completed in an integrative manner. Licensed NDs seek to treat patients naturally as possible, but if symptoms are severe, there licensed NDs can recommend conventional therapeutics. Below are some integrative options that a naturopathic doctor may recommend. As always, this blog post is meant to be educational only, and before trying anything new, make sure to always consult your provider first.

NaturaL options for psoriasis

Naturopathic doctors may recommend a combination of natural treatments for additive effects on health and wellness. Some options that a licensed naturopathic doctor may recommend depending on various root causes are:

  • Diet: Fasting and vegetarian diets have been shown to improve psoriasis symptoms, and diets rich in omega-3 fatty acids have also been shown to be of benefit. Additionally, some people with psoriasis haven gluten sensitivity, and those with antigliadin antibodies benefit from a gluten-free diet. In regards to alcohol, alcohol elimination may be recommended since alcohol can cause the release of histamine and science reveals that histamine may play a role in the disease process of psoriasis.

  • Micronutrients: Vitamin D is necessary for regulating skin health and immune health, especially in those with psoriasis; and a licensed ND will recommend targeted dosing depending on what vitamin D lab levels show.

  • Lifestyle medicine: Reducing body mass index in those who are overweight or obese will help reduce inflammatory cytokines in the body, which can reduce psoriasis severity.

  • Stress management: Relaxation therapy has been shown to decrease disease severe and improve quality of life in those with psoriasis in combination with standard dermatology treatment after 2 months.

  • Environmental medicine: Reduction of exposure to chemicals, such as cigarette smoke, may be recommended since it increases free radicals in the body. And, those with psoriasis have already been shown to have an imbalance in antioxidants that can neutralize free radicals in the skin. Additionally, those with severe psoriasis were shown to have higher levels of the heavy metal cadmium compared to the general population, which could compromise healthy immune function.

  • Gut health and the gut microbiome: The gut microbiome is a combination of the bacteria, viruses, fungi, and other microbes found in the gastrointestinal tract. And, imbalances in the gut microbiome have been associated with psoriasis, specifically with changes in populations of bacteria called Firmicutes, Bacteroides, Ruminococcus, and Megasphera. Additionally, probiotics with Bifidobacterium infants 35,624 and Lactobacillus pentosus GMNL-77 have shown to provide benefit to those with psoriasis. And, probiotics were shown to reduce levels of inflammatory cytokines and inflammation markers.

  • Infections: Streptoccocal throat infection has been linked with guttate psoriasis, and there are various herbal treatments that an ND may recommend for this.

Conventional treatments for psoriasis

Licensed NDs may also recommend some conventional therapies for psoriasis. However, if disease is severe, licensed ND’s and general medical practitioners will refer to dermatologists and/or rheumatologists. Some conventional treatments for psoriasis are:

  • UVA and UVB light/sun exposure

  • Topical treatments

    • Corticosteroids

    • Tacrolimus & pimecrolimus

    • Tazarotene

    • Vitamin D creams

  • Systemic treatments

    • Acitretin

    • Humira

    • Cyclosporine

    • Enbrel

    • Remicade

    • Methrotrexate

      & more


Takeaways & Summary

Psoriasis is a chronic skin condition that has different root causes. And, from what we understand so far about psoriasis, there is a combination between one’s genetics and the environment that leads to disease. There are various root causes and risk factors that can increase someone’s risk for getting psoriasis, and understanding these elements helps with treatment. And in regards to treatment, there are integrative options that a licensed ND can recommend depending on root causes and symptoms severity. In this blog post, you learned about:

  1. The 7 types of psoriasis & how they can look different and be located on different parts of the body

  2. The various root causes of psoriasis

  3. Natural, holistic options that address root causes

  4. Conventional therapies that can be prescribed to manage psoriasis


This May, I focused on different topics in skin health. Click the links below to read my blog posts for this month:

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DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. DR. BRYANT ESQUEJO, ND HAS NO FINANCIAL TIES TO ANY SUPPLEMENT COMPANIES, PHARMACEUTICAL COMPANIES, OR TO ANY OF THE PRODUCTS MENTIONED IN THIS POST. THIS POST IS NOT MEANT TO TREAT, CURE, PREVENT, OR DIAGNOSE CONDITIONS OR DISEASES AND IS MEANT FOR EDUCATIONAL PURPOSES. AS ALWAYS, PLEASE CONSULT YOUR DOCTOR BEFORE TRYING ANY NEW TREATMENTS OR SUPPLEMENTS.