Psoriasis and Chinese Medicine

Psoriasis is a chronic inflammatory skin condition that can be difficult to live with. It may appear as dry, scaly patches on the elbows or knees, affect the scalp, hands or feet, or occur in other parts of the body. For some people it is relatively mild; for others, the itching, discomfort and visibility of the condition can have a considerable effect on everyday life.

Psoriasis tends to come and go. There may be periods when the skin is relatively quiet, followed by a flare in which the patches become more inflamed, itchy or extensive.

Chinese medicine takes a somewhat different approach to understanding this pattern. Rather than treating psoriasis as a single condition with a single cause, Chinese medicine looks at the particular characteristics of the skin and the person’s wider constitution. The colour and appearance of the lesions, the degree of itching, dryness or inflammation, digestion, sleep, stress, menstrual history where relevant, and other symptoms may all contribute to the diagnosis.

Acupuncture can be used as part of an individualised Chinese medicine approach, alongside appropriate conventional dermatological care.

What is psoriasis?

Psoriasis occurs when the normal process of skin-cell production becomes accelerated. New skin cells reach the surface much more quickly than usual, producing the characteristic thickened and scaly plaques.

The most familiar form is plaque psoriasis, in which raised areas of skin develop with a dry, scaly surface. On lighter skin these may appear pink or red with silvery-white scaling. On darker skin, psoriasis may appear grey, violet, dark brown or purple, and the appearance can be less immediately recognisable.

Psoriasis commonly affects the elbows, knees and scalp, but it can occur almost anywhere, including the hands, feet, nails and skin folds.

It is important to remember that psoriasis is not contagious. You cannot catch it from another person.

Why does psoriasis flare up?

There is no single cause of psoriasis. Genetics and the immune system both appear to play important roles.

Certain factors can trigger or aggravate psoriasis in people who are susceptible to it. These can include:

• psychological stress
• infections
• injury or irritation to the skin
• smoking
• excessive alcohol consumption
• certain medicines
• hormonal changes
• other factors that vary from person to person

The relationship between stress and psoriasis can be particularly frustrating. A flare can itself be stressful, while periods of stress may make the skin worse, creating a difficult cycle.

This is one reason why it can be useful to look beyond the skin itself when trying to understand recurring flare-ups.

Psoriasis and Chinese medicine

Chinese medicine does not have a single equivalent of the Western diagnosis of psoriasis.

Instead, the practitioner considers the individual pattern underlying the skin condition.

In traditional Chinese medicine, chronic skin disorders may involve combinations of Heat, Blood Heat, Blood Stasis, Dampness, Wind and deficiency. These terms describe patterns within the Chinese medical system rather than being direct translations of modern biomedical mechanisms.

For example, a person whose psoriasis is intensely red, inflamed and itchy may present quite differently from someone whose lesions are relatively pale, dry and longstanding.

Two people with the same dermatological diagnosis may therefore receive quite different Chinese medicine diagnoses and treatments.

Heat and inflammation

Redness, warmth, irritation and pronounced itching may suggest a pattern involving Heat.

In Chinese medicine, Heat can affect the Blood and manifest through the skin. Where this pattern is present, treatment may be directed towards clearing Heat and supporting the body’s regulation of the skin.

Blood and dryness

Longstanding psoriasis can sometimes become dry and thickened. In Chinese medicine, dryness may be considered in relation to the Blood and its ability to nourish the skin.

The treatment approach may therefore be quite different from that used for an acutely inflamed, bright-red presentation.

Dampness

Some people with chronic skin problems also present with signs that Chinese medicine associates with Dampness. These might include a feeling of heaviness, digestive symptoms or particular characteristics of the skin lesions.

Where Dampness is part of the overall pattern, treatment may include attention to digestion and the function of the Spleen in Chinese medicine.

Stress and the movement of Qi

Stress is particularly interesting from a Chinese medicine perspective.

The Liver is traditionally associated with the free movement of Qi. Prolonged emotional tension or frustration may be understood as contributing to Liver Qi constraint, which can in turn become associated with Heat or affect other aspects of the person’s pattern.

This does not mean that psoriasis is simply “caused by stress”. Psoriasis is a complex inflammatory disease and should not be reduced to an emotional explanation.

Rather, stress may be one factor that influences the course of the condition in some people.

Can acupuncture help psoriasis?

Acupuncture may be used as part of a broader Chinese medicine treatment for someone with psoriasis.

The aim is not necessarily to treat the skin in isolation. Treatment may be directed towards the wider pattern identified during the consultation.

For example, treatment may take into account:

• the appearance and distribution of the psoriasis
• itching, dryness and inflammation
• digestion
• sleep
• stress and emotional tension
• energy levels
• menstrual or hormonal factors where relevant
• other symptoms and constitutional characteristics

The acupuncture points selected will therefore vary from person to person.

It is also important to be realistic about what acupuncture can offer. Psoriasis is a chronic medical condition, and acupuncture should not be presented as a replacement for appropriate medical treatment.

Conventional treatments can include emollients, topical corticosteroids, vitamin-D-based treatments, phototherapy and, where appropriate, systemic medicines or biologic treatments. Treatment depends on the severity and location of the psoriasis.

Chinese medicine can be considered as a complementary approach rather than a substitute for appropriate dermatological care.

Looking at the whole pattern

One of the things I find particularly useful about Chinese medicine is that it does not require every person with psoriasis to fit the same pattern.

Someone might come for treatment because of psoriasis on the elbows and scalp, but the consultation may reveal a quite different picture from someone with psoriasis affecting the hands and feet.

The practitioner may ask about digestion, sleep, thirst, bowel movements, temperature, stress, appetite and other apparently unrelated symptoms.

This is not because these symptoms are assumed to “cause” psoriasis. They help build up a picture of the person as a whole and, within Chinese medicine, help determine the most appropriate treatment strategy.

Looking after your skin

Whatever approach you take to managing psoriasis, looking after the skin itself remains important.

Regular use of moisturising treatments can help keep the skin comfortable, while identifying and reducing personal triggers may help some people reduce flare-ups. A balanced diet, regular exercise, avoiding smoking and moderating alcohol consumption are also recommended as part of general psoriasis care.

If you have persistent or troublesome psoriasis, it is worth discussing it with your GP or dermatologist. This is particularly important if your existing treatment is not working or is causing side effects.

It is also important to mention new joint symptoms. Psoriasis can be associated with psoriatic arthritis, which can cause persistent joint pain, swelling and stiffness. Early assessment and treatment can be important.

Psoriasis is more than a skin condition

Living with visible skin changes can be surprisingly difficult. Itching and discomfort are only part of the experience; some people also become self-conscious about exposing their skin or feel that other people are looking at them.

This can make the condition particularly frustrating when it repeatedly improves and then returns.

A useful approach is therefore not to look for one miraculous treatment, but to build a sensible long-term strategy for managing the condition.

For some people, Chinese medicine and acupuncture may have a place within that strategy.

Acupuncture for psoriasis in London

At Blue Dragon Acupuncture, I take an individualised approach to Chinese medicine. Rather than treating psoriasis according to a fixed recipe, I look at the particular presentation of the skin condition alongside the wider pattern of symptoms.

If you are considering acupuncture for psoriasis, I would be happy to discuss your particular situation and whether Chinese medicine might be appropriate for you.

Important: Acupuncture and Chinese medicine should not be used as a substitute for diagnosis or treatment by your GP, dermatologist or other appropriate healthcare professional. If you have been diagnosed with psoriasis, continue any prescribed treatment unless your doctor advises otherwise.

Psoriasis is a chronic inflammatory skin condition that can be difficult to live with. It may appear as dry, scaly patches on the elbows or knees, affect the scalp, hands or feet, or occur in other parts of the body. For some people it is relatively mild; for others, the itching, discomfort and visibility of the condition can have a considerable effect on everyday life.

Psoriasis tends to come and go. There may be periods when the skin is relatively quiet, followed by a flare in which the patches become more inflamed, itchy or extensive.

Chinese medicine takes a somewhat different approach to understanding this pattern. Rather than treating psoriasis as a single condition with a single cause, Chinese medicine looks at the particular characteristics of the skin and the person’s wider constitution. The colour and appearance of the lesions, the degree of itching, dryness or inflammation, digestion, sleep, stress, menstrual history where relevant, and other symptoms may all contribute to the diagnosis.

Acupuncture can be used as part of an individualised Chinese medicine approach, alongside appropriate conventional dermatological care.

What is psoriasis?

Psoriasis occurs when the normal process of skin-cell production becomes accelerated. New skin cells reach the surface much more quickly than usual, producing the characteristic thickened and scaly plaques.

The most familiar form is plaque psoriasis, in which raised areas of skin develop with a dry, scaly surface. On lighter skin these may appear pink or red with silvery-white scaling. On darker skin, psoriasis may appear grey, violet, dark brown or purple, and the appearance can be less immediately recognisable.

Psoriasis commonly affects the elbows, knees and scalp, but it can occur almost anywhere, including the hands, feet, nails and skin folds.

It is important to remember that psoriasis is not contagious. You cannot catch it from another person.

Why does psoriasis flare up?

There is no single cause of psoriasis. Genetics and the immune system both appear to play important roles.

Certain factors can trigger or aggravate psoriasis in people who are susceptible to it. These can include:

• psychological stress
• infections
• injury or irritation to the skin
• smoking
• excessive alcohol consumption
• certain medicines
• hormonal changes
• other factors that vary from person to person

The relationship between stress and psoriasis can be particularly frustrating. A flare can itself be stressful, while periods of stress may make the skin worse, creating a difficult cycle.

This is one reason why it can be useful to look beyond the skin itself when trying to understand recurring flare-ups.

Psoriasis and Chinese medicine

Chinese medicine does not have a single equivalent of the Western diagnosis of psoriasis.

Instead, the practitioner considers the individual pattern underlying the skin condition.

In traditional Chinese medicine, chronic skin disorders may involve combinations of Heat, Blood Heat, Blood Stasis, Dampness, Wind and deficiency. These terms describe patterns within the Chinese medical system rather than being direct translations of modern biomedical mechanisms.

For example, a person whose psoriasis is intensely red, inflamed and itchy may present quite differently from someone whose lesions are relatively pale, dry and longstanding.

Two people with the same dermatological diagnosis may therefore receive quite different Chinese medicine diagnoses and treatments.

Heat and inflammation

Redness, warmth, irritation and pronounced itching may suggest a pattern involving Heat.

In Chinese medicine, Heat can affect the Blood and manifest through the skin. Where this pattern is present, treatment may be directed towards clearing Heat and supporting the body’s regulation of the skin.

Blood and dryness

Longstanding psoriasis can sometimes become dry and thickened. In Chinese medicine, dryness may be considered in relation to the Blood and its ability to nourish the skin.

The treatment approach may therefore be quite different from that used for an acutely inflamed, bright-red presentation.

Dampness

Some people with chronic skin problems also present with signs that Chinese medicine associates with Dampness. These might include a feeling of heaviness, digestive symptoms or particular characteristics of the skin lesions.

Where Dampness is part of the overall pattern, treatment may include attention to digestion and the function of the Spleen in Chinese medicine.

Stress and the movement of Qi

Stress is particularly interesting from a Chinese medicine perspective.

The Liver is traditionally associated with the free movement of Qi. Prolonged emotional tension or frustration may be understood as contributing to Liver Qi constraint, which can in turn become associated with Heat or affect other aspects of the person’s pattern.

This does not mean that psoriasis is simply “caused by stress”. Psoriasis is a complex inflammatory disease and should not be reduced to an emotional explanation.

Rather, stress may be one factor that influences the course of the condition in some people.

Can acupuncture help psoriasis?

Acupuncture may be used as part of a broader Chinese medicine treatment for someone with psoriasis.

The aim is not necessarily to treat the skin in isolation. Treatment may be directed towards the wider pattern identified during the consultation.

For example, treatment may take into account:

• the appearance and distribution of the psoriasis
• itching, dryness and inflammation
• digestion
• sleep
• stress and emotional tension
• energy levels
• menstrual or hormonal factors where relevant
• other symptoms and constitutional characteristics

The acupuncture points selected will therefore vary from person to person.

It is also important to be realistic about what acupuncture can offer. Psoriasis is a chronic medical condition, and acupuncture should not be presented as a replacement for appropriate medical treatment.

Conventional treatments can include emollients, topical corticosteroids, vitamin-D-based treatments, phototherapy and, where appropriate, systemic medicines or biologic treatments. Treatment depends on the severity and location of the psoriasis.

Chinese medicine can be considered as a complementary approach rather than a substitute for appropriate dermatological care.

Looking at the whole pattern

One of the things I find particularly useful about Chinese medicine is that it does not require every person with psoriasis to fit the same pattern.

Someone might come for treatment because of psoriasis on the elbows and scalp, but the consultation may reveal a quite different picture from someone with psoriasis affecting the hands and feet.

The practitioner may ask about digestion, sleep, thirst, bowel movements, temperature, stress, appetite and other apparently unrelated symptoms.

This is not because these symptoms are assumed to “cause” psoriasis. They help build up a picture of the person as a whole and, within Chinese medicine, help determine the most appropriate treatment strategy.

Looking after your skin

Whatever approach you take to managing psoriasis, looking after the skin itself remains important.

Regular use of moisturising treatments can help keep the skin comfortable, while identifying and reducing personal triggers may help some people reduce flare-ups. A balanced diet, regular exercise, avoiding smoking and moderating alcohol consumption are also recommended as part of general psoriasis care.

If you have persistent or troublesome psoriasis, it is worth discussing it with your GP or dermatologist. This is particularly important if your existing treatment is not working or is causing side effects.

It is also important to mention new joint symptoms. Psoriasis can be associated with psoriatic arthritis, which can cause persistent joint pain, swelling and stiffness. Early assessment and treatment can be important.

Psoriasis is more than a skin condition

Living with visible skin changes can be surprisingly difficult. Itching and discomfort are only part of the experience; some people also become self-conscious about exposing their skin or feel that other people are looking at them.

This can make the condition particularly frustrating when it repeatedly improves and then returns.

A useful approach is therefore not to look for one miraculous treatment, but to build a sensible long-term strategy for managing the condition.

For some people, Chinese medicine and acupuncture may have a place within that strategy.

Acupuncture for psoriasis in London

At Blue Dragon Acupuncture, I take an individualised approach to Chinese medicine. Rather than treating psoriasis according to a fixed recipe, I look at the particular presentation of the skin condition alongside the wider pattern of symptoms.

If you are considering acupuncture for psoriasis, I would be happy to discuss your particular situation and whether Chinese medicine might be appropriate for you.

Important: Acupuncture and Chinese medicine should not be used as a substitute for diagnosis or treatment by your GP, dermatologist or other appropriate healthcare professional. If you have been diagnosed with psoriasis, continue any prescribed treatment unless your doctor advises otherwise.